ED Pills — Viagra & Cialis, the right drug at the right dose

“These medicines help when they are matched to the right patient and dose, but they have important contraindications, especially for men taking heart medication that dilates blood vessels. Reviewing health conditions and current medicines first is essential.”

What are ED pills?

ED pills are medications that treat erectile dysfunction (ED) by helping the penis become firm when you are sexually aroused. The most commonly used are PDE5 inhibitors — Viagra (sildenafil) and Cialis (tadalafil) — along with lower-cost generics such as Sidegra, Sinafil, Elonza and Talafil.

Each drug has a different onset, duration and set of contraindications. At Lover Clinic, a doctor reviews your health and current medications before every prescription to match the medicine to your health.

Types of ED medication

1. Viagra — sildenafil

The first approved PDE5 inhibitor, with a long record of clinical use.

• Generics in the same group: Sidegra, Sinafil, Elonza
• How it works: Blocks the PDE5 enzyme, relaxing blood vessels in the penis so more blood flows in during arousal
• Pros: Longest history of use, relatively fast-acting
• Limitation: Short duration — about 3–4 hours
• How to take it: On demand, 30–60 minutes before sex — best for men who can plan ahead

Tip: Take it on an empty stomach. A high-fat meal slows absorption and delays the effect.

2. Cialis — tadalafil

Also a PDE5 inhibitor, but with a much longer half-life than sildenafil.

• Generic in the same group: Talafil
• Pros:
  • Works for up to 36 hours (hence the nickname “the weekend pill”), and food affects absorption less than sildenafil
  • Can be taken on demand (higher dose) or daily at a low dose, so there’s no need to time your pill
  • In some cases also helps control symptoms of an enlarged prostate (BPH) — useful for men with both conditions
• How to take it: On demand about 30–60 minutes before sex, or a low daily dose for men who are sexually active regularly

3. Alprostadil (Caverject) — prostaglandin E1

Dilates the blood vessels of the penis directly, through a different mechanism from PDE5 inhibitors. Available as an intracavernosal injection or a urethral pellet.

• Works even without sexual stimulation; erections typically last around 60–90 minutes
• An option when PDE5 inhibitors don’t work, or can’t be used (for example, in men taking nitrates)
• Suited to nerve-related ED, such as after prostate surgery or with diabetic neuropathy

Important: The dose must be tested and adjusted in the clinic first (in-office titration) before you use it at home, following your doctor’s instructions.

Viagra vs Cialis: what’s the difference?

	Viagra (sildenafil)	Cialis (tadalafil)
Onset	30–60 min	30–60 min
Duration	About 4 hours	Up to 36 hours
Effect of food	Fatty meals delay it	Minimal
Regimen	On demand	On demand or daily
Generics	Sidegra, Sinafil, Elonza	Talafil
Best for	Men who can plan ahead	Men who want flexibility, or who also have BPH

Medication and service fees

The cost depends on which medicine your doctor prescribes, the strength and the quantity; generics cost less than the original brands. Your doctor explains the options and the cost before treatment starts.

The clinic does not sell medication over the counter. Everything below is dispensed on a doctor’s prescription, only after an assessment of your suitability and any contraindications. Prices are per box, so you can plan the cost in advance.

Sildenafil group (Viagra and generics)

Medication	Price per box
Viagra 50 mg (4 tablets/box)	1,500 THB
Viagra 100 mg (4 tablets/box)	2,100 THB
Sidegra 50 mg (4 tablets/box)	550 THB
Sidegra 100 mg (4 tablets/box)	890 THB
Sinafil 50 mg (4 tablets/box)	750 THB
Sinafil 100 mg (2 tablets/box)	550 THB
Elonza 50 mg (4 tablets/box)	750 THB
Elonza 100 mg (4 tablets/box)	990 THB

Tadalafil group (Cialis and generics)

Medication	Price per box
Cialis 5 mg (28 tablets/box)	4,900 THB
Cialis 10 mg (4 tablets/box)	2,950 THB
Talafil 5 mg (30 tablets/box)	2,900 THB
Talafil 10 mg (4 tablets/box)	1,200 THB

Why does the 5 mg box cost more than the 10 mg? Because 5 mg is the once-daily formulation, so a box holds far more tablets than an on-demand pack — not because the medicine itself is more expensive. Your doctor confirms the tablet count and the total cost before treatment starts.

Alprostadil group

Medication	Price per box
Caverject (Alprostadil)	Ask at the clinic

Prices may change with the manufacturer’s batch and supply. Ask on LINE @loverclinic for current medication, consultation and medical service fees before your visit.

Brand-name vs generic ED pills

Generics such as Sidegra, Sinafil and Elonza (sildenafil) and Talafil (tadalafil) contain the same active ingredient as Viagra and Cialis and work the same way. The main difference is a lower price, along with the inactive ingredients and packaging. Your doctor can recommend the option that suits you.

Who should not take ED pills

• Men taking nitrates (such as chest-pain tablets placed under the tongue) or riociguat — never combine them; blood pressure can fall to life-threatening levels
• Men with severe heart disease, or who have been advised to avoid physical exertion
• Men who have had a heart attack or stroke in the last 6 months
• Men with very low blood pressure, or uncontrolled high blood pressure
• Men with severe liver or kidney disease (the dose may need adjusting)
• Men taking alpha-blockers (some prostate or blood pressure medications) — the doctor must adjust the dose first

Possible side effects

Most are mild and pass on their own: headache, facial flushing, nasal congestion, indigestion, dizziness, temporary blue-tinted vision (with sildenafil), or back and muscle pain (with tadalafil).

Go to hospital immediately if you have: an erection lasting more than 4 hours, chest pain, sudden blurred vision or vision loss, or sudden ringing in the ears or hearing loss.

Why you shouldn’t buy Viagra online

Many ED pills sold online or through sellers without a pharmacist are counterfeit, with unreliable doses and sometimes other contaminants. Beyond not working, they can be dangerous for men with underlying conditions. Getting your prescription through a doctor gives you medicine ordered direct from the manufacturer and a risk screening at the same time.

Pills help — but they don’t fix the cause

ED is often an early warning sign of vascular disease, diabetes or low testosterone. ED pills help you achieve an erection each time, but they don’t restore function at the source. To reduce long-term reliance on medication, your doctor may recommend:

• Root-cause ED treatment — vascular, hormonal and psychological assessment
• Shockwave therapy (Li-ESWT) — stimulates new blood vessel growth and can be combined with pills
• Testosterone replacement (TRT) — for men with low testosterone and reduced libido

Medical disclaimer: Every class of ED medication has its own indications, contraindications and side effects, which vary between individuals. This page is general medical information, not a diagnosis or treatment plan. Do not buy or take ED medication without consulting a doctor — get a specialist assessment before starting any treatment.