How long do ED pills last for?

Erectile dysfunction (ED) medications vary in how long they stay active in your body. The duration of their effects can range from about four hours to more than 24 hours, especially with higher doses of Cialis (tadalafil).

“Will it last through another cycle? It’s not guaranteed,” says Dr. Louis Liou, chief of urology at Harvard-affiliated Cambridge Health Alliance. “To have sex more than once a day, Cialis is your best bet.”

Each dose is designed to support a full sexual encounter—from erection to climax—but repeated cycles may require timing and medication choice considerations.

What Are the Common Durations of ED Medications?

• Sildenafil (Viagra): Typically lasts 4 to 6 hours. It generally takes effect within 30 to 60 minutes.

• Tadalafil (Cialis): Known for its longer duration, lasting up to 36 hours or more. It’s sometimes called “the weekend pill” because of this.

• Vardenafil (Levitra): Effects last about 4 to 6 hours, similar to sildenafil.

• Avanafil (Stendra): Has a quicker onset, usually working within 15 minutes and lasting about 6 hours.

How ED Pills Work in Your Body

These medications enhance the effect of nitric oxide—a chemical that relaxes muscles in the penis and increases blood flow—making it easier to achieve and maintain an erection during sexual stimulation.

• ED pills do not cause spontaneous erections. Sexual arousal is still necessary for the medication to work.

• The effectiveness of ED medications may vary based on factors such as age, underlying health conditions (e.g., diabetes, cardiovascular disease), and other medications being taken.

Side Effects and Safety Considerations

Common side effects of ED drugs, ranked from most to least frequent, include:

• Headache

• Flushing

• Upset stomach

• Nasal congestion

• Vision changes (such as a blue tint)

• Diarrhea

• Dizziness

• Rash

A rare but serious risk is priapism—an erection lasting four hours or more—which requires immediate emergency care to prevent permanent damage.

Important Safety Information

• ED medications should never be taken with nitrates, a class of heart medications, because the combination can cause dangerously low blood pressure.

• Alpha blockers, often prescribed for urinary symptoms, can also lower blood pressure and must be spaced at least four hours apart from ED drugs.

• Your doctor might start you on a lower ED drug dose if you’re on alpha blockers or recommend a medication like tamsulosin (Flomax), which has less effect on blood pressure.

• Men with certain health conditions, such as severe heart or liver problems, should consult their doctor before using ED pills.

Tips for Getting the Most from Your ED Medication

• Take the pill on an empty stomach or avoid heavy meals beforehand, as food—especially fatty food—can delay absorption and effectiveness.

• Avoid excessive alcohol, which can impair erectile function and reduce the medication’s effectiveness.

• Follow your healthcare provider’s instructions closely, and do not exceed the prescribed dosage.

• If one medication does not work, talk to your doctor about trying a different option or adjusting the dose.

When to See a Doctor

If ED medications don’t improve your symptoms after several attempts, or if you experience severe side effects such as chest pain, dizziness, or an erection lasting longer than four hours, seek medical attention immediately.

Take Control of Your ED with Expert Support

Understanding how long ED medications last and their safety is key to effective treatment. Bastion Health offers expert virtual care to help you choose the right medication and dosage for your needs—all conveniently covered through your employer-sponsored benefits.