Why Over-the-Counter Viagra & ED Drugs Are Risky
When you have a cold, you probably head to the drugstore to buy cough medicine and throat lozenges. If you have a headache, you might pick up some acetaminophen or ibuprofen. But can you get Viagra over the counter? The answer to this question, strictly speaking, is “no.”
Viagra OTC isn’t something that legally exists. However, there are some products that misrepresent themselves as over-the-counter erectile dysfunction pills and many of these are available over the counter. Some may even illegally contain the right ingredients — a dangerous problem when you understand what Viagra is.
Below, we've explained why Viagra and other ED drugs are only available by prescription and how you can get your hands on them if you're experiencing erectile dysfunction, and addressed why over-the-counter “Viagra substitutes” are best avoided in favor of proven options like brand-name Viagra or its generic.
Can You Buy Viagra Over the Counter?
Over-the-counter (OTC) medications are available for a wide range of ailments, and the fact that they’re usually readily available and affordable makes them convenient to use. And if you’ve ever Googled “Is Viagra over-the-counter something I can buy?” you probably know that plenty of products would like you to believe they’re your solution.
But when it comes to men’s health conditions like erectile dysfunction, you won’t find medications like Viagra over the counter in any gas station or local pharmacy.
Viagra and its generic version, sildenafil (also called sildenafil citrate) is a prescription drug used to treat erectile dysfunction. So, if the question you’re asking is whether or not you can buy Viagra over the counter, the answer is no — you’ll need to have a prescription from your healthcare provider.
Over The Counter Viagra: Is There One That Works?
Over-the-counter products marketed as Viagra alternatives or OTC Viagra aren't actually Viagra at all. Though they may make some big claims about being able to do things like dilate blood vessels, improve blood flow or even increase your levels of sex hormones, there isn't currently much evidence to corroborate the claim that these OTC Viagra substitutes are effective. Many of them can't even prove that they're safe.
Many “online pharmacy” products not only use fake or unproven ingredients, but are often made in unsafe, unsanitary conditions. What it “is,” however, is another question.
You can usually find these "Viagra substitutes" behind the counter at a gas station (somewhere between the cigarillo wraps and the iPhone 6 chargers), as well as in places like local convenience stores, sex shops and even online.
Most of these products are just supplements — often herbal supplements — that haven’t been tested or approved by the FDA for ED. For the most part, there’s no proof that they provide any real benefits for your sexual performance or that they work effectively to treat erectile dysfunction.
And since they’re sold without a prescription, they may be unsafe if you use other types of medication, especially for hypertension (high blood pressure) or heart disease.
That said, concerns over affordability and the perceived hassle of obtaining a prescription drug drive many men with ED to seek out other options, which sometimes include OTC erectile dysfunction drugs or “Viagra substitutes.”
And that’s not good.
What's So Bad About OTC ED Pills?
There are two things that should worry you about OTC Viagra products: what they say is inside, and what they don’t say is inside.
Let’s start with what’s on the ingredient list. Most over-the-counter Viagra substitutes usually contain herbal ingredients such as horny goat weed, ginseng and L-arginine.
Overall, there’s very little evidence that these herbal supplements have any real benefits for erections, sexual desire or general sexual activity, with many ingredients failing to outperform placebos. Horny goat weed does contain icariin, which is a mild PDE5 inhibitor (meaning it works the same way as Viagra), but it still can’t quite stack up to the efficacy you get from prescription medications. As such, it’s best not to rely on them as any type of reliable treatment for ED.
In addition to their lack of efficacy data, it’s especially important to avoid over-the-counter alternatives to Viagra due to the large amount of unknown, frequently unlabeled ingredients that are sometimes used in these products.
This means you face a real risk of experiencing drug interactions if you use these products with other prescription medications. Like Spanish fly and other alternative products, these products are all flash and no substance.
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Popular Over-the-Counter ED Pills: What’s Inside, and the Risks
Many non-prescription erectile dysfunction supplement packages have similar disclaimers on their labels, and typically this is what they say:
“These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”
That’s because the FDA doesn’t regulate these statements in the same way that they regulate claims for prescription medications — something that makes them different from the likes of Viagra.
Some OTC ED pills on the market include:
Libido Max®
Male Extra®
Virectin®
VigRX Plus®
When shopping for OTC erectile dysfunction remedies, you’ll find that many are marketed as “male enhancement” pills.
Many claim to be designed for more than just boosting erectile function — some also claim to increase stamina, improve libido and boost testosterone levels.
In a nutshell, they’re billed as over-the-counter ED pills that work fast. But not quite.
Libido Max
Alleged to be made with natural ingredients such as L-arginine, horny goat weed and yohimbe, Libido Max is alleged to support blood flow around the body and function as a pleasure booster.
There’s debate about how effective it is, with a variety of users giving it mixed reviews due to potential side effects and lack of efficacy.
Male Extra
Manufactured by Marlia Health Innovations in the UK, Male Extra claims to produce larger and harder erections while also enhancing sexual ability.
This male sexual performance supplement features natural ingredients such as pomegranate and L-arginine, which are purported to promote vitality and increased energy.
Although L-arginine may offer some performance benefits, there’s very little in the way of clinical research to suggest that it has significant effects on erections, performance in bed or general sexual desire.
Virectin
Virectin contains ingredients including L-arginine, tongkat ali, vitamin B3 (niacin) and selenium.
While Virectin claims to support testosterone levels, boost libido and enhance drive during sexual activity, and while some of the active ingredients in Virectin may offer mild benefits, there isn’t any high-quality evidence to suggest that it improves sexual arousal or treats issues such as erectile dysfunction. And the vitamins — while nice — aren’t a treatment for ED.
Plus, like, re-read that warning.
VigRX Plus
Marketed as the world’s “leading male enhancement product,” VigRX Plus contains red ginseng, saw palmetto, ginkgo biloba and other ingredients alleged to stimulate sexual activity and help with maintaining a firm erection.
In one study published in the journal BMC Complementary and Alternative Medicine, researchers found that the herbal product was more effective than a placebo in improving sexual function in men. However, there’s currently no reliable, high-quality research that compares VigRX to established medications for ED, such as sildenafil or other PDE5 inhibitors.
OTC ED Pills with FDA Warnings
We mentioned above that OTC ED pills aren't regulated by the FDA in the same way as prescription medications and why that's potentially dangerous, so now let's talk about specific products.
Over the years, the FDA has issued numerous health warnings about tainted male enhancement pills. In fact, the FDA has issued so many warnings that it maintains a large online database that lists tainted sexual enhancement products.
Products on the list include brands such as:
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 was a problem with the purity or safety of the ingredients — the same types of problem we mentioned earlier.
For example:
The product “Man Up Now” is made with sulfoaildenafil, a synthetic chemical that’s similar to the active ingredient in Viagra, sildenafil.
There’s an FDA notice against Extenze, stating that the company’s products have been found to contain undeclared amounts of sildenafil, a well-known erectile dysfunction drug most commonly found in Viagra. Most of the other ingredients in Extenze have not been proven to be safe or effective. The company has faced multiple lawsuits that challenge the legitimacy of the product’s claims — most notably, that it can increase penis size.
Vimax is another popular supplement for treating erectile dysfunction and other forms of male sexual dysfunction. It’s marketed as a “100% natural product” that contains herbal ingredients for enhancing male virility. However, like many over-the-counter ED products, Vimax also contains ingredients that aren’t listed on its label, namely prescription ED medications. In a 2015 notification, the FDA warned consumers that Vimax contains tadalafil, an ingredient that’s found in the prescription ED medication Cialis®. These ingredients can create safety risks. Tadalafil can interact with many common medications for treating high blood pressure and chest pain, and if you’ve previously had a heart attack or other cardiovascular event, you shouldn’t use tadalafil at all without discussing it with a healthcare provider.
Because of these risks, it’s best to avoid any supplements containing unlabeled ingredients and instead stick to proven, FDA-approved treatments prescribed only by healthcare professionals.
Some of these over-the-counter erectile dysfunction pills contain more than one active ingredient, meaning they may have a higher risk of causing side effects and/or drug interactions.
Others contain unsafe, poorly measured doses of active ingredients.
For example, the FDA demanded that the manufacturers of “Mr. Magic Male Enhancer” take the product off the market because the two main ingredients, which were illegal over-the-counter sildenafil analogues (hydroxyhomosildenafil and sulfoaildenafil), were not declared on the list of ingredients.
All of the PDE5 inhibitors currently available to treat erectile dysfunction can cause interactions when used with medications for hypertension and some heart conditions, such as a risk of a sudden drop in blood pressure.
Even though these issues can occur even with FDA-approved, legally prescribed medications in some cases, you typically learn about risks when you speak to a healthcare provider before receiving a prescription.
Your healthcare provider can prevent dangerous drug interactions and keep you from harm from those underlying health conditions. And unlike the “swallow it all” packets the guy with the ponytail hands you, prescriptions come at a dosage that’s appropriate for you.
With OTC erection pills, the potentially harmful ingredients are not only improperly listed on the product labeling, but they’re often used in unsafe doses.
Many of these products have been found to contain other chemicals, some of which have yet to undergo testing.
As such, if you’re considering an “all-natural” over-the-counter alternative to Viagra, our recommendation would be to like, not do it, man.
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What About Natural Remedies for ED?
Men turn to several nutritional and herbal supplements and natural remedies for ED for better erections and sexual function, but we have to caution you that the research on the benefits of natural ED treatments is mixed at best.
Some particular compounds have been shown to improve flow in blood vessels and more, including:
Dehydroepiandrosterone (DHEA)
L-arginine
Pycnogenol
Yohimbe
Propionyl-L-carnitine
Want to see what research has to say about them? Read on.
Dehydroepiandrosterone (DHEA)
Dehydroepiandrosterone, or DHEA, is a hormone produced by the adrenal cortex. It’s an important precursor for several sex hormones, including testosterone.
DHEA appears to decline with age, with low DHEA levels linked with an elevated risk of erectile dysfunction. Although research findings are inconclusive right now, some studies suggest that DHEA may have an effect on receptors that manage blood flow to the penis.
However, there isn’t yet a clear link between DHEA supplementation and improved erections of sexual performance.
L-arginine
Next up on the "Might Work To Help You Get Hard But Probably Not" list is L-arginine, an amino acid that's purported to help boost production of nitric oxide — which plays a role in relaxing smooth muscles in the arteries that supply your penis, and plays a major role in producing erections.
The precise role of L-arginine in nitric oxide production and erections is complex, but research suggests it may be useful as a treatment for mild ED.
A meta-analysis published in the Journal of Sexual Medicine looked at 10 different randomized controlled trials and found that arginine supplements may provide benefits for men with mild to moderate ED.
Our full guide to L-arginine and erectile dysfunction goes into more detail about how L-arginine works within your body, as well as its potential effects on your erectile health.
Pycnogenol
Pycnogenol, a nutritional supplement derived from French maritime pine bark extract, may offer similar benefits for erectile dysfunction. In fact, pycnogenol and L-arginine are sometimes used together in natural supplements for ED.
One study from 2003 looked into the effects of L-arginine and pycnogenol as a combined treatment for erectile dysfunction and found that a supplement promoted improvements in sexual function after three months of use.
By the end of the three-month study, 92.5 percent of the men who participated had experienced a normal erection.
These are good signs for sure, but we’re far from establishing any actually definitive case for pycnogenol.
Yohimbe
Yohimbe is a type of tree native to central and western Africa. Its bark contains Yohimbe, an alleged traditional aphrodisiac. But don't call it the Viagra tree just yet.
Although scientific research on yohimbe and erectile dysfunction is mixed overall, some studies have found that it may offer benefits for men with sexual performance issues.
For example, a recent review published in the Turkish Journal of Urology, which used data from eight studies, found that yohimbine — the active ingredient in yohimbe — was associated with an improvement in erectile function when used in combination with other treatments.
However, the researchers also noted that Yohimbe wasn’t fully effective as a treatment for male sexual function issues when it was used on its own.
Propionyl-L-carnitine
Propionyl-L-carnitine, or PLC, is a natural supplement widely promoted for its potential to increase energy levels.
Although research on propionyl-L-carnitine on its own isn’t conclusive, several studies suggest that it may offer benefits for erectile function when used with ED medications.
For example, one study published in the journal Current Medical Research and Opinion found that men with erectile dysfunction — and diabetes — showed larger improvements with propionyl-L-carnitine and sildenafil (the active ingredient in Viagra) than with sildenafil alone.
However, as noted, diabetes was a pre-existing condition for the participants in this study. Additionally, study participants had already unsuccessfully tried sildenafil by itself. There’s no way to know if these results would be replicated in a larger study with healthy participants.
Other Supplements
Other supplements that may help to increase blood flow and improve sexual function include:
Rhodiola rosea
Although these remedies may have some promise, it’s important to keep in mind that they, as well as other natural supplements, aren’t evidence-based medications, nor are they approved by the FDA to treat any type of disease.
This means that they haven’t been thoroughly tested for efficacy and safety in the precise way that FDA-approved drugs have. The FDA says Viagra works. The FDA says dietary supplements may or may not. What are you going to do with this information?
What Should You Use to Treat ED Instead of OTC Viagra?
While over-the-counter alternatives to Viagra might seem appealing, you’ll get better results — and keep yourself safer — by working with your healthcare provider to find the right medication.
If you have erectile dysfunction caused by a physical health issue, using ED medication to improve your erections might be the best option.
These medications work by increasing blood flow to your penis, which can make it easier to get and maintain an erection when you feel sexually aroused.
Currently, there are several safe and effective FDA-approved medications for treating ED. With a prescription from your healthcare provider, you can purchase oral ED drugs such as:
sildenafil (the active ingredient in Viagra)
tadalafil (Cialis)
vardenafil (Levitra®)
avanafil (Stendra®)
Some of these medications are designed for daily use to improve your erectile function over the long term, while others can be used as needed.
There’s also a prescription injectable medication called alprostadil that’s approved by the FDA for ED. And there are some compounded medications for ED that may or may not include alprostadil, such as BiMix, TriMix, and QuadMix.
We offer several ED medications via our online platform, following a consultation with a licensed healthcare provider. This allows you to quickly and easily access FDA-approved medications for ED from home without any awkward visits to your primary care provider’s office.
Other ED Treatments
Aside from medication, there are plenty of non-pharmacological ways to address ED. Healthcare professionals can help you in identifying the underlying cause of your ED and determine the best type of treatment, which we prefer to organize under the mental health and physical health banners.
Let’s take a look at each of these in detail.
Physical Health Improvements for ED
Making simple changes to your habits and lifestyle can improve your erections and sexual performance.
You can reduce the severity of ED (or potentially stop it altogether) by exercising regularly, eating a balanced diet, maintaining a healthy weight, quitting smoking and avoiding excessive alcohol consumption.
Our guide to naturally protecting your erection can walk you through strategies to get started on your own.
Mental Health Improvements for ED
ED is not all about the physical body — around 40 percent of all ED cases are psychological in origin, according to some research. Stress, anxiety, self-esteem issues and a poor body image can all cause problems — even if there are no clear physical causes for ED present.
If this feels a little overwhelming to consider, the good news is that you’re not alone at all. How you feel is normal and very common, and most importantly, it’s treatable.
If you’re experiencing some psychological hangups that are causing you some grief in the bedroom — things like PTSD, past trauma, performance anxiety, etc. — therapeutic practices might be just what the doctor ordered. Psychotherapy — like cognitive-behavioral therapy or sex therapy — is an excellent way for you to work one-on-one with a mental health provider to isolate your sexual sticking points and grease those bearings.
Other Options
There are a few options for ED that we haven’t talked about yet.
Eroxon is a recently FDA-authorized topical gel for ED that’s available without a prescription. It’s rubbed on the head of the penis and stimulates the nerves to cause an erection.
Vacuum erectile devices are also an option to try for those who want a non-prescription way to address ED. Lastly, in severe cases, surgery can help with ED.
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Getting Pills Like Viagra Over the Counter: What You Really Need to Know
Needing help with ED is normal for many men these days, young and old. Unfortunately, feeling comfortable enough to ask for safe help from a medical professional hasn’t been normalized so well.
Before you get roped into the health risks by some shiny packaging at the local bodega, remember that you’ve got nothing to be ashamed of. That’s what many of these dangerous products prey on, and they do it profitably:
ED Solutions are big business. Erectile dysfunction is such a widespread issue for men of all ages, so it’s no wonder that there are so many prescription medications and other products out there to treat it.
A lot of what you see on shelves isn’t going to work. Many Viagra over-the-counter products that are marketed online and sold in gas stations, sex stores and elsewhere aren’t effective.
Those OTC products could also be dangerous. Many contain unlabeled ingredients that could be dangerous if used with other medications. As such, if you’re considering trying those gas station boner pills you saw for sale for just a few dollars, you should think again.
Instead of using ineffective and potentially unsafe over-the-counter alternatives, consider an affordable generic medication, such as sildenafil or tadalafil. We offer these medications via our online ED consultation as part of our range of erectile dysfunction treatment options.
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 or medication.