Premature ejaculation is when ejaculation occurs earlier than desired, often within 1 minute of penetrative sex. It’s characterized by an inability to delay orgasm to the extent that it causes bother or frustration to the patient and/or their partner.
There are many possible causes of PE, ranging from physical causes to psychological causes. One of the problems with diagnosing and treating PE is that, until recently, there has not been agreement on its definition, and there’s no set “time to ejaculation” that defines PE.
If you feel you ejaculate too quickly during sex, treatment may be appropriate for you.
Can premature ejaculation be treated?
Yes. Although no single treatment works for everyone, many men can be treated successfully through over-the-counter topicals, prescription medication, behavior modification, or a combination of these treatments.
Some people see immediate results, but for many it takes time. Some men may need to try a few different methods before finding the right solution.
It’s estimated that 30% of men, of all age groups, suffer from PE (Montorsi, 2005)—although that number may be higher, since only a small fraction of men with PE talk with their doctor about it (Porst, 2007).
Treatments for premature ejaculation (PE)
We offer prescription medications and an OTC medication that is clinically proven to help you last longer.
Requires prescription through online visit with a U.S.-licensed healthcare professional
Roman Swipes
4% benzocaine wipes
$22/month
Starting at
Convenient, over-the-counter wipes. Made by Roman Health in USA.
Your doctor or nurse practitioner will decide which treatment option is most appropriate for you after reviewing the information you provide in your online visit.
For prescription treatment, your doctor or nurse practitioner will decide which treatment option is most appropriate for you after reviewing the information you provide in your online visit.
For Roman Swipes, apply disposable Swipe to the most sensitive parts of the penis. Allow to dry for about 5 minutes.
Our treatments are backed by real data and trusted by real medical professionals. No snake oil, no gimmicks.
88% of participants using benzocaine wipes were no longer considered to have PE at the end of two months (Shabsigh, 2019).
Member stories
“Great service, I always get my prescription fast, customer service is awesome they always answer my questions and the product is as good as the brand name prescription I got in the past”
Roman member
“Never saw myself wanting or needing this stuff, but when the time came – so did I! The process was easy, the product is discreet, and let me tell ya parties on both sides of the aisle were singing from the same song sheet. Great job, Roman!”
Roman member
“Just wanted to say how affordable and easy using Roman has been. Very happy with the outcome and the medication. Recommend to anyone who may be dealing with any of the issues that they can help with.”
Roman member
Side effects
We believe in transparency. These are the side effects that patients may experience as a result of using PE medication.
If you’re allergic to benzocaine, you might experience typical skin symptoms like redness and swelling. Contact your primary care provider if you notice any reaction
The medications available for treating PE work for the vast majority of patients with a low risk of causing side effects. However, just as no drug works on everyone, no drug is 100% safe—and these treatments are no exception. The potential side effects depend on which medication you use, so be sure to check out each medication’s Important Safety Information for specifics. To reduce the risk of side effects, your doctor or nurse practitioner will work with you to find the lowest effective dose of the medication. This is the dose at which the medication still works but is least likely to have any adverse effects.
Discuss it all with your healthcare professional
Concerned about the potential side effects of treatment? Not a problem. You’ll be matched with a U.S.-licensed healthcare professional who will offer guidance, answer your questions, and help if you experience any side effects.
Pricing
With Roman, all you’ll ever pay for is the cost of your medication. No co-pays, no insurance claims, no hassles.
Next, we will ask some questions about your symptoms and medical history to see if treatment is right for you.
Starting price for prescription PE treatment* $2/dose
Your first visit with a doctor or nurse practitionerFree
2-day shipping on medicationsFree
All future visits with your doctor or nurse practitionerFree
Total$2 per dose
* Note that price may vary based on strength and frequency of use
How Roman Works
Technology has enabled a massive shift in the way healthcare can be provided. With Roman, you can receive expert quality care from your phone or computer, without ever leaving the comfort of home.
Do everything right from your mobile device
Free 2-day shipping (discretely packaged)
No commitments – cancel whenever you want
The roman way
Answer a few questions about your health.Report your symptoms and medical history to a U.S.-licensed healthcare professional who will determine the treatment best suited for you and then follow up via secure messaging in your Roman portal.
Receive free, 2-day shipping for treatment.If treatment is prescribed, you’ll receive it within 2 days—packaged discreetly and shipped for free.
Get free follow ups for ongoing care.Continue to take and adjust your treatments. Schedule follow-ups with your physician or nurse practitioner. Note: you should continue to receive regular, in-person care in addition to using Roman.
The old way
Find a doctor who accepts your insurance
Make an appointment with the doctor
Travel to the doctor’s office
Sit in the waiting room until the doctor is ready for you
Consult with the doctor to get your prescription
Drive to the pharmacy to pick up your prescription
Everything Roman does is scientifically backed and vetted by leading experts in men’s health. We’re changing healthcare for good, and we know it’s worth it. Because when men feel better, the people who love them do, too.
In the news
iPharmacy Roman fights stigmas with premature ejaculation meds
There’s a war brewing to become the cloud pharmacy for men’s health. Roman, which launched last year offering erectile …
Next, we will ask some questions about your symptoms and medical history to see if treatment is right for you.
FAQs
For any additional questions, please reach out to care@ro.co. We can also be reached by phone at (888) 798-8686, Monday – Friday, 9:30am-5pm EST.
How does prescription PE treatment work with Roman?
Roman is a telemedicine company that provides a discreet, convenient, and affordable way for you to receive PE treatment from a doctor or nurse practitioner—all without leaving the couch. Roman Swipes are available for purchase directly from the website as an over-the-counter (OTC) product that does not require a prescription. If you are interested in prescription treatment, it starts with an online visit. The online visit will ask you about your symptoms, your medical history, and other basic information. You’ll also be asked to upload a photo of your ID to verify your identity. Once you have done all of this, a doctor or nurse practitioner will review everything, determine if you’re a candidate for PE treatment through telemedicine, and craft a personalized treatment plan for you.
Is PE medication effective?
Although no single treatment works for everyone, most men can be treated successfully. There are multiple oral medications, topical therapies, and other techniques that can be used alone or in combination with one another. Some people see immediate results, but for many men it takes some time before results are apparent. Some may find they need to try a few different methods before finding the right solution. If things don’t go as planned or if you experience an adverse side effect, don’t give up. You have options and we are here to help you find the best solution.
Why is ED medication sometimes prescribed for PE?
There are many possible causes of PE, ranging from physical causes to psychological causes. Although it may seem odd to get prescribed ED medication for PE, numerous studies have shown that it can be effective. There are a few reasons ED medication might help:
ED medication can help relax the smooth muscles of organs involved in ejaculation
ED medication can affect the nervous system in ways that may delay ejaculation
ED medication may decrease the sensitivity of the penis
ED medication can prolong the duration of an erection, increasing confidence, the perception of ejaculatory control, and overall sexual satisfaction
ED medication can make it easier to get a second erection after ejaculation
Some patients may also have coexisting ED and PE. For these patients, it is recommended ED get treated first, to see if it has beneficial effects on PE.
There are also other important differences between the medications. For example, sildenafil citrate is less effective when taken with food and it can cause temporary blue vision (as if you’re looking through blue-tinted glasses) in some users. Tadalafil can be taken with food and is much less likely to cause temporary blue vision in users. Tadalafil can also be taken daily at lower doses.
What are the non-prescription options for treating PE?
Your doctor or nurse practitioner may recommend a combination of medication and behavioral therapy tips to deal with PE. No two people are alike, and it may take time and experimentation to find the methods that work best for you. Some recommended non-prescription techniques include:
Topical anesthetics: Topical anesthetics can be applied to the penis just before sexual activity. They come as creams, lotions, or sprays and are available over-the-counter. The advantage of topical applications is that the side effect rate is low.
Condoms: Condoms can help with PE by decreasing penile sensitivity. They also have the added benefit of reducing the risk of sexually transmitted infections and unwanted pregnancy.
Behavioral modification: The squeeze and stop-start techniques are two different strategies that can be practiced during masturbation or sexual activity, and—over time—they can improve control over the timing of ejaculation.
Psychotherapy: Counseling, whether in person, by telephone, or by text messaging, may increase the likelihood of success for some patients.
Will ED medication automatically give me an erection?
There are three prescription-strength medications for PE available on the Roman platform: sildenafil citrate (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis), and sertraline (a type of medication known as a selective serotonin reuptake inhibitor, or SSRI). Your doctor or nurse practitioner will decide which treatment option is most appropriate for you after reviewing the information you provide in your online visit. While one medication may be better for one person, a different medication may be better for another person. It all depends on your specific medical history, symptoms, and preferences. Of note, there is no medication that is specifically FDA-approved for the treatment of PE. However, sildenafil citrate, tadalafil, and sertraline can be prescribed off-label for this purpose, if appropriate.
In addition to these three prescription medications, Roman Swipes is an over-the-counter treatment for PE that you can purchase directly from the website without going through an online visit.
What is off-label usage of a medication?
Off-label usage of a medication refers to using the medication for purposes that have not specifically been approved by the FDA. Healthcare professionals have the discretion to prescribe medications off-label if they believe it is an appropriate course of treatment for a particular patient.
How is sertraline used to treat PE?
Sertraline can be used in two ways to treat PE. It can be taken daily at a convenient time (e.g., after brushing your teeth in the morning) or it can be taken as-needed 4–8 hours before you plan to have sex. Studies have found that taking the medication daily is generally more effective than taking it as needed. However, taking the medication daily also increases the risk of experiencing side effects. Your doctor or nurse practitioner can work with you to help determine if daily or as-needed dosing is best for you.
Can I use Roman Swipes along with prescription treatment?
Yes. Using Roman Swipes in combination with prescription treatment is not dangerous and can actually help delay ejaculation even more. This is especially good for patients who do not see enough of a benefit from prescription medication alone. On the other hand, some people will find that the combination delays ejaculation too much, decreasing satisfaction for them or their partner(s).
What is the most important information I should know about sertraline (ZOLOFT) ?
Sertraline and other antidepressant medicines may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms, or call 911 if there is an emergency.
1. Suicidal thoughts or actions:
Sertraline and other antidepressant medicines may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.
Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe.
Pay particular attention to such changes when sertraline is started or when the dose is changed.
Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:
attempts to commit suicide
acting aggressive or violent
new or worse depression
feeling agitated, restless, angry or irritable
an increase in activity or talking more than what is normal for you
acting on dangerous impulses
thoughts about suicide or dying
new or worse anxiety or panic attacks
trouble sleeping
other unusual changes in behavior or mood
2. Serotonin Syndrome. This condition can be life-threatening and symptoms may include:
agitation, hallucinations, coma, or other changes in mental status
coordination problems or muscle twitching (overactive reflexes)
racing heartbeat, high or low blood pressure
nausea, vomiting, or diarrhea
sweating or fever
muscle rigidity
3. Increased chance of bleeding: Sertraline and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin.
4. Manic episodes. Symptoms may include:
greatly increased energy
racing thoughts
unusually grand ideas
severe trouble sleeping
reckless behavior
excessive happiness or irritability
talking more or faster than usual
5. Seizures or convulsions.
6. Glaucoma (angle-closure glaucoma). Many antidepressant medicines including sertraline may cause a certain type of eye problem called angle-closure glaucoma. Call your healthcare provider if you have eye pain, changes in your vision, or swelling or redness in or around the eye. Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.
7. Changes in appetite or weight. Children and adolescents should have height and weight monitored during treatment.
8. Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this. Symptoms may include:
Headache
weakness or feeling unsteady
confusion, problems concentrating or thinking, or memory problems
Do not stop sertraline without first talking to your healthcare provider. Stopping sertraline too quickly may cause serious symptoms including:
anxiety, irritability, high or low mood, feeling restless or changes in sleep habits
headache, sweating, nausea, dizziness
electric shock-like sensations, shaking, confusion
What is sertraline (ZOLOFT)?
Sertraline is a prescription medicine used to treat:
Major Depressive Disorder (MDD)
Panic Disorder
Social Anxiety Disorder
Obsessive Compulsive Disorder (OCD)
Posttraumatic Stress Disorder (PTSD)
Premenstrual Dysphoric Disorder (PMDD)
It is important to talk with your healthcare provider about the risks of treating depression and also the risks of not treating it. You should discuss all treatment choices with your healthcare provider.
Sertraline is safe and effective in treating children with OCD age 6 to 17 years. It is not known if sertraline is safe and effective for use in children under 6 years of age with OCD or children with other behavior health conditions. Talk to your healthcare provider if you do not think that your condition is getting better with sertraline treatment.
Who should not take sertraline (ZOLOFT)?
Do not take sertraline if you:
take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.
have taken an MAOI within 2 weeks of stopping sertraline unless directed to do so by your healthcare provider.
have stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider.
take any other medicines that contain sertraline (such as sertraline HCl or sertraline hydrochloride).
take the antipsychotic medicine pimozide (Orap®) because this can cause serious heart problems.
are allergic to sertraline or any of the ingredients in sertraline. See the end of this Medication Guide for a complete list of ingredients in sertraline.
take Antabuse® (disulfiram) (if you are taking the liquid form of sertraline) due to the alcohol content.
People who take sertraline close in time to an MAOI may have serious or even life-threatening side effects. Get medical help right away if you have any of these symptoms:
high fever
rapid changes in heart rate or blood pressure
uncontrolled muscle spasms
confusion
stiff muscles
loss of consciousness (pass out)
What should I tell my healthcare provider before taking sertraline (ZOLOFT)?
Before starting sertraline, tell your healthcare provider if you have:
liver problems
heart problems
bipolar disorder or mania
kidney problems
or have had seizures or convulsions
low sodium levels in your blood
a history of a stroke
high blood pressure
or have had bleeding problems
Are pregnant or plan to become pregnant. Your baby may have withdrawal symptoms after birth or may be at increased risk for a serious lung problem at birth. Talk to your healthcare provider about the benefits and risks of taking sertraline during pregnancy.
Are breastfeeding or plan to breastfeed. A small amount of sertraline may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking sertraline.
Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Sertraline and some medicines may interact with each other, may not work as well, or may cause serious side effects
Your healthcare provider or pharmacist can tell you if it is safe to take sertraline with your other medicines. Do not start or stop any medicine while taking sertraline without talking to your healthcare provider first.
Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.
How should I take sertraline (ZOLOFT)?
Take sertraline exactly as prescribed. Your healthcare provider may need to change the dose of sertraline until it is the right dose for you.
Sertraline Tablets may be taken with or without food.
Sertraline Oral Solution may look cloudy or hazy after mixing, this is normal.
Sertraline Oral Solution must be diluted before use
Do not mix sertraline until you are ready to take it.
When diluting sertraline Oral Solution, use only water, ginger ale, lemon/lime soda, lemonade, or orange juice.
The oral dropper contains latex. If you are sensitive or allergic to latex, ask your healthcare provider or pharmacist about the best way to measure your medicine.
If you miss a dose of sertraline, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of sertraline at the same time
If you take too much sertraline, call your healthcare provider or poison control center right away, or go to the nearest hospital emergency room right away.
What should I avoid while taking sertraline (ZOLOFT)?
Sertraline can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how sertraline affects you. Do not drink alcohol while you take sertraline.
What are the possible side effects of sertraline (ZOLOFT)? Sertraline may cause serious side effects, including
The most common side effects in adults who take sertraline include:
nausea, loss of appetite,
diarrhea, or indigestion
increased sweating
tremor or shaking
agitation
change in sleep habits including increased sleepiness or insomnia
sexual problems including decreased libido and ejaculation failure
feeling tired or fatigued
anxiety
The most common side effects in children and adolescents who take sertraline include abnormal increase in muscle movement or agitation, nose bleeds, urinary incontinence, aggressive reaction, possible slowed growth rate, and weight change. Your child’s height and weight should be monitored during treatment with sertraline.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of sertraline. For more information, ask your healthcare provider or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
How should I store sertraline?
Store sertraline at room temperature, 68°F to 77°F (20°C to 25°C).
Keep sertraline bottle closed tightly.
Keep sertraline and all medicines out of the reach of children.
General information about the safe and effective use of sertraline:
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use sertraline for a condition for which it was not prescribed. Do not give sertraline to other people, even if they have the same condition. It may harm them. This Medication Guide summarizes the most important information about sertraline. If you would like more information, talk with your healthcare provider. You may ask your healthcare provider or pharmacist for information about sertraline that is written for healthcare professionals.
For more information about sertraline call 1-800-438-1985 or go to www.pfizer.com
What are the ingredients in sertraline?
Active ingredient: sertraline hydrochloride
Inactive ingredients: Tablets: dibasic calcium phosphate dihydrate, D&C Yellow #10 aluminum lake (in 25 mg tablet), FD&C Blue #1 aluminum lake (in 25 mg tablet), FD&C Red #40 aluminum lake (in 25 mg tablet), FD&C Blue #2 aluminum lake (in 50 mg tablet), hydroxypropyl cellulose, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate, synthetic yellow iron oxide (in 100 mg tablet), and titanium dioxide. Oral solution: glycerin, alcohol (12%), menthol, butylated hydroxytoluene (BHT)
Popular Questions
The PDR states that it is not recommended to drink alcohol while taking sertraline although there is no known interaction between sertraline and alcohol.
There is no major drug interaction between sertraline and alcohol. However, the manufacturer of Zoloft (brand name for sertraline) recommends against using sertraline with alcohol.
Sertraline can be used in two ways to treat P.E. It can be taken daily at a convenient time (e.g. after brushing your teeth in the morning) or it can be taken 4-8 hours before you plan to have sex. Daily use is generally more effective. However, some people may prefer to take a pill only when they plan to have sex instead of daily. For example: people who have sex once or twice a month may not want to take a pill daily. Some people also may just not like the idea of having to take medicine every day.
Sertraline can be taken with or without food. Grapefruit juice may increase sertraline levels in the blood by inhibiting the breakdown of sertraline.
Yes, you can get a prescription through a quick and easy online visit, if determined appropriate by a network of U.S. licensed physicians.
Important safety information
Sildenafil 20mg (generic revatio)
Read this Patient Information before you start taking sildenafil 20 mg (Revatio) and each time you get a refill. There may be new information. This information does not take the place of talking with your doctor about your medical condition or treatment. If you have any questions about sildenafil, ask your doctor or pharmacist.
What is the most important information I should know about sildenafil 20 mg tablets (Revatio)?
Never take sildenafil with any nitrate medicines. Your blood pressure could drop quickly to an unsafe level. Nitrate medicines include:
Medicines that treat chest pain (angina)
Nitroglycerin in any form including tablets, patches, sprays, and ointments
Isosorbide mononitrate or dinitrate
Street drugs called “poppers” (amyl nitrate or nitrite)
Ask your doctor or pharmacist if you are not sure if you are taking a nitrate medicine.
What is sildenafil 20 mg tablets (Revatio)?
20 mg sildenafil is a prescription medicine used in adults to treat pulmonary arterial hypertension (PAH). With PAH, the blood pressure in your lungs is too high. Your heart has to work hard to pump blood into your lungs. It improves the ability to exercise and can slow down worsening changes in your physical condition.
Sildenafil is not for use in children
Adding sildenafil to another medication used to treat PAH, bosentan (Tracleer®), does not result in improvement in your ability to exercise.
20 mg sildenafil tablets contain the same medicine as VIAGRA® (sildenafil), which is used to treat erectile dysfunction (impotence). Do not take 20 mg sildenafil tablets with VIAGRA or other PDE-5 inhibitors.
Who should not take sildenafil 20 mg tablets (Revatio)?
Do not take sildenafil if you:
Take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
Are allergic to sildenafil, as contained in VIAGRA® and REVATIO®
You’ve ever had blockage of veins in your lungs, which is called pulmonary veno-occlusive disease
Are a women or a child
Before you take sildenafil, tell your healthcare provider if you:
Have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
Have had heart surgery within the last 6 months
Have pulmonary hypertension
Have had a stroke
Have low blood pressure, or high blood pressure that is not controlled
Have a deformed penis shape
Have had an erection that lasted for more than 4 hours
Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
Have ever had severe vision loss, including an eye problem called NAION
Have bleeding problems
Have or have had stomach or intestinal ulcers
Have liver problems
Have kidney problems or are having kidney dialysis
Have any problem with the shape of your penis or Peyronie’s disease
Have any other medical conditions
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Sildenafil may affect the way other medicines work, and other medicines may affect the way sildenafil works, causing side effects.
Especially tell your healthcare provider if you take any of the following:
Medicines called nitrates
Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn®(dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase®or Invirase®), or atazanavir sulfate (Reyataz®)
Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
Other medicines that treat high blood pressure
K antagonists (like coumadin or warfarin)
Other medicines or treatments for ED
Sildenafil is the same medicine found in VIAGRA® and REVATIO®. REVATIO® is used to treat a rare disease called pulmonary arterial hypertension (PAH). VIAGRA® should not be used with REVATIO® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])
Know the medicines you take. Keep a list of your medicines and show it to your doctor and pharmacist when you get a new medicine.
Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.
How should I take sildenafil 20 mg tablets (Revatio)?
Take sildenafil exactly as your doctor tells you.
Sildenafil may be prescribed to you as tablets or an oral suspension
Take sildenafil tablet or oral suspension 3 times a day about 4 to 6 hours apart
Take sildenafil tablets or oral suspension at the same times every day.
Sildenafil oral suspension will be mixed for you by your pharmacist. Do not mix sildenafil oral suspension with other medicine or flavoring. Shake well for at least 10 seconds before each dose.
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose, and take your next dose at the regular time.
Do not take more than one dose of sildenafil at a time.
Do not change your dose or stop taking sildenafil on your own. Talk to your doctor first.
If you take too much sildenafil, call your doctor or go to the nearest hospital emergency room.
What are the possible side effects of sildenafil 20 mg tablets (Revatio)?
low blood pressure. Low blood pressure may cause you to feel faint or dizzy. Lie down if you feel faint or dizzy.
more shortness of breath than usual. Tell your doctor if you get more short of breath after you start REVATIO. More shortness of breath than usual may be due to your underlying medical condition.
decreased eyesight or loss of sight in one or both eyes (NAION). If you notice a sudden decrease or loss of eyesight, talk to your doctor right away.
sudden decrease or loss of hearing. If you notice a sudden decrease or loss of hearing, talk to your doctor right away. It is not possible to determine whether these events are related directly to this class of oral medicines, including REVATIO, or to other diseases or medicines, to other factors, or to a combination of factors.
heart attack, stroke, irregular heartbeats, and death. Most of these happened in men who already had heart problems.
erections that last several hours. Tell your doctor right away if you have an erection that lasts more than 4 hours.
The most common side effects with sildenafil 20 mg tablets (Revatio) include:
Nosebleed
Headache
upset stomach
getting red or hot in the face (flushing)
trouble sleeping
Fever
erection increased
respiratory infection
Nausea
Vomiting
Bronchitis
Pharyngitis
runny nose
pneumonia in children
Tell your doctor if you have any side effect that bothers you or doesn’t go away.These are not all the possible side effects of REVATIO. For more information, ask your doctor or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How should I store sildenafil 20 mg tablets (Revatio)?
Store tablets at controlled room temperature, between 20°C -25°C (68°F to 77°F).
Store constituted oral suspension below 30°C (86°F) or in a refrigerator between 2°C to 8°C (36°F to 46°F). Do not freeze oral suspension.
Throw away oral suspension after 60 days.
Keep all medicines away from children.
General information about sildenafil 20 mg tablets (Revatio)
Medicines are sometimes prescribed for purposes that are not in the patient leaflet. Do not use REVATIO for a condition for which it was not prescribed. Do not give REVATIO to other people, even if they have the same symptoms you have. It could harm them.
This patient leaflet summarizes the most important information about REVATIO. If you would like more information about REVATIO talk with your doctor. You can ask your doctor or pharmacist for information about REVATIO that is written for health professionals.For more information go to www.REVATIO.com or call 1-800-879-3477.
What are the ingredients in sildenafil 20 mg tablets (Revatio)? Active ingredients: sildenafil citrate Inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose monohydrate, and triacetin
Important safety information
Cialis
Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.
What is Cialis?
Cialis® is a drug that is used to treat erectile dysfunction (ED). It comes in four doses, 2.5 mg, 5 mg, 10 mg, and 20 mg. Cialis® can be taken as needed in any of the four doses. The 2.5 mg and 5 mg doses are also approved for daily use for ED. Cialis® in the 2.5 mg and 5 mg doses is also FDA-approved for men suffering from urinary symptoms due to benign prostatic hyperplasia (BPH) with or without ED. Physicians on the Roman platform physicians do not currently treat BPH. If you feel you need Cialis for the treatment of BPH, please seek in-person care. For as needed dosing, the 10 mg dose is the most commonly used dose, although some people may benefit from higher or lower doses. Cialis® is part of a “family” of medicines used to treat ED called phosphodiesterase-5 inhibitors (PDE5i). Other drugs in this family include Viagra (sildenafil), Levitra (vardenafil), and Stendra (avanafil). All of these drugs have the same mechanism of action, but there are subtle differences that may lead the doctor to recommend one drug over the other based on your treatment goals.
Does Roman Offer Genuine Cialis?
Roman offers branded Cialis® and its generic, tadalafil, to treat ED. They are both FDA-approved to treat ED. They can be taken as needed (from 2.5 mg to 20 mg) or daily (in the 2.5 mg and 5 mg doses) to treat ED.
What is Cialis?
Cialis® is a drug that is used to treat erectile dysfunction (ED). It comes in four doses, 2.5 mg, 5 mg, 10 mg, and 20 mg. Cialis® can be taken as needed in any of the four doses. The 2.5 mg and 5 mg doses are also approved for daily use for ED. Cialis® in the 2.5 mg and 5 mg doses is also FDA-approved for men suffering from urinary symptoms due to benign prostatic hyperplasia (BPH) with or without ED. Physicians on the Roman platform physicians do not currently treat BPH. If you feel you need Cialis for the treatment of BPH, please seek in-person care. For as needed dosing, the 10 mg dose is the most commonly used dose, although some people may benefit from higher or lower doses. Cialis® is part of a “family” of medicines used to treat ED called phosphodiesterase-5 inhibitors (PDE5i). Other drugs in this family include Viagra (sildenafil), Levitra (vardenafil), and Stendra (avanafil). All of these drugs have the same mechanism of action, but there are subtle differences that may lead the doctor to recommend one drug over the other based on your treatment goals.
What is Tadalafil?
Tadalafil is the chemical name of the active ingredient in Cialis®. Cialis® was originally patented and sold by Eli Lilly. It is FDA-approved to treat ED and urinary symptoms due to BPH. After the patent expired in 2018, the FDA gave permission to other drug companies to manufacture a generic version of Cialis®. The FDA requires generic drugs to be bioequivalent to the brand name version. This means that they act the same way in the body and are expected to produce the same effects as the original brand name drug. Generic drugs are generally much cheaper than the original brand name drug, and most drugs prescribed in the US are generic.
Does Roman Offer Genuine Cialis?
Roman offers branded Cialis® and its generic, tadalafil, to treat ED. They are both FDA-approved to treat ED. They can be taken as needed (from 2.5 mg to 20 mg) or daily (in the 2.5 mg and 5 mg doses) to treat ED.
How Does Cialis Work?
In order to understand how Cialis® works to treat ED, it’s important to first understand the basics of how erections work. Erotic stimulation (by physical touch, erotic thoughts, smells, etc.) causes the local tissues to release nitric oxide (NO), which increases the amount of a chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscles on the sides of the penis, the corpora cavernosa, to relax allowing blood to rush into the penis. At the same time veins that drain blood from the penis get compressed causing the increased blood to be trapped in the penis causing an erection. An enzyme called phosphodiesterase-5 breaks down cGMP leading the penis to return to its flaccid state. PDE5i, like Cialis®, block this enzyme leading to higher levels of cGMP and improving the ability to obtain and maintain an erection.
How Should I Take Cialis?
Cialis® should be taken at least 30–60 minutes before sex. Cialis is a long acting drug and will stay active in your body for up to 36 hours, which is sometimes why it’s nicknamed “the weekend pill.” Some people have better results when they take Cialis® at least 2 hours before sex. Cialis® absorption is not affected by food and can be taken with or without food.
What is Daily Cialis?
In addition to as needed dosing, Cialis® is also approved for daily use in the 2.5 mg and 5 mg doses. This creates a steady amount of medicine in the blood and completely eliminates the need to plan for sex. With daily Cialis®, treatment for ED becomes part of your daily routine. Most men who are eligible for ED treatment can take daily Cialis® with certain exceptions, including airline pilots, air traffic controllers, and people taking certain medicines (e.g., some HIV medicines, certain antibiotics and antifungals). You should speak with your doctor to determine if daily Cialis is an appropriate treatment option for you.
What Should You Know Before Taking Cialis
Contraindications
Who should not take Cialis® or generic Cialis®?Do not take Cialis® or generic Cialis® if you:
take medicines called nitrates (such as nitroglycerin)
use street drugs called “poppers” such as amyl nitrate or amyl nitrite, and butyl nitrate
take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)
are allergic to Cialis® or any of the ingredients in Cialis®. See the end of this section for a complete list of ingredients in Cialis®.
What should I tell my healthcare provider before taking Cialis® or generic Cialis®?
To make sure Cialis® is safe for you, tell your healthcare provider if you have any of the following before you take Cialis® or generic Cialis®:
Have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
Have had heart surgery within the last 6 months
Have pulmonary hypertension
Have had a stroke
Have low blood pressure, or high blood pressure that is not controlled
Have a deformed penis shape
Have had an erection that lasted for more than 4 hours
Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
Have ever had severe vision loss, including an eye problem called NAION
Have bleeding problems
Have or have had stomach or intestinal ulcers
Have liver problems
Have kidney problems or are having kidney dialysis
Have any other medical conditions
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Cialis® and generic Cialis® may affect the way other medicines work, and other medicines may affect the way Cialis® and generic Cialis® works, causing side effects.
Drug Interactions
Tell your healthcare provider if you take any of the following because these drugs interact with Cialis® and generic Cialis®:
Medicines called nitrates
Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Cialis® or generic Cialis® with alpha-blockers can lead to a drop in blood pressure or to fainting
Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
Other medicines that treat high blood pressure
Other medicines or treatments for ED
Adcirca® (tadalafil) is used to treat a rare disease called pulmonary arterial hypertension (PAH) and has the same active ingredient as Cialis®. Cialis® and generic Cialis® should not be used with Adcirca® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Revatio® [sildenafil citrate])
Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.
Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.
Cialis® Side Effects
What are the possible side effects of Cialis® and generic Cialis®? Cialis® and generic Cialis® can cause serious side effects. Rarely reported side effects include:
an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). It is uncertain whether PDE5 inhibitors directly cause the vision loss. Stop taking Cialis® and call your healthcare provider right away if you have sudden vision loss in one or both eyes.
sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Cialis® or generic Cialis® and contact a doctor right away.
The most common side effects of Cialis® and generic Cialis® are:
headache
flushing
upset stomach
abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
stuffy or runny nose
back pain
muscle pain
nausea
dizziness
Rash
In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking Cialis®. Most, but not all, of these men had heart problems before taking Cialis®. It is not known if Cialis® caused these problems.
Tell your healthcare provider if you have any side effect that bothers you or does not go away.
These are not all the possible side effects of Cialis® and generic Cialis®. For more information, ask your healthcare provider or pharmacist, or see the full Prescribing Information for Cialis®.
Talk to your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What Happens if I Overdose?
Taking more than the recommended amount of Cialis® or generic Cialis® greatly increases your risk of side effects, including severe ones that can be dangerous, such as severe low blood pressure or an erection that won’t go away even after 4 or more hours (priapism). Never take more than the amount prescribed to you by your doctor. If you have any severe side effects after taking more than the recommended amount, or even after taking the amount of medicine prescribed to you, seek out emergency medical attention immediately.
Popular questions
Physicians should inform patients that substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS can increase the potential for side effects.
No. Do not exceed one dose in a 24 hour period
You can eat normally. Except, it is worth noting grapefruit juice can possibly affect the absorption of Cialis (Tadalafil).
Yes, you can get a prescription through a Roman online visit for Erectile Dysfunction or an online visit for Premature Ejaculation, if determined appropriate by a U.S. licensed physician.
