Straightforward care,
handled discreetly.

In-depth guide

A plain-language guide to erectile dysfunction treatment online

Erectile dysfunction (ED) means having trouble getting or keeping an erection firm enough for sex. It is common, it has many possible causes, and it is a medical issue rather than a personal failing. Causes can include blood vessel or heart conditions, diabetes, certain medicines, stress, and relationship factors. Because ED can sometimes be an early sign of another health problem, it is worth a real medical review.

This guide explains how our online process works, which options a licensed provider may consider, what they cost, and what you should know about safety before you start. It is general education, not medical advice. Clinical care is provided by licensed providers through our partner, Agile Telehealth. Prolong Health does not practice medicine, and a provider decides whether any treatment is right for you.

How the program works, step by step

1. Choose an option. Look at the options below and pick the one you want to ask about. This is only a starting point. Your provider may recommend something different, or decide that no medication is appropriate.
2. Complete a short online intake. You answer questions about your health history, your current medicines, and your symptoms. Be complete and honest. Details such as heart conditions, blood pressure, and every prescription or over-the-counter product you take change what is safe for you.
3. A licensed provider reviews your intake. In most cases the review is asynchronous, which means you do not need to be online at the same time as the provider. A live video visit happens only when your state requires it or when the provider needs one to make a safe decision.
4. Medication is ordered if appropriate. If the provider decides treatment is appropriate, the medication is ordered for you. A prescription is never guaranteed. If the provider has concerns, they may ask follow-up questions or advise you to see a doctor in person.
5. It ships discreetly. Approved medication is sent directly to you in discreet packaging.
6. Refills are reviewed every 12 weeks. Before a refill, a provider does another asynchronous review. This is a chance to report side effects, new medicines, or changes in your health.

What's included

• Review of your online intake by a licensed provider.
• A live video visit if your state requires one or the provider needs one.
• If prescribed, your medication, shipped discreetly.
• A provider review before each refill, every 12 weeks.
• No insurance billing. Care is cash-pay.

Pricing summary

Prolong Health is cash-pay. FSA and HSA cards, Visa, Mastercard, Apple Pay, and Google Pay are accepted. American Express is not accepted.

Single-dose vials come in 10-packs. The Quadruple (sildenafil, tadalafil, apomorphine, and L-citrulline) is $119 per 10-pack, about $12 per vial. The Triple (sildenafil, tadalafil, and apomorphine) is $109, about $11 per vial. The Double (sildenafil and tadalafil) is $99, about $10 per vial. "Go Long" (silodosin and tadalafil) is $99, about $10 per vial.

Fast-dissolving ODT or troche forms come in 6-packs and 12-packs. The Triple is $102 for 6 or $156 for 12. The Double is $96 for 6 or $144 for 12. Go Long is $96 for 6 or $144 for 12.

Daily Boost is tadalafil taken daily, in 2.5 mg or 5 mg tablets. A 28-tablet supply is $112.

These are compounded combination products. Whether any of them is appropriate for you is up to the provider.

Eligibility, safety and side effects

Sildenafil and tadalafil are PDE5 inhibitors. Like all medicines, they have risks. The points below are general information from public drug labels. Your provider will review the details that apply to you. The medicines offered here are compounded. Compounded medications are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they are marketed. They are also not the same as brand-name products.

Common side effects

• Headache.
• Flushing, meaning warmth or redness in the face.
• Stuffy or runny nose.
• Indigestion or upset stomach.
• Dizziness.
• Back or muscle aches.
• Silodosin is an alpha-blocker. It can cause dizziness or low blood pressure, and it can cause retrograde ejaculation, where semen goes backward into the bladder instead of out.
• Apomorphine can cause nausea, dizziness, low blood pressure, and drowsiness.

Serious risks and warnings

• Never combine sildenafil or tadalafil with nitrate medicines such as nitroglycerin. The combination can cause a dangerous drop in blood pressure.
• An erection that lasts 4 hours or longer (priapism) is a medical emergency. Go to an emergency room right away.
• Sudden loss of vision, or sudden hearing loss, is rare but serious. Stop the medicine and get medical care right away.
• Use extra caution if you take an alpha-blocker, have a heart condition, have had a heart attack or stroke recently, have very low or uncontrolled blood pressure, or have severe liver or kidney disease. Tell your provider about all of these.
• Sexual activity puts demand on the heart. If you have chest pain, dizziness, or nausea during sex, stop and seek care.

Do not take more than your provider and the label instruct. Do not share your medication with anyone. If you are unsure whether something is a side effect or an emergency, contact a medical professional or call 911.

Sources and further reading

• U.S. Food and Drug Administration: Compounding and the FDA, Questions and Answers
• MedlinePlus (National Library of Medicine): Sildenafil
• MedlinePlus (National Library of Medicine): Tadalafil
• MedlinePlus (National Library of Medicine): Silodosin
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Erectile Dysfunction

Frequently asked questions