With so many men affected, it's no surprise that Viagra, with its trademark little blue pill, is probably the best-known ED treatment in the world. While it works brilliantly for many men, it might not be right for everyone.
If Viagra isn't suitable for you, or you're struggling with its side effects, don't worry! In this guide, we'll walk you through the 22 alternatives to help you find the best solution for your body.
Three key takeaways
Several medicines work just like Viagra. They differ in how quickly they start and how long they last, so the right one depends on your health and how you like to plan things.
There are options beyond tablets, too. If you can't or don't want to take pills, you could try a gel, a spray, or a pump.
Natural remedies have limited evidence, but lifestyle changes are still worth making alongside your treatment.
Oral medicine alternatives to Viagra
1. Sildenafil (generic/unbranded Viagra)
If the price of Viagra is what's holding you back, why not try generic sildenafil? It contains the same active ingredient as Viagra, so it's just as effective. It's much cheaper, too, because it doesn't carry a branded label.
If you don't want to wait for a prescription, Viagra has an over-the-counter alternative: Viagra Connect.
It contains the same active ingredient, sildenafil, but it's only available in the standard 50mg strength. You'll just need to answer a few quick safety questions from a pharmacist first.
Prefer not to swallow tablets? Viagra Connect Melts contain the same 50mg of sildenafil in a thin film that dissolves on your tongue without water. They typically start working within 30-60 minutes and last up to four hours.
3. Tadalafil (Cialis, Cialis Together, and Stamiz)
One of the main brand-name alternatives to Viagra is Cialis. It contains the active ingredient tadalafil, which works in the same way as other ED medicines. It relaxes the blood vessels leading to the penis, allowing more blood flow when you're sexually aroused.
"The main difference between Cialis and Viagra is that Cialis lasts a lot longer. Viagra is typically only effective for four to six hours, whereas Cialis lasts for an impressive 36 hours after use.
"This longer window means you don't need to schedule sex, which many men find takes the pressure off.
"If you're looking for an erectile dysfunction treatment that you can get over-the-counter, Cialis Together is a great option. It contains the same active ingredient but is only available in a 10mg dose."
Levitra is a well-established ED medication containing vardenafil as its active ingredient. You'll need to take it 60 minutes before sex, with the effects lasting between 4-6 hours. High-fat meals can slow down how quickly it kicks in, which is something to consider.
Spedra is another prescription tablet for ED, and it contains the active ingredient avanafil. It's taken around 15-30 minutes before sex, so it works faster than Viagra. If spontaneity matters to you, Spedra could be an ideal option.
Hezkue is a prescription-only oral spray. It contains sildenafil, the same active ingredient as Viagra, but you spray it into your mouth instead of swallowing a tablet.
Each 30ml bottle can be dosed flexibly, giving up to 20 doses at 25mg, 10 at 50mg, or five at 100mg. It starts working in as little as 20 minutes, with effects lasting for around four hours. It can be a good fit if you find swallowing tablets difficult.
7. Eroxon gel
Eroxon is a drug-free gel for erectile dysfunction. You apply it to the head of the penis shortly before sex. It creates a cooling then warming sensation that stimulates nerve endings and is designed to help you get an erection within 10 minutes.
It's available without a prescription, making it a useful option if you can't or would rather not take tablets. As with any ED treatment, you'll still need to be sexually aroused for it to work.
8. Vitaros cream (alprostadil)
Vitaros is a cream that you apply to the tip of the penis, and it's usually considered if tablets like sildenafil haven't worked for you.
Containing alprostadil, the same active ingredient in Vitaros cream, Caverject is a small injection that you give into the side of the penis.
It sounds daunting, but you won't be left to figure it out on your own. It's usually started under specialist care, where you'll be shown how to inject yourself.
Other ED treatments
10. Testosterone replacement therapy (TRT)
Testosterone replacement therapy (TRT) is a treatment for men whose ED is linked to low testosterone (hypogonadism). Low testosterone can cause a lower sex drive and, if it's severe, erection problems.
It isn't a general ED treatment, and it isn't recommended for men whose testosterone levels are normal. Your doctor will need to confirm low testosterone with blood tests first.
11. Penis pumps and tension rings
Penis pumps (also called vacuum erection devices) are a drug-free option for treating erectile dysfunction. They work by creating a vacuum or suction around the penis, drawing in blood and helping you to achieve an erection.
Many men find it easier to maintain an erection if they also slip on a tension ring around the base of the penis to keep it firm during sex.
However, don't leave a tension ring on for more than 30 minutes, and speak to your doctor first if you take blood thinners or have a blood condition. You can also use pumps and rings alongside other ED treatments, under guidance from your clinician.
A note on unlicensed Viagra alternatives
You should be very careful about buying erectile dysfunction medicines from unregulated websites or through social media.
Products like Kamagra Oral Jelly (an oral jelly containing sildenafil) aren't approved for sale in the UK or EU, and fall outside the UK's strict licensing and quality requirements, so there’s no guarantee that they’re standardised to contain the declared active ingredient at the stated dose, or that they’re free from contaminants.
Also, some products sold as Kamagra may be counterfeit or illegally supplied, so there’s no assurance that they contain any active ingredient at all.
All of this could pose a serious risk to your health. Only buy from a UK-registered pharmacy. If you experience a side effect from any medicine, you can report it through the MHRA Yellow Card Scheme.
Natural Viagra alternatives
The evidence for these natural alternatives is limited or mixed, and you shouldn't use them in place of a licensed treatment.
12. Ginseng
Ginseng is often talked about as a natural alternative to Viagra. It may help to promote the release of nitric oxide in your body, which dilates blood vessels. This means more blood can flow into the penis, potentially improving your erection.
The evidence is low quality, though, and it's not as potent as prescription medications. Some men find it a gentler option, especially if they can't take ED tablets.
13. Horny goat weed (epimedium)
Horny goat weed is a traditional Chinese medicine that’s been used for centuries.
The theory is that it may help improve blood flow to the penis by inhibiting PDE5, the same enzyme that medicines like Viagra target. But there haven't been enough human trials to know whether it works.
14. L-arginine
L-arginine is another natural alternative to Viagra that may improve blood flow in people with erectile dysfunction.
15. Watermelon
Watermelon contains the amino acid L-citrulline, which is thought to improve blood flow by widening your blood vessels.
16. Dark chocolate
Dark chocolate contains flavanols and plant nutrients that may increase blood flow. It may also help your body produce nitric oxide, which supports erections.
17. Oat straw
Oat straw is traditionally promoted as a way to boost energy and sexual stamina. But these claims aren't backed by strong clinical evidence.
18. Pomegranate juice
Pomegranate juice may help with your erectile dysfunction symptoms. It's high in antioxidants and can help to maintain healthy blood circulation. It may also increase the amount of nitric oxide in your bloodstream, which the muscles in the penis need to relax.
Lifestyle changes that can help ED
19. Keeping a healthy, balanced diet
ED is often linked to blood flow issues, so keeping your blood vessels healthy matters.
Eating a healthy, balanced diet, losing weight if you're overweight, and cutting back on foods high in fat can reduce your risk of vascular issues caused by high cholesterol, high blood sugar, high triglyceride levels, and obesity.
20. Quit smoking
When you stop smoking, your blood circulation improves, which means blood can flow more easily to the penis during sex. Beyond the bedroom benefits, giving up smoking also reduces your risk of serious health issues like heart disease and stroke.
21. Healthy sleeping patterns
Not getting enough sleep can contribute to ED, as it also affects your circulation and testosterone levels. Aim for around 7-9 hours each night.
To get a better night's sleep, try to keep a regular sleep schedule. You should also create a relaxing bedtime routine and keep your room dark, quiet, and cool.
22. Cut down on alcohol
Drinking too much alcohol can cause erection problems, as it can reduce blood flow and impair nerve signals. The NHS advises not drinking more than 14 units of alcohol a week.
When you're stressed, you might notice your sex drive taking a hit. Even if you can get an erection, maintaining it can become a struggle when your mind's preoccupied with other worries.
Anxiety can make it difficult to feel aroused in the first place. And the struggle to get an erection can then contribute to sexual performance anxiety.
Thankfully, erectile dysfunction caused by anxiety is usually temporary and often improves once you've worked through what's stressing you out.
Depression affects ED differently. It disrupts the chemical balance in your brain, which can reduce your desire for sex altogether. If you're dealing with depression, speak to your GP as treating the underlying cause often helps to improve erectile function.
Which Viagra alternative is best for me?
“If you're experiencing erectile dysfunction, have a chat with your doctor or a healthcare professional before trying to treat it yourself. They can help to rule out any underlying medical conditions that might be causing your symptoms.
“Finding the right alternative to Viagra can take a bit of time. What works for one person might not be the answer for you, so don't be discouraged if the first thing you try isn't quite right. Sometimes, it's a case of trial and error until you find what suits you.”
Frequently asked questions about Viagra alternatives
What is the strongest alternative to Viagra?
There isn't one single strongest alternative; it depends on what’s right for you personally.
Sildenafil, tadalafil, vardenafil, and avanafil all work in the same way, and mainly differ in how quickly they take effect and how long they last. Our prescribers can help you find the right one and the right dose for you.
Can you buy over-the-counter Viagra alternatives?
Yes. Viagra Connect, Viagra Connect Melts, Cialis Together, and Eroxon gel are all available without a prescription. For the tablets and melts, you'll just need to answer a few quick safety questions from a pharmacist first.
Is Kamagra Jelly safe to use?
No. Kamagra isn’t licensed for use in the UK, which means it hasn't undergone the strict testing that UK-licensed medicines must pass to confirm their quality, purity, and consistency.
Also, some products sold as Kamagra may be counterfeit or illegally supplied, so there’s no assurance that they contain any active ingredient at all.
For your safety, always buy licensed ED treatments from a UK-registered pharmacy, like Chemist4U.
What's the fastest-working natural alternative to Viagra?
No natural remedy has good evidence that it works quickly, or if it even works at all. If speed matters, licensed options have clearer evidence behind them. Spedra is taken 15-30 minutes before sex, and Eroxon gel is designed to work within 10 minutes.
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