Viagra Professional, which contains sildenafil as its active ingredient, has been a go-to solution for erectile dysfunction for over two decades. But it’s not the only option anymore. Today, men have more choices than ever - and not all of them work the same way, cost the same, or have the same side effects. If you’re wondering whether Viagra Professional is still the best pick, or if another pill might suit you better, you’re not alone. Let’s break down what’s out there, what actually works, and who it works for.

What is Viagra Professional?

Viagra Professional is a branded version of sildenafil citrate, the same compound found in the original Viagra. It’s designed to help men get and keep an erection by increasing blood flow to the penis. The standard dose is 100 mg, taken about 30 to 60 minutes before sexual activity. Its effects usually last 4 to 6 hours, though some men report benefits for up to 8 hours. It doesn’t cause an erection on its own - you still need sexual stimulation.

It works by blocking an enzyme called PDE5. When this enzyme is inhibited, nitric oxide can relax the smooth muscles in the penis, allowing more blood in. Simple. Effective. But not perfect for everyone.

How Sildenafil Compares to Tadalafil (Cialis)

Tadalafil, sold under the brand name Cialis, is the most common alternative to sildenafil. The biggest difference? Duration.

While sildenafil lasts 4-6 hours, tadalafil can last up to 36 hours. That’s why Cialis is sometimes called the "weekend pill." If you want flexibility - not having to plan sex around when you take a pill - tadalafil gives you a much wider window.

But there’s a trade-off. Tadalafil can cause more back pain and muscle aches in some users, especially at higher doses. It also takes longer to kick in - up to 2 hours - compared to sildenafil’s 30-minute average.

Another key point: Cialis comes in a daily low-dose version (2.5 mg or 5 mg), which keeps a steady level in your system. That means you don’t need to time it before sex. For men who have sex more than twice a week, this can be more convenient than popping a pill on demand.

Levitra (Vardenafil): Faster, But Shorter

Vardenafil, sold as Levitra or Staxyn, is another PDE5 inhibitor. It works similarly to sildenafil but is slightly more potent. A 10 mg dose of vardenafil is roughly equal to a 50 mg dose of sildenafil.

One advantage: it can work faster - some men report effects in as little as 25 minutes. It’s also less affected by food, so you don’t need to take it on an empty stomach like you do with sildenafil.

But its duration is similar to sildenafil: about 4-5 hours. And it’s more likely to cause nasal congestion or dizziness. It’s also more expensive than generic sildenafil in most places.

Stendra (Avanafil): The New Kid on the Block

Avanafil, sold as Stendra, is the newest FDA-approved PDE5 inhibitor. It hits the bloodstream quickly - often in 15 minutes. That’s faster than any other ED pill on the market.

It also has a lower risk of causing visual disturbances (like blue-tinted vision), which some men report with sildenafil. Side effects are generally mild: headache, flushing, and nasal stuffiness.

But here’s the catch: Stendra isn’t available as a generic. It’s significantly more expensive than sildenafil. For many, the speed advantage doesn’t justify the cost unless you’re in a situation where timing is critical.

Four men in daily scenarios, each associated with a different ED medication choice.

Generic Sildenafil: The Budget-Friendly Choice

Viagra Professional is a branded version of sildenafil. But you can buy generic sildenafil at most pharmacies for a fraction of the price. The active ingredient is identical. The only differences are in the filler ingredients, pill shape, and packaging.

In the U.S., generic sildenafil costs about $10-$20 per pill, while branded Viagra Professional can run $50-$80. In countries with strict price controls, like Canada or the UK, the difference is even starker.

Many men switch to generic sildenafil without noticing any change in effectiveness. If cost is a concern - and it is for most - generic sildenafil is the smartest starting point.

What About Natural Alternatives?

You’ll see ads for herbal supplements like L-arginine, ginseng, horny goat weed, or yohimbine. Some studies suggest mild benefits, but none are FDA-approved for treating ED.

For example, a 2023 review in the Journal of Sexual Medicine found that ginseng showed a slight improvement in erection quality in small trials, but results were inconsistent. Yohimbine, once popular, carries risks of anxiety, high blood pressure, and heart palpitations - especially for men with existing cardiovascular issues.

Unlike sildenafil, these supplements aren’t regulated. That means the actual amount of active ingredient can vary wildly between brands. Some contain hidden pharmaceuticals - including sildenafil itself - which can be dangerous if you’re already taking other medications.

Which One Should You Choose?

There’s no single "best" ED pill. It depends on your lifestyle, health, and priorities.

  • If you want low cost and proven results → generic sildenafil
  • If you want flexibility and spontaneity → tadalafil (Cialis)
  • If you need fast action and eat high-fat meals often → vardenafil (Levitra)
  • If you want the fastest onset and can afford it → avanafil (Stendra)
  • If you prefer daily dosing → low-dose tadalafil

Also consider your health. Men with heart conditions, low blood pressure, or those taking nitrates (like nitroglycerin) should never take any PDE5 inhibitor. These drugs can cause a dangerous drop in blood pressure when mixed with nitrates.

And if you have liver or kidney disease, your doctor may need to adjust your dose. Sildenafil and vardenafil are processed by the liver, so impaired function can lead to higher drug levels in your blood.

A floating medical chart showing four ED drugs blocking enzymes, with a doctor guiding toward consultation.

Side Effects: What to Expect

All PDE5 inhibitors share similar side effects:

  • Headache (most common)
  • Flushing or warmth in the face
  • Nasal congestion
  • Upset stomach
  • Dizziness

Less common but serious side effects include sudden vision loss (NAION) or hearing loss - though these are extremely rare. If you experience either, stop taking the pill and seek medical help immediately.

Sildenafil is more likely than others to cause blue-tinted vision or light sensitivity. Tadalafil is more likely to cause back pain. Avanafil has the lowest rate of visual side effects.

What About Over-the-Counter Options?

In the U.S., no ED pills are available over the counter. All require a prescription. But in some countries - like the UK - lower-dose sildenafil (50 mg) is sold OTC under the brand name Viagra Connect.

Be cautious of websites selling "generic ED pills" without a prescription. Many are counterfeit. The FDA has warned about pills containing toxic substances, incorrect dosages, or no active ingredient at all.

If you’re buying online, only use pharmacies that require a prescription and are verified by the National Association of Boards of Pharmacy (NABP).

When to Talk to Your Doctor

ED isn’t just a sexual issue. It’s often an early warning sign of heart disease, diabetes, or high blood pressure. Studies show that men with ED have a higher risk of heart attack within 5 years.

If you’re considering any ED medication, talk to your doctor first. They can check for underlying conditions, review your medications, and help you pick the safest option.

Also, if one pill doesn’t work after a few tries, don’t assume it’s hopeless. Different men respond differently. Switching from sildenafil to tadalafil, for example, can make all the difference.

Is Viagra Professional stronger than generic sildenafil?

No. Viagra Professional contains the same active ingredient - sildenafil citrate - as generic versions. The only differences are in the inactive ingredients, packaging, and brand name. Both work the same way, at the same strength, and have identical side effects. Generic sildenafil is just cheaper.

Can I take sildenafil with alcohol?

Moderate alcohol (like one or two drinks) is usually fine, but heavy drinking can reduce sildenafil’s effectiveness and increase side effects like dizziness and low blood pressure. Alcohol also worsens erectile dysfunction on its own, so drinking too much defeats the purpose.

How long does it take for sildenafil to work after eating?

A heavy, high-fat meal can delay sildenafil’s onset by up to an hour. For fastest results, take it on an empty stomach or with a light meal. Vardenafil and avanafil are less affected by food.

Is tadalafil safe for daily use?

Yes. Low-dose tadalafil (2.5 mg or 5 mg) is FDA-approved for daily use. It helps maintain consistent blood flow and can improve both spontaneous and planned sexual activity. It’s often prescribed for men with frequent sexual activity or those who also have BPH (enlarged prostate).

Can ED pills cure erectile dysfunction?

No. ED pills treat the symptoms - they don’t cure the underlying cause. If your ED is due to diabetes, heart disease, stress, or low testosterone, you’ll need to address those issues too. Lifestyle changes like losing weight, quitting smoking, or exercising regularly can improve ED on their own.

If you’ve tried sildenafil and it didn’t work well, don’t give up. Try tadalafil next. Or switch to a lower dose. Or talk to your doctor about combining treatment with therapy or lifestyle changes. ED is common, treatable, and rarely just "in your head." The right solution exists - you just need to find it.