Sildenafil Alternative Drugs: What Are the Substitutes

Sildenafil citrate alternative
, reviewed by​
Kim Matthews
 – Updated October 17, 2022
Table of Contents

Sildenafil was the first product of its kind introduced for the treatment of erectile dysfunction (ED). It maintained its safety and effectiveness in long-term studies. However, for one reason or another, some men look for Sildenafil alternatives.

The Australian pharmaceutical market is ready to offer medicines based on the following main ingredients:

  • Tadalafil;
  • Vardenafil;
  • Avanafil.

Important information! Currently, no extensive study has provided data on the statistically significant difference in the effectiveness of various ED pills.

Today medicines have opened a new era in treating psychogenic ED and most erection problems associated with metabolic disorders or diseases of specific organs and systems. They have the exact mechanism of action, belong to the same drug group (PDE5i), and have similar side effects.

These drugs cause the expansion of the penis blood vessels facilitating its blood supply during sexual arousal. Sexual stimulation releases nitric oxide (NO), which has a vasodilating effect in the cavernous bodies.

Similar biochemical reactions happen in many body organs and systems. However, the effect of PDE5i is most evident in the cavernous bodies of the penis. This type of phosphodiesterase is responsible for the erectile function of the penis.

You can see some differences in the duration of these drugs.

NameDuration (h)
Sildenafil≈ 4
Vardenafil≈ 4
Avanafil≈ 6
Tadalafil≈ 36

As you can see, Tadalafil-containing pills have the longest effect. This effect is more suitable if a man needs more extended treatment, for example, on weekends. In addition, they have one more difference — small doses of these drugs are approved for daily use.

It may not be appropriate to use Sildenafil citrate alternative medicines if you have:

  • Very low blood pressure.
  • Unstable angina.
  • Recently had a stroke or heart attack.
  • Non-arteritic anterior ischemic optic neuropathy.

If PDE5i are unacceptable as a treatment method, a doctor may prescribe testosterone for men with hypogonadism (low testosterone level). It reduces ED symptoms and improves libido, but its effectiveness may not be optimal.

Dietary supplements, intracavernous injections, intraurethral suppositories, and vacuum pumps are not widely used due to potential complications, inconvenience, or questionable efficacy.


The clinical diagnosis and treatment of ED have changed over the past two decades. The appearance of effective and safe PDE5i you can take orally has transformed the global market of ED drugs.

All of these fast-acting and easy-to-use drugs have some differences. A doctor can help you choose the best treatment option by the time taken to work, duration of effects, dosage regimen, and other characteristics.

Social Share:
See Also:
Table of Contents
Would love your thoughts, please comment.x