Terms and conditions

Visit the FDA's Safe Disposal of Medicines website for more information. In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies. You can only get Viagra with a prescription, but L-arginine, Dehydroepiandrosterone, and Propionyl-L-carnitine are potential OTC alternatives. Most over-the-counter ED supplements are not FDA approved and have little evidence to support their use. Prescription ED alternatives are available for people who do not respond well to Viagra. Sildenafil citrate, brand name Viagra, is a pill usually prescribed for erectile dysfunction (ED). It belongs to the drug class phosphodiesterase-5 (PDE-5) inhibitors which work by relaxing vascular smooth muscle and increasing blood flow in the penis to cause erection. Viagra is a prescription medication, but there are over-the-counter alternatives in use, such as L-arginine, dehydroepiandrosterone, ginseng, and propionyl-l-carnitine supplements, which will be discussed below. Save up to 80% on Viagra with SingleCare Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you. No, you cannot purchase Viagra over the counter; it is only available with a prescription. This is due to the risk of adverse effects, as well as the risk of abuse and misuse, as people often use Viagra for recreational purposes.

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It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Liqrev, Revatio) for PAH, do not stop taking your medication until you talk to your doctor. Call your doctor if you have any unusual problems while you are taking this medication. People who use Viagra recreationally are likely to mix it with illegal substances such as marijuana, ecstasy, methamphetamines, cocaine, and even alkyl nitrites—the combination of Viagra and alkyl nitrites is associated with fatal cardiovascular problems. Recreational Viagra is also a risk factor for priapism (erection lasting over 4 hours). Without immediate medical attention, priapism can cause permanent damage to penile tissue. Because of these reasons, you cannot get Viagra without consulting your healthcare provider. However, there are some over-the-counter (OTC) supplements marketed as “Viagra alternatives,” but they are not similar to Viagra in efficacy and safety. Viagra can be a safe and effective treatment when not improperly used, but it is not always the best option. While OTC supplements may not have proven efficacy and safety, Viagra alternatives also include prescription medications, which are United States Food and Drug Administration (FDA)-approved for ED. They are not sold over the counter; you need a consultation with your healthcare provider to get them. “Generally, all of the prescription alternatives to Viagra can be effective, but individual response, side effect profile, and personal preference often guide the best choice,” Dr. Carter says. “On account of its longer duration (36 hours), Cialis can also be taken daily in a low-dose form for continuous effect. I often prescribe Cialis to my patients who want more sexual freedom and spontaneity,” Dr. Carter says. “Stendra is a more selective PDE5 inhibitor than Viagra. I often prescribe it to my patients who want more spontaneity and fewer side effects compared to Viagra,” Dr. Carter says. I often prescribe it to my patients who have been dissatisfied with their response to Viagra,” Dr. Carter says. Alprostadil is a vasodilator that can be injected into the penile shaft or used as a suppository, which is inserted into the urethra. The inconvenience of its dosing mechanism may make it a less popular option.

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There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes. Talk to your doctor about the risks of taking sildenafil. Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. Viagra OTC substitutes include dietary supplements and herbal remedies.

Further information

Keep all medication out of sight and reach of children as many containers are not child-resistant. Place the medication in a safe location – one that is up and away and out of their sight and reach. Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Talk to your pharmacist about take-back programs in your community. These supplements are not approved by the FDA. “In my opinion, patients should exercise caution when considering natural supplements as substitutes for Viagra. I tell my patients that many over-the-counter products marketed for erectile dysfunction are unregulated and may contain undisclosed prescription drugs or harmful ingredients,” says Jason B. Carter, board-certified urologist and medical adviser at Aeroflow Urology. Hence, it is always important to check with your healthcare provider before using OTC Viagra substitutes. “I believe it is imperative that men who have erectile dysfunction get evaluated by a physician,” says Philip Werthman, MD, board-certified urologist and director of the Center for Male Reproductive Medicine and Vasectomy Reversal in Los Angeles, CA. “I believe men who take over-the-counter supplements miss the opportunity to see a healthcare provider that can diagnose and prevent a more serious disease process that can be cardiovascular, hormonal, or neurologic in nature,” Dr. Werthman says. Determining the root cause of erectile dysfunction can have positive implications for long-term health. Finding and reversing problems like hypertension or low testosterone, which can manifest as erectile dysfunction, has the potential to be highly beneficial. L-arginine is an amino acid produced by the body and also present in dietary proteins. L-arginine is referred to as a physiological substrate for nitric oxide (NO)—a compound known to relax smooth muscles and widen blood vessels in the penis. A study found that people on 1,500 to 5,000 mg of L-arginine supplement experienced improvement in erectile dysfunction compared to the placebo group. L-arginine supplements stand out because of their natural occurrence, bioavailability when taken orally, and tolerability when used for a long time. However, they may cause side effects, including decreased blood pressure, nausea, and vomiting. Also, people with renal problems may experience increased blood urea nitrogen levels, and the supplement may trigger abdominal cramps and bloating in people with cystic fibrosis. Dehydroepiandrosterone (DHEA) is a prohormone produced in the adrenal glands, ovaries, testes, and brain. In target tissues, DHEA is converted into sex hormones such as androstenedione and testosterone. A 2018 review article published in the World Journal of Men’s Health noted that decreased secretion of DHEA may be a risk factor for erectile dysfunction. But, it also suggested that there is no solid evidence to support that DHEA helps with erections or that it is safe to use, especially over a long time. Using DHEA over a long period or at high doses may be associated with cancer, and short-term use at low doses may lead to side effects such as acne, insomnia, mood changes, headache, and stomach upset. Ginseng is a popular herb used for various purposes in East Asian countries. Its active ingredient, ginsenosides, may help produce nitric oxide. In a systematic review evaluating the effects of ginseng on men with mild to moderate difficulty with erections, people taking ginseng reported improvement in their ability to have sexual intercourse, although they did not experience sexual satisfaction. The systematic review also reported “trivial effect on erectile function” compared to a placebo and with little to no side effects. Carnitine is an amino acid produced by the liver, brain, and kidneys, and also obtained from animal protein. “Propionyl-L-carnitine is a derivative of L-carnitine that has been studied for its potential vascular and metabolic benefits.

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If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( or by phone (1-800-332-1088). Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension at room temperature or in a refrigerator, but do not freeze it. Dispose of any unused suspension after 60 days. Research suggests it may improve blood flow and enhance nitric oxide activity, which is important for erections,” Dr. Carter says. “Some studies have shown that, when used in combination with PDE5 inhibitors, it may enhance their effectiveness, especially in men with diabetes or following prostate cancer surgery.