Over-the-counter Viagra alternatives

Needing a little help to get an erection isn't uncommon. One large study found that about half of men in the US experience some form of erectile dysfunction (ED) at some point in their lives, making it a prevalent issue. But despite how common it is, many people don’t want to talk about it—even with their healthcare providers. One large study estimated that only around 60% of men who experience ED seek help from a medical professional for their condition. 

It’s no wonder so many people seek out pills like Viagra over-the-counter (OTC). While many are curious about the best OTC ED pills, you can’t get erectile dysfunction drugs like Viagra over-the-counter in the United States. However, many other safe options are available, and getting prescription medications without having to visit a doctor in person has never been easier. Read on to learn more about over-the-counter Viagra alternatives.  

Can you get over-the-counter Viagra?

The short (and probably disappointing) answer is no, you can’t get Viagra over-the-counter in the US. Viagra, which is FDA approved to treat erectile dysfunction, is a safe and effective way to get harder, longer-lasting erections. But despite how safe the medication is, it still requires a prescription from a licensed healthcare provider. 

If you come across a website or store offering OTC Viagra, be wary. Viagra is one of the most counterfeited drugs in the world. Pfizer, the company that makes brand-name Viagra, has found dangerous substances like printer ink, amphetamines ("speed"), and metronidazole (an antibiotic) in these counterfeit Viagra pills.

Luckily, there are both over-the-counter “natural” alternatives to Viagra you can try, and ways to get real, prescription medication without ever leaving the comfort of your home. If you’re looking for ED treatment, safe and reputable telehealth companies like Ro can give you online access to licensed healthcare professionals that can evaluate your symptoms, prescribe medication to treat ED, and ship it straight to your house.

When it comes to treating ED, Viagra is the most well-known medication available, but there are others, too. It’s part of a class of prescription drugs called PDE-5 inhibitors, which includes: 

• Viagra (generic: sildenafil)

• Cialis (generic: tadalafil)

• Levitra (generic: vardenafil)

• Stendra (generic: avanafil)

These drugs can help treat ED by improving blood flow to the penis, allowing for harder, longer-lasting erections. 

The reason that these medications require a prescription from a licensed healthcare provider is that while they are considered to be safe, they aren’t right for everyone. Your doctor will evaluate your medical history to understand if Viagra, or one of the many alternatives is right for you.

The possible side effects of Viagra and other PDE-5 inhibitors include headache, flushing, upset stomach, vision changes, low blood pressure, stuffy or runny nose, muscle pain, nausea, dizziness, or rash. 

5 potential over-the-counter Viagra substitutes

While you can’t get the “real deal” over-the-counter, there are some viagra alternatives available OTC that are advertised as treatments for ED. Certain supplements marketed as "natural Viagra" include horny goat weed, red ginseng, yohimbine, l-arginine, and DHEA. 

It's important to note that studies have not directly compared these herbal supplements and prescription erectile dysfunction drugs such as Viagra. Some of these herbal remedies do show promise for improving erections, though. Here's what you need to know about them:

Red ginseng or Korean ginseng

A study published in 2018 examined 24 different controlled trials with more than 2,000 participants. They concluded that Korean red ginseng might be an effective erectile dysfunction treatment but called for further research to verify their findings.

Horny goat weed

The effects of this dietary supplement haven’t been tested for treating ED in humans, so we don't know for sure that it works. However, horny goat weed contains a compound called icariin, which inhibits PDE-5, just like Viagra, Levitra, and Cialis, making it a promising option for treating erectile dysfunction.

Yohimbe/yohimbine

Studies on using yohimbine to treat ED in humans are limited. One study suggests that yohimbe may help men with mild erectile dysfunction successfully achieve and maintain an erection long enough to have sex. More research is needed since this study only included 18 participants (Guay, 2002).

L-arginine

This amino acid has been shown to lower blood pressure by boosting the production of nitric oxide in the body, a chemical that plays an essential role in erections when it facilitates blood flow into the penis. In fact, some research suggests the supplement may be as effective for treating high blood pressure as lifestyle changes such as diet and exercise. The research on l-arginine for ED is not as clear, but some small studies have shown that it may make it easier to get an erection or make sex more satisfying, at least when compared to a placebo. 

DHEA (dehydroepiandrosterone)

DHEA is a hormone produced by your body that helps make sex hormones like estrogen and testosterone. Although taking supplements containing DHEA can boost levels of DHEA in the body, studies have found they don’t significantly impact testosterone levels and may even increase estrogen levels. High estrogen levels may be associated with erectile dysfunction. 

Bottom line? DHEA probably isn’t a slam dunk for treating your ED. You’re better off asking a healthcare provider about prescription options.

Where to get Viagra pills safely and discreetly

While you can’t get Viagra or other PDE-5 inhibitors over-the-counter, these medications are easy to get if you have a prescription, so don’t be afraid to discuss your options with a healthcare provider. It’s easier than ever to get ED meds online, shipped discreetly to your home. Some companies offer specific brands, generic versions only, or a combination. 

It's worth knowing about the generic version since there can be a significant price difference between Viagra and its generic alternative. 

Viagra and generic Viagra come in three doses: 25 mg, 50 mg, and 100 mg. The same active ingredient, sildenafil, is also available in a medication called Revatio. While Revatio is technically prescribed to treat a lung condition, since it contains the same active ingredient as Viagra, it is sometimes prescribed off-label to treat ED. In addition to the 20 mg dose Revatio comes in, it can also be prescribed in 40 mg, 60 mg, 80 mg, and 100 mg doses. 

The recommended starting dose for men with ED is 50 mg of sildenafil, though your healthcare provider might up your dose to 100 mg if 50 mg doesn’t do the trick or lower your dose to 25 mg if you find that 50 mg causes intolerable side effects.

Whatever method you choose to treat erectile dysfunction, ED is a common problem and nothing to be ashamed of. Talk to your healthcare provider about any prescription drugs or supplements you're taking to ensure there's no potential drug interaction before starting Viagra, generic sildenafil, or any other ED drugs. Also discuss any health conditions you may have, such as heart disease or high blood pressure. They'll work with you to get you on the right medication regimen to improve your sex life and sexual function.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

October 19, 2023

Written by

Linnea Zielinski

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.