ED telehealth guide
Sildenafil is a prescription-only erectile dysfunction treatment (a PDE5 inhibitor). This guide explains how to complete a compliant telehealth consult, verify a licensed online pharmacy, and compare costs with generics. We also clarify when sildenafil (brand name: Viagra) is appropriate and how to avoid counterfeits.
How to Get an Online Prescription (Step-by-Step)
- Choose a licensed telehealth service that supports e-prescribing to licensed pharmacies with NABP/FDA verification.
- Create an account and complete the medical intake honestly (ED history, meds, allergies).
- Join the telehealth consult and answer safety/eligibility questions for this PDE5 inhibitor.
- Complete ID verification and provide recent vitals or labs if requested.
- If appropriate, receive an e-prescription for sildenafil and choose where to send it for fulfillment.
Before you start: what to prepare. Have a government ID, your medication list with doses, allergies, and a concise medical history (heart disease, surgeries, vision/hearing issues). Note recent vitals (blood pressure, heart rate) and ED details: onset, severity, what triggers or improves symptoms, and any prior response to PDE5 inhibitors. List potential interaction risks such as nitrates or riociguat, alpha-blockers, and CYP3A4 inhibitors; document alcohol and nicotine use. Preparing these items speeds up verification and helps the clinician decide if prescription-only sildenafil is appropriate.
When a prescription may be deferred. The clinician may decline or delay prescribing if you use nitrates/riociguat, have unstable cardiovascular disease, uncontrolled hypertension or hypotension, recent stroke/MI, severe hepatic/renal impairment, significant eye disorders, or concerning side effects with prior PDE5 use. Missing information, inconsistent history, suspected drug interactions, or the need for an in-person exam (e.g., new chest pain, severe nocturia, neurologic symptoms) can also pause prescribing until further evaluation is completed.
Typical costs. In many U.S. telehealth settings, an initial ED consult is commonly in the ~$20–$75 range; some platforms include the e-prescription at no extra charge, while others add a small eRx/admin fee (often $0–$20). Follow-ups may be included or billed separately (commonly $0–$50). Medication pricing and any pharmacy dispensing/shipping fees are separate and vary by pharmacy and insurance; generic sildenafil is usually lower-cost than brand products. Always review each service’s fee schedule and pharmacy accreditation before proceeding.
How to Verify a Legitimate Pharmacy (Checklist)
- Licensing & accreditation: The site lists its pharmacy license and physical address; NABP/FDA verification is provided (Digital Pharmacy accreditation or equivalent).
- Prescription policy: A valid prescription is required for sildenafil (a PDE5 inhibitor); no “no-RX,” “instant,” or “discount” claims.
- Pharmacist access: A named pharmacist-in-charge is shown with contact options and counseling hours.
- E-prescribing & records: Accepts e-prescriptions, provides clear patient information leaflets, and keeps dispensing records.
- Quality & sourcing: Medications come from approved manufacturers with lot/expiry on labels and consistent pill imprints.
- Security & privacy: HTTPS checkout, transparent privacy policy, and clear data use disclosures.
- Transparent fees: Upfront pricing for medication, dispensing, and shipping; no hidden membership or “handling” fees.
- Delivery expectations: Stated delivery timeline, shipment tracking, discreet packaging, and clear return/cancellation policies where applicable.
Red flags to avoid
- Offers erectile dysfunction treatment without a prescription or advertises “no-RX.”
- Hides license number, pharmacist name, or physical address; unverifiable “seals.”
- Pushes foreign-only sourcing for domestic patients or ships “samples” with mixed pill appearance.
- Uses only unusual payment methods (e.g., crypto/wire) and heavy “instant/cheap/discount” language.
Doses, Safety, Contraindications of Sildenafil
Sildenafil dosage and safety depend on your medical history and concurrent medications. This PDE5 inhibitor is prescription required and should be used exactly as directed by your clinician.
- Titration: most adults start at 50 mg; consider 25 mg if ≥65 years, on alpha-blockers, or using strong CYP3A4 inhibitors; may increase to 100 mg if well tolerated and needed; maximum once daily.
- Onset & duration: typical onset 30–60 minutes; high-fat meals may delay effect; avoid grapefruit juice due to CYP3A4 interaction.
- CYP3A4 interactions: use caution or lower dose with agents such as ketoconazole, itraconazole, ritonavir, clarithromycin.
- Alpha-blockers: start low and separate dosing to reduce hypotension risk.
- Cardiovascular risk: recent MI or stroke (e.g., ≤6 months), severe hypotension (<90/50 mmHg), unstable angina, high-risk arrhythmias — do not initiate without specialist advice.
Doses
- Typical starting dose: 50 mg taken 30–60 minutes before sexual activity; may work from 30 minutes and up to several hours; do not take more than once daily.
- Adjustments: increase to 100 mg or reduce to 25 mg based on effect and side effects; older adults or those on interacting medicines often start at 25 mg.
- Food/alcohol: a high-fat meal can delay onset; limit alcohol to reduce dizziness or low blood pressure.
- Consistency: use only with a valid prescription and follow clinician guidance; this PDE5 inhibitor is for on-demand use unless your clinician advises otherwise.
Safety
- Common effects: headache, flushing, nasal congestion, dyspepsia, dizziness, back pain; usually mild and short-lived.
- Less common but important: temporary visual tint or sensitivity to light; rare sudden vision or hearing loss—stop use and seek care urgently.
- Interactions: do not combine with nitrates or riociguat; use caution with alpha-blockers (start low and separate timing) and strong CYP3A4 inhibitors (e.g., certain antifungals or antibiotics).
- When to stop and seek care: chest pain, fainting, allergic reaction, or erection lasting more than 4 hours (priapism).
Contraindications
- Nitrates/riociguat: absolute contraindication due to risk of dangerous hypotension.
- Unstable cardiovascular disease: recent MI or stroke, severe hypotension/uncontrolled hypertension, or high-risk arrhythmias.
- Severe hepatic/renal impairment or conditions like retinitis pigmentosa—use may be inappropriate or require specialist advice.
- Prior NAION or serious vision disorders: discuss alternatives; risks may outweigh benefits.
ED telehealth exam · Verify online pharmacy
Educational content only; always follow your clinician’s dosing and safety advice for sildenafil as part of an erectile dysfunction treatment plan.
Costs Generics (Sildenafil vs Tadalafil)
Both sildenafil and tadalafil are prescription-only PDE5 inhibitor options for erectile dysfunction treatment, and total cost depends on dose strength, quantity, and fulfillment channel. Prices vary widely between licensed pharmacies and by region, so it’s best to plan with ballpark ranges rather than a single sticker price. Always use a licensed pharmacy that passes NABP/FDA verification and avoid unverified sellers. A brief price snapshot and monthly examples below can help you estimate realistic out-of-pocket totals.
Price snapshot (US cash-pay, August 2025)
- Generic sildenafil tablets: as low as ≈ $2 per tablet at some pharmacies via common savings programs; actual price depends on strength (25/50/100 mg) and location.
- Generic tadalafil 5 mg (daily): ≈ $286 for 90 tablets (≈ $3.18 per tablet) with widely available savings programs; ≈ $95 for 30 tablets using the same per-tablet math.
Example monthly totals (for planning)
- Sildenafil on-demand: 8 doses/month × $2–$4 ≈ $16–$32; 12 doses/month × $2–$4 ≈ $24–$48.
- Tadalafil daily 5 mg: 30 tablets/month ≈ $95–$100 based on the 90-count example above.
| Attribute | Sildenafil (generic) | Tadalafil (generic) |
|---|---|---|
| Onset / Duration | ~30–60 min / ~4–6 h | ~30–60 min / up to ~36 h |
| Dosing pattern | On-demand 25/50/100 mg; max once daily | On-demand 10/20 mg or daily 2.5/5 mg |
| Cost profile | Often lower per tablet; monthly cost scales with use frequency | Per-tablet may be higher; daily low-dose can stabilize monthly total |
| Per-mg value | Common strengths enable straightforward per-mg comparisons | Daily vs on-demand changes per-mg math; follow prescription |
| Supply options | 30–90-day fills; mail-order can improve unit pricing | 30–90-day fills; daily regimens suit mail-order predictability |
| When it’s economical | Infrequent, predictable use | Frequent activity or a wider timing window |
How pricing is determined
- Dose & quantity: higher strengths and small fills usually raise per-unit cost; 60–90-day supplies often lower it.
- Fulfillment channel: insurance vs cash pay vs mail-order materially changes the final price.
- Formulation choice: on-demand vs daily tadalafil shifts monthly totals even if per-tablet prices differ.
- Pharmacy fees & shipping: dispensing and delivery fees vary; review them before checkout.
Practical ways to keep costs reasonable (without “discount” language)
- Prefer generic when clinically appropriate and prescribed.
- Compare monthly totals (dose × frequency × quantity), not just per-tablet price.
- Ask about 60–90-day mail-order fills at a licensed pharmacy.
- Check plan coverage and any prior authorization for ED prescriptions.
- Only consider tablet splitting if your prescriber/pharmacist approves and the tablet is scored; never exceed prescribed dosing.
Prices are illustrative and vary by region and pharmacy. Use a verified online pharmacy and follow your clinician’s prescription. Both medicines are prescription required; avoid any site offering PDE5 inhibitors without a valid telehealth consult.
FAQ
Can I buy “Viagra” online legally?
In most regions, sildenafil (Viagra) is prescription required. You can complete a compliant telehealth consult, obtain a valid prescription, and fill it through a licensed online pharmacy that passes NABP/FDA verification; avoid any site advertising “no-RX” or “instant” access.
Is sildenafil available over the counter?
No—sildenafil is a prescription-only PDE5 inhibitor in most countries. Check local regulations, but assume a telehealth consult and a valid prescription are needed before fulfillment at a licensed pharmacy.
How do I get an online prescription for sildenafil?
Choose a licensed telehealth service, complete the medical intake honestly, and attend the consult; if appropriate, the clinician issues an e-prescription routed to your chosen licensed pharmacy. See the step-by-step guide: get a sildenafil prescription or review the ED telehealth exam checklist.
How long does sildenafil take to work and how long does it last?
Typical onset is 30–60 minutes and duration is about 4–6 hours. A high-fat meal may delay effect; follow clinician guidance and see the dosing page: sildenafil dosage.
What side effects should I expect and when should I seek care?
Common effects include headache, flushing, nasal congestion, and dizziness; they are usually mild and brief. Stop and seek care for chest pain, severe reaction, sudden vision or hearing loss, or an erection lasting more than 4 hours; more details at sildenafil side effects.
Who should avoid sildenafil?
Avoid use with nitrates or riociguat, and use caution with alpha-blockers and strong CYP3A4 inhibitors. People with recent MI or stroke, severe hypotension, unstable cardiovascular disease, or certain eye disorders may not be candidates; see contraindications and consult your clinician.
How can I verify that an online pharmacy is legitimate?
Confirm a valid license and physical address, NABP/FDA verification, a prescription-required policy, and access to a pharmacist for counseling. Avoid “no-RX,” unclear fees, or crypto-only payments; follow the pharmacy verification checklist.
What does sildenafil usually cost?
Cash-pay generics can be as low as about $2 per tablet at some pharmacies; tadalafil daily 5 mg often runs around $95–$100 for 30 tablets based on common 90-count pricing math. For planning examples, see Costs Generics (Sildenafil vs Tadalafil).
This FAQ is for educational purposes and does not replace personalized medical advice. Always follow your clinician’s prescription and use a licensed pharmacy.
Regulatory & Safety Resources
Quick, high-trust resources to verify pharmacy licensure, read official medication guides, and avoid counterfeits.
- FDA BeSafeRx — how to spot safe online pharmacies.
- NABP Digital Pharmacy Accreditation — accreditation lookup and standards.
- EMA Medicines — EU product info and safety updates.
- GPhC Register (UK) — check a pharmacy’s registration.
Use licensed, prescription-required services only; avoid any site advertising “no-RX” or “instant” access.
