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PDE5-inhibitors like Viagra, Levitra, Cialis, Stendra and their generics are available only by prescription in such countries as the United States, Canada and Australia. It is legal to buy sildenafil over the counter in the UK and New Zealand. In countries like India, Mexico, China, Thailand PDE5-inhibitors are nominally classified as prescription drugs but, in fact, are sold freely online and in land-based drugstores. In Turkey these ED meds are available over the counter but only in land-based pharmacies, not online. Customers from countries where PDE5-inhibitors are classified as RX-only can purchase meds from abroad without prescription, but may be required to present a valid prescription if the shipment is held up at the customs. Alternative ED treatments like alprostadil and testosterone require a prescription. Others, like vacuum erection devices, DHEA, L-arginine and herbal supplements, are sold without restrictions.
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The answers to this question are inconsistent. This is due to the fact that different countries have different regulations regarding the prescription status of PDE5-inhibitors – medications like Viagra, Cialis, Levitra, Stendra, etc. The section below outlines the current situation with ED drugs in some countries.
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You may already know most of the names: Cialis, Levitra, Staxyn, Stendra, Viagra. Learn more about these medications that can help men with erectile dysfunction get and keep an erection.
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Viagra, Cialis, Levitra, and Stendra are oral medications for treating erectile dysfunction. All four work in similar ways, but there are also key differences, such as how long they work and their
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WHAT ARE THE MOST EFFECTIVE ERECTILE DYSFUNCTION DRUGS? FIND OUT WITH THIS COMPARISON CHART
Originally created and launched by Pfizer in 1998, Viagra is the most well-known pill to treat  erectile dysfunction (ED). Also known as the ‘little blue pill’, due to its shape and size. The active ingredient, what makes this work, is known as Sildenafil, or sildenafil citrate. It is the key active ingredient that makes Viagra and other ED pills work. 
 Although created to treat heart problems and low blood pressure, on finding it had other benefits, the FDA granted Pfizer the ability to sell this as an erectile dysfunction wonder drug around the world. However, in 2012, Pfizer lost the global patent and wasn’t able to recover it. 
What that meant is suddenly, other drugs manufacturers were able to get in on this market selling drugs where the main active ingredient is Sildenafil, or sildenafil citrate. So although no one else can sell Viagra, with that being a Pfizer brand, other companies can and do sell alternatives to men, with Sildenafil as the key active ingredient. You can purchase all of these with or without a prescription or doctors appointment; including buying them online or over the counter. 
The six most common and popular erectile dysfunction (ED) pills and medicines on the market are: Viagra, Cialis, Levitra, Staxyn, Stendra, and injections or the MUSE suppository. 
 Viagra: No article or any information about erectile dysfunction pills would be complete without this one, the famous little blue pill. Although there are many cheaper imitations in bar, pub and restaurant toilets – and of course online (not counting the list here, all of which are on the same level as the original, fully FDA approved, with the same or similar active ingredients), you can be in no doubt when you’ve bought and taken Viagra. It is more expensive than some of the others, with it being a globally protected brand of Pfizer. With erectile dysfunction impacting up to 21% of men across the world, many drugs companies, including Pfizer are now offering Viagra online and over the counter through select pharmacies. No need to see a doctor if you consider the problem a concern but not worrying enough to speak to a doctor about this.
Cialis is the brand name for a drug known as Tadalafil, also designed to treat erectile dysfunction. It can also contribute towards treatments for benign prostatic hyperplasia (BPH), and pulmonary arterial hypertension; both related to blood pressure, which puts it in the right medicine family to treat and manage the symptoms of ED. It was first released in 2003 in the U.S. and UK, mainly available on prescription and in some cases, over the counter and online.
Staxyn: also known as vardenafilhydrochloride, is an orally dissolving tablet designed by Bayer HealthCare Pharmaceuticals Inc., with global distribution through GlaxoSmithKline, which gained approval in 2003. The manufacturer recommends that “Sexual stimulation is required for a response to treatment.” It is known for being an effective cure for erectile dysfunction.
Stendra: known as a “second-generation” medicine for ED, it’s also statistically proven to help treat patients in “difficult to treat populations”, according to the manufacturer, Metuchen Pharmaceuticals, LLC. There are also fewer side effects with this medicine.
Levitra: also known as Vardenafil, this is sold under slightly different names in India and Italy – Staxyn and Vivanza, respectively. Unlike other ED medicine, in the UK and US it’s a prescription only drug to avoid recreational misuse.
Penile injections or the MUSE suppository: This treatment is either injected into the penis or placed on the tip of the penis. It is known for being more effective when injected, ensuring at least 80% of men who take this get an erection. Anyone with a penile implant should not take this drug in either format and it is usually only prescribed through a doctor.
 What happens if any of the above options don’t cure erectile dysfunction? 
 In the event of taking one of the pills listed in the table above and it not working, it’s worth considering trying one of the others. 
If in doubt, however, it is always useful to remember a few things when taking any medication to cure erectile dysfunction: 
1.       It’s also important to remember that these rarely work alone. You need to be stimulated and aroused for the active ingredient to start working. 
2.       Most if not all have some dietary restrictions or limitations, such as not taking after a big meal or drinking too much 
3.       In some cases, these pills don’t mix well with other medicine, such as that for blood pressure. Heart medication could interact in a negative way with any of the above pills, as can anything based on grapefruit.  
4.       It’s also important to remember that these rarely work alone. You need to be stimulated and aroused for the active ingredient to start working. 
5.       Other factors that can influence whether these work or not include general physical health and mental health. 
6.       Remember, taking this sort of medicine is generally speaking not a long-term solution, no matter how effective. Other dietary, health, lifestyle and mental health changes might be needed to ensure someone can get an erection naturally without relying permanently on medication. 
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