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Over-the-Counter Viagra & ED Drugs: Why They Aren’t Worth the Risks

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 6/24/2021

When you have a cold, you probably head to the drug store for cough medicine and throat lozenges. 

If you have a headache you might pick up some acetaminophen or ibuprofen. Over-the-counter medications are available for a wide variety of ailments and they are usually inexpensive and easy to come by.

But what about over-the-counter erectile dysfunction medications that are marketed as Viagra?

Below, we’ve explained the process of getting a prescription for Viagra (sildenafil) and other ED medications. 

We’ve also looked at over-the-counter “Viagra substitutes” and why these are best avoided in favor of real, proven ED treatment options like Sildenafil, one of the most widely used ED medications in the world.

Is Viagra Available Over the Counter?

Viagra is a prescription drug used to treat erectile dysfunction. It is not available over the counter and requires a health professional to prescribe it. 

However, many “online pharmacies” claim to sell over-the-counter Viagra. Many times, this is a counterfeit drug and should be avoided at all costs. 

If you have erectile dysfunction (ED) symptoms, getting a prescription for Viagra isn’t as difficult—or as jarring—as you might think. 

That said, affordability and the hassle of obtaining a prescription drug drive many men with ED to seek out other options, which sometimes include over-the-counter (OTC) erectile dysfunction drugs or “Viagra substitutes.”

What are Over The Counter Viagra Substitutes?

Search online for terms like “over the counter Viagra” and you’ll find page after page advertising Viagra “substitutes” that are available without a prescription.

Most of these products are supplements that haven’t been tested or approved by the FDA. For the most part, there’s no proof that they provide any real benefits for your sexual performance, or that they work effectively in the treatment of erectile dysfunction.

As well as online marketplaces, these Viagra substitutes are often sold at convenience stores, gas stations, sex stores and other local shops.

Over-the-counter Viagra substitutes usually contain herbal ingredients like ginseng, rhino pills, horny goat weed and L-arginine

Right now, the scientific evidence on the effectiveness of these ingredients is mixed, at best, with most performing no better in testing than placebos.

It’s important not to rely on them as treatments for ED as these ingredients are unknown and may cause side effects.

In general, it’s best to avoid over-the-counter Viagra substitutes. These supplements are unlikely to work, and the few that do work are often spiked with drugs that aren’t legal to sell without a prescription.

So, when it comes to the question, “Is Viagra over the counter?” The answer is a definitive no. If you see over-the-counter Viagra or cleverly marketed “Viagra substitutes,” they should be avoided at all cost.

Popular OTC ED Drugs

Let's get down to specifics. If you take a stroll through the aisles at your local drug store, you’ll probably come across a variety of options for over-the-counter erectile dysfunction supplements. 

Some products on the market include the following:

  • Extenze®

  • Libido Max®

  • Male Extra®

  • Virectin®

  • VigRX Plus®

When shopping for OTC erectile dysfunction remedies, you’ll find that most products are marketed as “male enhancement” pills. 

Many of these products claim to be designed for more than just boosting erectile function — some of them also claim to increase stamina, improve libido and boost testosterone levels. 

Now, let’s take a closer look at these over-the-counter male enhancement products:

  • Extenze – One of the more popular male enhancement products on the market, Extenze claims to be 100 percent natural and more effective than other products. However, these claims don’t seem to hold water — most of the ingredients have not been clinically proven to be safe or effective. The company has faced multiple lawsuits challenging the legitimacy of the product’s claims — most notably, that it can increase penis size. There’s also an FDA notice against Extenze, which states that it has been found to contain undeclared amounts of sildenafil, a well-known erectile dysfunction drug most commonly found in Viagra.

  • Libido Max – Alleged to be made with natural ingredients like L-arginine, horny goat weed and yohimbe, Libido Max is designed to boost circulation and testosterone levels in order to enhance male performance. While this supplement is made from many natural ingredients, there are instances where users reported negative side effects and some people found it to be ineffective.

  • Male Extra – Manufactured by Marlia Health Innovations in the UK, Male Extra claims to produce bigger, harder erections while also enhancing sexual ability. It features key ingredients like pomegranate, L-arginine and creatine to improve circulation. Like the other products on this list, there’s not much in the way of effective clinical data or research to support Male Extra’s claims.

  • Virectin – It is designed to boost libido, improve testosterone levels and enhance sexual pleasure. It contains 16 key ingredients including amino acids and pro-sexual nutrients designed to improve blood vessel dilation. Yet, right on the packaging for Virectin is a legal disclaimer that reads: “Statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease or health condition.” Alrighty, then.

  • VigRX Plus – Intended for long-term use, VigRX Plus contains 10 natural ingredients such as ginkgo leaf, Asian red ginseng and Catuaba bark to enhance stamina and male performance. It takes 30 to 60 days of daily use to build up the effectiveness, but the manufacturer claims that it is over 70 percent effective.

  • Vimax – Made with ingredients like ginseng, ginkgo biloba and saw palmetto, Vimax is a natural male enhancement product, though reviews suggest that dosages for the active ingredients could be higher. It is also lacking in L-arginine which is one of the most beneficial natural supplements for male enhancement. However, Vimax also has an FDA warning against it.

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OTC ED Supplements with FDA Warnings 

Remember, products marketed as nutritional supplements are not held to the same FDA standards as prescription medications, so just because something is on a drug store shelf doesn’t mean it’s safe. 

In fact, the FDA has issued health warnings about numerous tainted OTC male enhancement pills — here are some of the products included on that list:

  • Man Up Now®

  • Stiff Nights®

  • Rock Hard Weekend®

  • Duro Extend Capsules For Men®

  • Vigor-25®

  • Magic Power Coffee®

  • Time Out®

  • Mr. Magic Male Enhancer®

  • Vitalex®

  • Xiadafil VIP Tabs®

What is it about these products that made the FDA issue a health warning? For many of them, it is a problem with the purity or safety of the ingredients. 

For example, Man Up Now is made with sulfoaildenafil, a chemical similar to the active ingredient in Viagra, sildenafil. 

Some of these supplements contain more than one active ingredient (for example, sildenafil and tadalafil), meaning they have a higher risk of causing side effects than the real drugs. 

Others are packed with huge, unsafe doses that are often twice as high as the strongest Viagra tablet.

The FDA demanded that the manufacturers of Mr. Magic Male Enhancer recall the product because the two main ingredients (hydroxyhomosildenafil and sulfoaildenafil) were not declared on the list of ingredients.

Many of these products (and some of those from the previous list) contain other chemicals, some of which have not been tested.

It is important to remember that even if products are described as “natural” or as an “herbal remedy” on the label, it doesn’t mean that they’re safe — health claims like this are not closely regulated and there is no official FDA-approved definition or requirement.  

If you have heart disease, or if you use nitrates or other medication to treat medical conditions such as high blood pressure, the hidden ingredients that are used in these “all natural” products could lead to dangerous side effects.

The risks are worth considering when trying to justify the lower price tag compared to the prescription "little blue pill".

What About Natural Remedies?

In addition to the over-the-counter ED drugs discussed in the previous section, there are also some nutritional and herbal supplements and natural remedies for ED that many men in search of an OTC ED treatment come across.

Dehydroepiandrosterone (DHEA)

Dehydroepiandrosterone (DHEA) is a hormone that, according to the National Institutes of Health, may improve sexual satisfaction and some of the symptoms of erectile dysfunction — so long as said ED isn’t a result of health conditions like diabetes or nerve disorders.

Even though the human body naturally produces this hormone, your levels decrease with age

Although the research is somewhat scarce for DHEA, it does indicate that when taken daily, it may help improve your erectile function.

L-arginine

Another supplement that may benefit your erectile function is L-arginine, an amino acid that helps boost nitric oxide production in the body. 

Nitric oxide plays a role in relaxing the corpus cavernosum smooth muscle to improve circulation and erectile function. 

The role L-arginine plays with nitric oxide and erectile function is complicated, but research suggests it may be useful as a treatment.

One meta-analysis of 540 patients across 10 different trials found that in doses between 1,500mg and 5,000mg, L-arginine “significantly improved” erectile function in men with mild to moderate erectile dysfunction.

However, a study in the Journal of Sexual Medicine about the potential role of L-arginine supplements on ED concluded that L-arginine offers no improvement in erectile function over placebo.

Pycnogenol

Pycnogenol, a nutritional supplement derived from French maritime pine bark extract, may offer similar benefits

In fact, pycnogenol and L-arginine are sometimes used together to potentially boost erectile function.

One NIH study looked at the efficacy of L-arginine used in concert with pycnogenol and found that men who used the two together saw drastic improvements in erectile function. 

By the end of the three-month study, 92.5 percent of patients had experienced a normal erection. 

Other supplements that are alleged to potentially help boost circulation and improve sexual function include:

  • Ginseng
    Ginkgo biloba
    Rhodiola rosea
    Horny goat weed

While the natural remedies discussed above may have some promise, it is important to remember that many natural remedies are not approved by the Food and Drug Administration and have not been tested for long-term safety or efficacy. 

Always do your own research and seek medical advice from your healthcare provider before trying a natural remedy.

What Should You Try Instead?

If you are concerned about the severity or frequency of your erectile issues, your first step should be to speak to your healthcare provider. 

With their help, you can identify the underlying cause of your ED and determine the best course of treatment.

Prescription Erectile Dysfunction Drugs

In cases where vascular issues or other health problems are to blame, taking erectile dysfunction medication might be the best option. 

If that’s the route you select, there are several options to choose from.

With a prescription from your healthcare provider, you can purchase brand-name erectile dysfunction drugs like Viagra (Sildenafil), Cialis, Levitra® (vardenafil), or Stendra® (avanafil). 

Some of these drugs are intended for daily use to improve long-term erectile function and some are intended for use as-needed. 

ED drugs come in several different dosages as well, so you’ll need to work with a healthcare professional to choose the right one for you.

Lifestyle Changes 

If you prefer not to take prescription medications for your erectile dysfunction, or if you are looking for a long-term solution to your problems, diet and lifestyle changes may be the best way to go. 

Here are some things you can change today: 

  • Increasing your consumption of lean proteins, high-fiber foods, and fresh fruits and vegetables can help improve circulation. 

  • Eat a healthier diet. Reducing your consumption of trans fats, fried foods, processed foods, refined sugar and alcohol can also benefit your erectile function and general sexual health. 

  • Getting regular exercise, maintaining a healthy body weight, making sleep a priority, quitting smoking and taking time to destress are all helpful.

Getting a Viagra Prescription: The Options

Here are your options to help you get a prescription for ED medication.

Visit Your Healthcare Provider

The first is to meet with your regular healthcare provider and talk about your symptoms. Many healthcare providers are open to prescribing medications like Viagra if you have persistent erectile dysfunction symptoms that are affecting your sex life.

Understandably, talking about ED with your healthcare provider isn’t always a comfortable experience. 

If you have gone to the same healthcare provider since childhood and have a friendly relationship, or just prefer not to talk about your sex life with your healthcare provider, it’s best to consider an alternative option.

Have an Online Medical Consultation

Today, there’s no need to visit your healthcare provider in person to get a prescription for Viagra and other ED medication.

Hims offers sildenafil, the active ingredient in Viagra. It’s available monthly, with your medication shipped directly to you. We also offer branded Viagra and generic Viagra.

Because generic sildenafil and Viagra are prescription drugs, you’ll need to complete an online medical consultation with an independent healthcare provider before your order is shipped. 

If you are an appropriate candidate for sildenafil, you’ll receive a valid prescription online.

Once you’ve got your prescription, you’ll receive your sildenafil or branded Viagra every month without having to visit your local pharmacy.

If you’re worried about awkward conversations with your regular healthcare provider, getting your prescription for Viagra online is a safe, easy alternative.

Frequently Asked  Questions about Viagra and OTC ED Drugs 

Am I Too Young For a Viagra Prescription?

When Pfizer first launched in the 1990s, Viagra was mainly marketed to middle-aged and older men as a treatment for erectile dysfunction. 

As a result, the medication—at least in its first few years—gained a reputation as a treatment for men in their 40s, 50s, 60s and up.

The reality is that erectile dysfunction is not a condition that only affects middle-aged and older men. 

A report on ED drugs and treatment from the Cleveland Clinic showed that as much as 40% of men are affected by ED by age 40, with a total of 52% of men surveyed reporting some experience with it.

In younger men, factors like exposure to porn could induce ED. In short, it’s not unusual or uncommon to experience some degree of erectile dysfunction in your 20s or 30s.

If you’re in your 20s or 30s and are concerned about erectile dysfunction, Viagra and other ED drugs can be an excellent treatment option. 

They’re safe, effective and completely suitable for younger men, meaning you’re not too young to use Viagra as a form of ED treatment.

How Does Viagra work? 

PDE5 Inhibitors, like Viagra, work by relaxing muscles and arteries inside the penis, which then helps increase blood flow to the penis.

How Long Does it Take for Viagra to Work? 

On average, Viagra takes about 30 to 60 minutes to become active in your system if taken orally. 

However, it can sometimes take up to 2 hours to have its full effect. Read more about how long Viagra takes to work and how long Viagra lasts in our guide.

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The Final Word on OTC ED Drugs

Erectile dysfunction is no small matter. The Massachusetts Male Aging Study conducted in 1994 reported a 52 percent prevalence for erectile dysfunction among men — the study also demonstrated that the condition becomes increasingly prevalent with age.

Because ED is such a widespread issue among men of all ages, it is no wonder that there are so many medications out there to treat it — prescription and over-the-counter. 

Unfortunately, not all ED drugs are created equal and not all of them are effective.

Over-the-counter ED drugs may seem like an affordable and convenient alternative to prescription medications, but there is little concrete evidence to suggest that most of these products are effective. 

You must also consider the risks of taking a supplement made with ingredients that have not been tested or approved by the FDA.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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