Ever since erectile dysfunction (ED) drugs were introduced, scientists have been looking at different formulas that may be easier to take while providing the right amount of medicine. Some people have a hard time swallowing pills. Some want a more discreet way to take them without having to grab a glass of water. One newer option is chewable tablets.
In the United States, chewable ED tablets are available only through the online subscription service BlueChew. According to the company website, it makes chewable versions of sildenafil (Viagra) and tadalafil (Cialis). (While the active ingredients have FDA approval, chewable forms of these drugs haven't been separately approved.)
Unlike traditional ED pills, chewables aren't made directly by drug companies in the U.S. They're created at a compounding pharmacy. A doctor affiliated with the company prescribes them for you after an online visit with the doctor.
The tablets are sent directly to your home. Monthly subscription costs range from $20 to $120, plus tax and shipping, depending on how many tablets you need. You can cancel your subscription whenever you like.
Compounding pharmacies tailor-make medications when the exact drug or formula you need isn’t available for sale. BlueChew partners with state-licensed compounding pharmacies across the country or works with a compounding pharmacy you choose. (The Professional Compounding Centers of America (PCCA) offers a search tool at https://www.pccarx.com/Resources/FindACompounder.)
Sildenafil was the first FDA-approved oral ED medication. It belongs to the class of drugs called PDE5 inhibitors. That means they stop PDE5, an enzyme that can hamper blood flow to your penis.
The chewable works the same way as the traditional little blue pill. You take it as needed, about an hour before sex, and its effects last for 4-6 hours. It’s best not to eat a high-fat meal beforehand. Sildenafil takes longer to work if there’s fat in your bloodstream.
The chews are available in 30 milligram and 45 milligram doses. That's slightly different from the 25 milligram and 50 milligram doses of the pills, which are prescribed for those over and under age 65 respectively. (Traditional sildenafil also comes in a 100-milligram dose.)
In a head-to-head comparison between the pill and chew forms, possible side effects were the same. They included:
- Short-lived vision issues
- Hot flashes
- Runny or stuffy nose
In most cases, side effects were mild and went away on their own.
Tadalafil is also a PDE5 inhibitor. It stays active for up to 36 hours, so you have more choice about when to take it. You can use it as needed or take one every day. You don’t need to watch what you eat, except to avoid grapefruit and grapefruit juice. They can change the way your body processes tadalafil.
The chews are available in 6 milligrams or 9 milligrams, while the tablets come in 10-milligram or 20-milligram single-dose pills and a 5-milligram daily pill.
Common side effects for tadalafil include:
- Runny or stuffy nose
- Discomfort in the belly area
- Back pain
- Achy muscles
These effects are usually mild and go away on their own after a short time.
Choosing Between the Two
There's no research comparing the chewable versions. But a 2017 review study found that tadalafil and sildenafil worked in pretty much the same way and had similar side effects. The one big difference was that many of those who took part in the study said they felt more confident when taking tadalafil. This may be because tadalafil's effects last longer -- up to 36 hours versus 12 hours for sildenafil.
No ED drug is safe to take if you’re on nitrates for your heart. The combination can cause your blood pressure to fall to a dangerous level. Discuss all medications you’re taking with the doctor who treats your ED. This will help you avoid interactions with blood pressure medicine and other drugs.
Films and tablets that quickly dissolve on or under your tongue are innovative delivery systems for ED drugs that also don’t require water. They may work faster than pills.
Vardenafil, another PDE5 inhibitor that's the active ingredient in Levitra, is available as a dissolving tablet (Staxyn). You take it an hour in advance and let it dissolve on your tongue.
An early trial of sildenafil film found that the 100-milligram dose was comparable to the conventional coated pill. It’s now available in Europe.