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FDA cannot confirm that the manufacturing, quality, storage, and handling of these products follow U.S. standards because these products are from an unknown source. Modern day, we have several new, exciting, experimental things, such as shockwave therapy of the penis or platelet-rich plasma or stem cell therapy. These are not ready for prime time, and so you should not, as a patient, have to spend your hard-earned money to see whether or not this works for you.
Reaction with other drugs – Some ED meds do not mix well with other prescriptions, presenting potentially dangerous outcomes. These drugs include nitrates (for chest pain/angina); alpha-blockers (enlarged prostate); and those that inhibit the enzyme CYP3A4 (a metabolizer in the liver and intestines). Both drugs consist of a slightly different chemical profile, which determines how fast the drug works, how soon it wears off, and the side effects. Viagra and Cialis are generally safe in most patients (with the exception of patients on nitrites); however, there are some things you should know in advance.