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Why Over-the-Counter ED Drugs May Not Be Worth the Risk

Michele Emery, DNP
Medically reviewed by Michele Emery, DNP Written by Our Editorial Team Last updated 4/17/2020

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?

Brand-name ED drugs like Viagra® and Cialis® require a prescription and they can be costly. Affordability and the hassle of obtaining a prescription drive many men with ED to seek out other options, which sometimes include over-the-counter (OTC) erectile dysfunction drugs.

So, what over-the-counter ED medications are out there, and do they actually work? Keep reading to find out why over-the-counter ED drugs may not be worth the money (or the risk).

What Are the Most Popular OTC Erectile Dysfunction Drugs?

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 – One bottle of this product will cost you about $45, but 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.”

    Welp. Alright, 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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Before you put anything new into your body, you need to make sure that it is safe. Read the packaging to determine the ingredients in the product and take some time to do your own research. 

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 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. 

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. 

The risks are definitely worth considering when trying to justify the lower price tag compared to prescription ED drugs.

What About Natural Remedies?

In addition to the over-the-counter ED drugs discussed in the previous section, there are also some nutritional supplements and natural remedies for ED that may be worth looking at.

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.


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-argenine 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-argenine “significantly improved” erectile function in men with mild to moderate erectile dysfunction.

However, there are also studies out there, like this one, which concluded that L-argenine offers no improvement in erectile function over placebo. i 


Pycnogenol, a nutritional supplement derived from French maritime pine bark extract, may offer similar benefits. In fact, pycnogenol and L-argenine are sometimes used together  to potentially boost erectile function.

One study looked at the efficacy of L-argenine 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:

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 FDA and have not been tested for long-term safety or efficacy. Always do your own research and talk to 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.

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®, or Stendra®. 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.

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. 

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

Reducing your consumption of trans fats, fried foods, processed foods, refined sugar and alcohol can also benefit your erectile function. 

In terms of lifestyle changes, getting regular exercise, maintaining a healthy body weight, making sleep a priority, quitting smoking and taking time to destress are all helpful.

The Final Word

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.