Can I buy erectile dysfunction medication online without prescription?
The answers to this question are inconsistent. This is due to the fact that different countries have different regulations regarding the prescription status of PDE5-inhibitors – medications like Viagra, Cialis, Levitra, Stendra, etc. The section below outlines the current situation with ED drugs in some countries.
Buy ED medications in United States
PDE5-inhibitors are available only by prescription in the United States. Patients must visit a licensed healthcare professional to obtain the prescription. There are also startups like Roman and Hims that dispense prescriptions online. The customer fills out a questionnaire, which is then reviewed by a doctor who either approves or declines the application for prescription based on the patient’s symptoms and current health status. In case of success, the customer is allowed to continue with the order and the medication is delivered to them. Roman and Hims offer branded Viagra and Cialis as well as generics.
Buy ED medications in Canada
A prescription is required to purchase PDE5-inhibitors. A patient either gets the prescription from the doctor or via a telemedicine service, such as Maple. Some online pharmacies marketed as Canadian online offer Viagra and similar meds without RX but these are illegal. Up to 74% of such rogue pharmacies are located outside of Canada.
Buy ED medications in United Kingdom
There is one PDE5-inhibitor available for purchase without prescription. This is Viagra Connect – sildenafil-based pills that come in one standard strength of 50mg. Patients suffering from ED buy Viagra Connect online or from local pharmacies after getting health assessed either by an online consultant or a licensed pharmacist. No physical examination is required. Other PDE5-inhibitors including regular Viagra, Levitra, Cialis, Spedra and generics are classified as RX-only.
Buy ED medications in Australia
All PDE5-inhibitors are available only by prescription in Australia although the Advisory Committee on Medicine Scheduling has been discussing the possibility of switching these drugs from prescription to OTC since 2016. The prescription for ED drugs is obtained either from the patient’s GP during a visit to the clinic or through telemedicine services like GP2U.
Buy ED medications in New Zealand
New Zealand legalized over-the-counter sales of sildenafil by qualifying pharmacists in 2014. Men between 35 and 70 years of age are allowed to purchase the drug called Silvasta without prescription. A brief health assessment without a physical checkup at the pharmacy is required. Other PDE5-inhibitors including Viagra, Levitra and Cialis are obtained only by prescription.
Buy ED medications in India, Mexico, China, Thailand
These countries are mentioned among common suppliers of generic PDE5-inhibitors sold with and without prescription in international online pharmacies. They share similar market characteristics in the ED treatment segment. Nominally, PDE5-inhibitors are classified as prescription medications there but, in fact, Viagra, Levitra, Cialis and generics are widely offered over the counter in both online and brick-and-mortar drugstores.
Buy ED medications in Turkey
ED medications are available over the counter in Turkey. These drugs are only sold in land-based pharmacies though as online distribution of drugs is not allowed in the country.
Alternative ED treatments offered online
There are other products aside from PDE5-inhibitors that are used to treat erectile dysfunction. An overview of such products offered on the Internet is provided below.
This medication is the second-line treatment usually prescribed to non-responders to PDE5-inhibitors, such as people with type 2 diabetes, for example. It comes in 3 forms – solution for penile injections, intraurethral pellets and topical cream. Common brand-name drugs containing alprostadil include Caverject, Muse and Vitaros. Alprostadil is a prescription-only medication.
Vacuum erection devices
A typical vacuum erection device, or VED, consists of a vacuum pump with a plastic cylinder used to drive blood towards the penis and facilitate erection and tension bands or rings to help maintain it. There are both prescription-only and over-the-counter VEDs.
The International Society for Sexual Medicine says testosterone replacement therapy is used in men with testosterone deficiency who do not respond to first-line treatments like PDE5-inhibitors. It’s unclear whether testosterone affects organic causes of ED or not but clinical studies have proven its ability to increase libido in male patients, as shown in the meta-analysis by Rizk et al. Supplements containing testosterone require a prescription. The so-called natural ‘testosterone boosters’ are sold over the counter but scientists claim such products don’t work.
DHEA, or dehydroepiandrosterone, is a hormone, whose role in treating erectile dysfunction is being investigated. It is a testosterone precursor that gets converted into testosterone in the body. It is available over the counter in the United States. A 2018 meta-analysis of medical researches performed by Ahmed El-Sakka lists 3 studies showing that DHEA is effective in treating sexual dysfunction in men and 1 study that showed no effect.
L-arginine is an amino-acid that converts to nitric oxide in the body. Nitric oxide, in its turn, plays a major role in the biochemistry of penile erection. This Healthline article by James Roland based on a meta-analysis of L-arginine studies shows that this supplement alone does not cure erectile dysfunction but its combinations with yohimbine and pycnogenol have proven effective in treating mild to moderate ED. L-arginine is available without a prescription.
There are studies focusing on the effects of horny goat weed, ginkgo biloba, red ginseng, yohimbe tree bark, etc. in lab animals or human patients with erectile dysfunction. These papers provide suggestive evidence for the effectiveness of natural ED remedies but their methodological quality and the numbers of study participants are usually low. None of the abovementioned herbal supplements are approved for the treatment of erectile dysfunction. Although these supplements are available for purchase without prescription, the FDA recommends against it as multiple ED products claiming to contain only natural ingredients are actually laced with sildenafil and other prescription medications. It increases the risk of suffering from serious side effects.
All in all, PDE5-inhibitors remain the first-line treatment for erectile dysfunction with efficacy ranging between 60% and 70%. While these drugs are classified as prescription-only in most places around the world, countries like New Zealand and the UK are leading the change by offering OTC access to sildenafil. PDE5-inhibitors are sold over-the-counter in online and brick-and-mortar stores in countries like India, Mexico, China, etc. and shipped abroad. It is unusual for US-based patients ordering such medications for personal use from foreign countries to experience problems at the customs. It is important to choose trustworthy suppliers, like Pharmacy-Checker-verified sites, for instance, to avoid counterfeits. Other ED treatments offered online without prescription include vacuum erection devices, DHEA, L-arginine and herbal supplements.
- How to buy Viagra Connect in the UK - https://www.viagraconnect.co.uk/you-viagra-connect#where-can-i-get-viagra-connect
- 2017 NABP report on rogue pharmacies claiming to be Canadian - https://nabp.pharmacy/wp-content/uploads/2016/08/Internet-Drug-Outlet-Report-August-2017.pdf
- ACMS discussion on switching PDE5-inhibitors from prescription to OTC in Australia - https://www.tga.gov.au/book-page/11-sildenafil-0
- New Zealand allows OTC sales of sildenafil by qualifying pharmacists - https://www.pharmaceutical-journal.com/news-and-analysis/new-zealand-allows-access-to-sildenafil-through-pharmacy/20066904.article
- Policies on PDE-5 inhibitors and other medications in Turkey - https://www.legitscript.com/blog/2013/04/turkeys-policies-on-internet-pharmacies/
- AI El-Sakka, A review of studies of DHEA’s effect on erectile function - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119841/
- The International Society for Sexual Medicine on testosterone replacement therapy - https://www.issm.info/sexual-health-qa/can-testosterone-replacement-therapy-help-men-with-erectile-dysfunction-ed/
- PJ Rizk et al, Testosterone replacement therapy in hypogonadal men with erectile dysfunction and low libido - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649360/
- Men’s Health Nutrition advisor Mike Roussel, PhD, on natural testosterone boosters - https://www.menshealth.com/fitness/a19531177/the-truth-about-testosterone-boosting-supplements/
- FDA policy on personal importation of prescription medicines - https://www.fda.gov/about-fda/fda-basics/it-legal-me-personally-import-drugs
- Biochemistry of penile erection - https://www.hopkinsmedicine.org/news/media/releases/researchers_uncover_biochemical_chain_of_events_needed_to_maintain_an_erection
- The effect of L-arginine on erectile function - https://www.healthline.com/health/erectile-dysfunction/l-arginine#effectiveness
- AW Shindel et al, The effect of Icariin, the purified extract of horny goat weed, on rats’ erectile function - http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2009.01699.x/full
- AJ Cohen, B Bartlik, Ginkgo biloba for antidepressant-induced erectile dysfunction - https://www.ncbi.nlm.nih.gov/pubmed/9611693
- DJ Jang et al, Red ginseng for improving erectile function, a systematic review - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2561113/
- AT Guay, Yohimbine for treatment of erectile dysfunction - https://www.ncbi.nlm.nih.gov/pubmed/11896474
- ‘All-natural’ supplements found to be laced with Viagra and other pharmaceutical drugs - https://www.buzzfeed.com/azeenghorayshi/natural-sex-supplements-are-actually-spiked-with-viagra
- JD Evans, SR Hill, Evaluation of efficacy of erectile dysfunction treatment with PDE5-inhibitors - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542406/#__sec15title