Sildenafil (Generic Viagra®)

Healthon offers comprehensive treatment protocols and nutritional recommendations for both women and men that address sexual health symptoms in an affordable, discreet, convenient, and outcome-driven way. As a digital-first health company, Healthon connects you with licensed healthcare professionals in your state who will review your comprehensive medical questionnaire and determine your eligibility—all from the comfort of your home.

The Healthon Sexual Health Program offers several medications for the treatment of erectile dysfunction (ED) and hypoactive sexual desire disorder (HSDD), including:

• Sildenafil (Viagra®) – A PDE5 inhibitor that helps men achieve and maintain erections.
• Tadalafil (Cialis®) – A long-acting PDE5 inhibitor, effective for up to 36 hours.
• Vardenafil (Levitra®/Staxyn®) – A PDE5 inhibitor with rapid onset.
• PT-141 (Bremelanotide) – A melanocortin receptor agonist used for HSDD in women and ED in men.


How do PDE5 inhibitors like Viagra, Cialis, and Vardenafil work?PDE5 inhibitors work by blocking the enzyme phosphodiesterase type 5 (PDE5), which breaks down cyclic guanosine monophosphate (cGMP), a molecule responsible for relaxing smooth muscle in the blood vessels of the penis. By inhibiting PDE5, these medications increase cGMP levels, allowing blood to flow more easily, resulting in an erection during sexual stimulation.


• Sildenafil (Viagra): Onset of action is about 30-60 minutes, lasting up to 4-6 hours.
• Tadalafil (Cialis): Onset of action is about 30 minutes, with effects lasting up to 36 hours.
• Vardenafil (Levitra): Onset of action is about 30-60 minutes, lasting up to 4-5 hours.

Rajfer, J., et al. (1992). Sildenafil: An orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. The New England Journal of Medicine, 336(13), 844-848. 
Jackson, G., et al. (2006). Cardiovascular safety of PDE5 inhibitors. International Journal of Clinical Practice, 60(8), 963-970.

Erectile dysfunction (ED) and hypoactive sexual desire disorder (HSDD) can significantly impact both physical and emotional well-being. Addressing these conditions is crucial because they affect:

• Quality of life: Untreated ED and HSDD can lead to stress, anxiety, and depression, negatively influencing personal relationships.
• Overall health: ED can sometimes be an early warning sign of cardiovascular issues, diabetes, or other underlying health conditions that need to be addressed.
• Self-esteem: Restoring sexual function and desire often leads to improved confidence and better mental health.
• Relationship satisfaction: Effective treatments can enhance intimacy and relationship dynamics.

Laumann, E. O., et al. (1999). Sexual dysfunction in the United States: Prevalence and predictors. JAMA, 281(6), 537-544. 
Corona, G., et al. (2016). The safety and efficacy of available treatments for erectile dysfunction. International Journal of Impotence Research, 28(2), 60-67. 

PDE5 inhibitors, such as Sildenafil (Viagra®), Tadalafil (Cialis®), and Vardenafil (Levitra®), work by blocking the enzyme phosphodiesterase type 5 (PDE5). This enzyme breaks down cyclic guanosine monophosphate (cGMP), a molecule that promotes relaxation of the smooth muscles in the blood vessels of the penis. By inhibiting PDE5, these medications allow cGMP levels to increase, leading to enhanced blood flow and an erection in response to sexual stimulation.


• Sildenafil (Viagra): Typically effective within 30-60 minutes and lasts for 4-6 hours.
• Tadalafil (Cialis): Known for its long duration of up to 36 hours, making it the preferred option for more spontaneity.
• Vardenafil (Levitra): Offers rapid onset of action, typically within 30 minutes, with effects lasting 4-5 hours.

Hatzimouratidis, K., et al. (2010). Guidelines on erectile dysfunction: European Association of Urology. European Urology, 57(5), 804-814.

Rajfer, J., et al. (1992). Sildenafil: An orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. The New England Journal of Medicine, 336(13), 844-848.

PT-141 works differently from PDE5 inhibitors. It activates melanocortin receptors in the brain, which are involved in sexual desire. It does not affect blood flow directly like PDE5 inhibitors but enhances sexual arousal by acting on the central nervous system.

• Administration: PT-141 is administered via subcutaneous injection, typically 45 minutes before anticipated sexual activity.
• Use: Approved for treating HSDD in premenopausal women and used off-label for ED in men.

Clayton, A. H., et al. (2016). Efficacy of bremelanotide for hypoactive sexual desire disorder: A randomized, placebo-controlled dose-ranging study in women. Journal of Sexual Medicine, 13(2), 180-194. 

While generally well-tolerated, PDE5 inhibitors can cause some side effects. Common side effects include:

• Headache
• Flushing
• Indigestion (dyspepsia)
• Nasal congestion
• Visual disturbances (e.g., blurred vision or sensitivity to light)


More serious but less common side effects:


• Hypotension (low blood pressure), especially when combined with nitrates
• Priapism (prolonged, painful erection lasting more than 4 hours)


Reference:


FDA Label for Sildenafil (Viagra)
FDA Label for Tadalafil (Cialis)
FDA Label for Vardenafil (Levitra)

PT-141 has a distinct side effect profile due to its mechanism of action:

• Nausea (most common side effect)
• Flushing
• Headache
• Injection site reactions (pain or redness)
• Increased blood pressure (temporary, generally subsides after a few hours)

FDA Label for Bremelanotide (Vyleesi)

Clayton, A. H., et al. (2016). Efficacy of bremelanotide for hypoactive sexual desire disorder: A randomized, placebo-controlled dose-ranging study in women. Journal of Sexual Medicine, 13(2), 180-194. 

PDE5 inhibitors and PT-141 are generally safe for most people, but there are important contraindications and cautions:


• PDE5 inhibitors should not be taken by individuals using nitrates (e.g., nitroglycerin) due to the risk of severe hypotension (low blood pressure).
• These medications should also be used with caution in individuals with uncontrolled hypertension, recent stroke, or severe heart conditions.
• PT-141 (Bremelanotide) is contraindicated in patients with uncontrolled hypertension or cardiovascular conditions, as it can cause a transient increase in blood pressure.

FDA Label for Sildenafil (Viagra)
FDA Label for Tadalafil (Cialis)
FDA Label for Bremelanotide (Vyleesi)

At Healthon, we strive to provide the most affordable and accessible treatmentswhile maintaining high standards of care and quality. Our pricing for PDE5 inhibitors (Viagra, Cialis, Vardenafil) and PT-141 is designed to be competitive, transparent, and significantly more affordable than many other providers without sacrificing the quality of medication or patient care.


• Sildenafil (Viagra): Prices start at $XX per month.
• Tadalafil (Cialis): Prices start at $XX per month.
• Vardenafil: Prices start at $XX per month.
• PT-141: Prices start at $XX per month.


All medications provided by HealthON are sourced from fully licensed, NABP and LegitScript-certified compounding pharmacies, ensuring the highest quality of treatment for our patients.

• Sildenafil (Viagra): Typically takes 30-60 minutes to take effect and lasts up to 4-6 hours.
• Tadalafil (Cialis): Begins working in about 30 minutes and can last up to 36 hours.
• Vardenafil (Levitra): Takes 30-60 minutes to start working and lasts for 4-5 hours.
• PT-141 (Bremelanotide): Takes about 45 minutes for sexual arousal to increase and can last up to 6 hours.

Hatzimouratidis, K., et al. (2016). EAU Guidelines on erectile dysfunction, premature ejaculation, penile curvature, and priapism. European Urology, 65(2), 339-348.

Clinical studies suggest some patients may benefit from combining PT-141 with a PDE5 inhibitor if directed by a healthcare provider, particularly in cases of ED with low sexual desire. Always consult with a healthcare professional before combining these medications.

Goldstein, I., et al. (2017). Safety and efficacy of the combination of sildenafil and bremelanotide for ED. Journal of Sexual Medicine, 14(4), 559-567.

At Healthon we prioritizes safety, quality, and compliance in every aspect of our treatment programs. To ensure this, we source our medications and formulations from fully compliant, FDA-registered pharmacies. These pharmacies are also certified by the National Association of Boards of Pharmacy (NABP), LegitScript, and maintain accreditation as Accredited Compounding Pharmacies. This extensive certification process guarantees that all medications dispensed through Healthon Health Programs meet the highest standards for quality and safety, giving patients peace of mind knowing that their health is in good hands.