But later, BlueChew introduced a third option: chewable vardenafil, the active ingredient in Levitra. BlueChew offers ED prescriptions through an online portal, allowing you to have medication delivered straight to your door wherever you live in the United States (as long as that isn’t North Dakota), without any physical doctor’s visit or trip to a pharmacy. While it may have been the first, BlueChew is no longer the only company to do all of this. It’s among a widening group of providers offering compounded forms of well-studied prescription ED medications.
These compounded drugs have the same therapeutic potency as traditional, brand-name pills. Dosages do vary from company to company, which is something we’ll outline later in this guide since it can affect the likelihood of side effects. The company recently introduced a daily version of its tadalafil chew. (Previously, only an as-needed version of tadalafil was available.) The main difference between daily and as-needed tadalafil prescriptions tends to be dosage, though BlueChew’s daily chew does include supportive supplemental ingredients. Some of these, such as vitamin D and folic acid, are even present at levels that studies indicate could be beneficial for men trying to address ED.37 38 Only a medical professional — like the kind affiliated with BlueChew or its competitors, or a doctor you’d see in a traditional office — can determine if you’re a safe and suitable candidate for these medications. If you are, it means the medical professional has reviewed pertinent details about your medical history, health, and current medications and concluded that using one of these medications will likely help address your ED symptoms without posing a serious risk to your health. But if you are approved, it does not guarantee you’ll experience no side effects. In fact, side effects are not uncommon. Thankfully, they tend to be very mild, with few people discontinuing treatment because of them.
But later, BlueChew introduced a third option: chewable vardenafil, the active ingredient in Levitra. BlueChew offers ED prescriptions through an online portal, allowing you to have medication delivered straight to your door wherever you live in the United States (as long as that isn’t North Dakota), without any physical doctor’s visit or trip to a pharmacy. While it may have been the first, BlueChew is no longer the only company to do all of this. It’s among a widening group of providers offering compounded forms of well-studied prescription ED medications. These compounded drugs have the same therapeutic potency as traditional, brand-name pills.
Dosages do vary from company to company, which is something we’ll outline later in this guide since it can affect the likelihood of side effects. The company recently introduced a daily version of its tadalafil chew. (Previously, only an as-needed version of tadalafil was available.) The main difference between daily and as-needed tadalafil prescriptions tends to be dosage, though BlueChew’s daily chew does include supportive supplemental ingredients. Some of these, such as vitamin D and folic acid, are even present at levels that studies indicate could be beneficial for men trying to address ED.37 38 Only a medical professional — like the kind affiliated with BlueChew or its competitors, or a doctor you’d see in a traditional office — can determine if you’re a safe and suitable candidate for these medications. If you are, it means the medical professional has reviewed pertinent details about your medical history, health, and current medications and concluded that using one of these medications will likely help address your ED symptoms without posing a serious risk to your health.
But if you are approved, it does not guarantee you’ll experience no side effects. In fact, side effects are not uncommon. Thankfully, they tend to be very mild, with few people discontinuing treatment because of them. In our surveying the landscape of available ED treatments — prescription medications, over-the-counter options like supplements, and various devices you’d use at home or in a clinical setting — none currently offer the same combination of effectiveness, safety, affordability, and convenience as the treatments BlueChew offers. To understand why BlueChew’s ED medications would cause side effects and also why those side effects would vary from drug to drug, it’s useful to know a few basic details of how the medications work. In our surveying the landscape of available ED treatments — prescription medications, over-the-counter options like supplements, and various devices you’d use at home or in a clinical setting — none currently offer the same combination of effectiveness, safety, affordability, and convenience as the treatments BlueChew offers. To understand why BlueChew’s ED medications would cause side effects and also why those side effects would vary from drug to drug, it’s useful to know a few basic details of how the medications work. All of BlueChew’s medications are PDE5 inhibitors, a class that also includes relative newcomer avanafil (Stendra), which BlueChew does not yet offer.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 25mg | 30 + 4 Pills | 47.97€ 45.69€ | |
| Kamagra Soft Tabs | 100mg | 12 Pills | 57.55€ 54.81€ | |
| Viagra Generic | 100mg | 360 + 10 Pills | 330.21€ 314.49€ | |
| Viagra Generic | 150mg | 60 + 4 Pills | 111.25€ 105.95€ | |
| Viagra Generic | 200mg | 120 + 8 Pills | 204.80€ 195.05€ | |
| Kamagra | 100mg | 20 Pills | 86.09€ 81.99€ | |
| Kamagra Polo | 100mg | 60 + 4 Pills | 189.39€ 180.37€ | |
| Viagra Generic | 50mg | 10 Pills | 26.87€ 25.59€ | |
| Kamagra Oral Jelly | 100mg | 30 + 5 Sachets | 136.20€ 129.71€ | |
| Viagra Generic | 50mg | 360 + 10 Pills | 225.33€ 214.60€ | |
| Kamagra Oral Jelly | 100mg | 220 + 18 Sachets | 662.24€ 630.70€ | |
| Kamagra Polo | 100mg | 32 Pills | 125.88€ 119.89€ |
PDE5 stands for “phosphodiesterase type 5.” (You can see why people use the abbreviation.) Phosphodiesterases are a superfamily of enzymes that act as regulators of signals being sent within cells. As the number in PDE5 would suggest, there are numerous families of phosphodiesterase that have been identified — 11, to be precise (PDE1 through PDE11) — and they all have different effects on the human body.3 Scientists further divide these families into subtypes and splice variants. As BlueChew’s medications are all PDE5 inhibitors, they all temporarily prevent PDE5 from doing what it normally would do in your body… which makes it useful to understand what PDE5 ordinarily does. You may sildenafil 100mg lowest price or may not have heard of the chemical, nitric oxide (NO). Some people take dietary supplements to increase NO in their bodies, typically with goals involving exercise performance, sexual performance, or general cardiovascular health.
As-needed BlueChew tadalafil comes in 6mg or 9mg doses, while daily tadalafil from BlueChew is 9mg. Tadalafil is a longer-acting sildenafil pfizer 100g drug than either of BlueChew’s other treatments. Despite its differences, as it’s a PDE5 inhibitor, tadalafil is capable of causing several of the same side effects as the two other BlueChew medications. The most common side effects of tadalafil are mild and include:11 Dyspepsia (discomfort in the upper abdomen caused by stomach upset) Nasal congestion, runny nose, and/or sneezing Notice that this list differs from sildenafil’s side effects in a couple meaningful ways. First, visual side effects aren’t likely to occur with tadalafil because tadalafil doesn’t inhibit PDE6.
But unlike sildenafil, tadalafil may cause back pain and muscle aches. This is owing to the fact that tadalafil inhibits PDE11 — something that sildenafil and vardenafil do not do.10 If you’re already susceptible to back pain, this might make you prefer those other two medications rather than tadalafil. Though the majority of people do not experience anything but potentially mild side effects, 2-3% do contend with more significant back pain and myalgia.12 You might look at these lists of side effects and conclude that, since its list is shorter, BlueChew tadalafil doesn’t pose the same risk of side effects as the other BlueChew medications. However, studies indicate that tadalafil users experience side effects at least as often as users of other PDE5 inhibitors.3 And tadalafil, particularly at higher doses, can produce side effects that last longer than those of sildenafil or vardenafil.23 Research suggests that 53% of tadalafil users may experience side effects in the first year of treatment, while that number rises to 73% by the end of year two. This is because NO, vascularly downstream of where it is released in the body, causes the conversion of GTP (guanosine triphosphate) into cGMP (cyclic guanosine monophosphate).
| Side Effect | Description | Occurrence Rate | Severity |
|---|---|---|---|
| Headache | Common due to vasodilation | 20% | Mild |
| Dizziness | Feeling of lightheadedness | 10% | Mild-moderate |
| Flushing | Redness of face and neck | 15% | Mild |
| Nasal Congestion | Stuffiness or blocked nose | 8% | Mild |
| Visual Disturbances | Blurred or blue-tinted vision | 2% | Mild |
cGMP relaxes the smooth muscles in the walls of blood vessels, which is what causes them to widen — something called vasodilation.4 So, NO can promote increased blood flow. When it is released vascularly upstream from the spongy tissues of the penis, NO leads to more cGMP in those tissues, which enables the increase in blood flow and accumulation of blood there, causing an erection.5 What causes an erection to stop, meanwhile, is PDE5; when the body feels that it’s time for an erection to end, PDE5 is released to bind to the cGMP, causing smooth muscles in the blood vessels to return to normal.6 This means less blood flow to the penis, and the erection goes away. Inhibiting PDE5 is an effective way to allow many (but not all) men with ED to get erections strong enough for the sexual activity they want. And the reason these treatments don’t cause spontaneous erections is that arousal is still necessary for the brain to signal to the cavernous nerve (a nerve in the penis) to release NO there.6 (Remember, NO has the aforementioned effects vascularly downstream of where it is released.) None of the PDE5 medications that BlueChew offers are completely selective for PDE5. In other words, they can inhibit other families of PDE as well. To the limited extent that they do collaterally inhibit other PDE families, they can produce different side effects corresponding to those PDE families and what their normal jobs are in our bodies.
And while all three of the medications share a small set of common potential side effects — headache, nasal congestion, and dyspepsia — most adverse side effects happen because of the medications inhibiting other PDE families aside from PDE5.35 Sildenafil and vardenafil collaterally inhibit PDE1 over the counter drugs containing sildenafil and PDE6. Tadalafil, meanwhile, doesn’t cause that kind of collateral effect, but it does collaterally inhibit PDE11.6 This provides some explanation for why these medications differ in the side effects they're most likely to cause. As the active ingredient in Viagra, sildenafil is probably the most common and certainly the longest-studied ED medication on the market today. It’s the one that started them all, the only one introduced in the 20th century; if you’re old enough, you may remember Bob Dole as a spokesman for it following his presidential campaign in the late ‘90s. Like vardenafil, sildenafil is an as-needed medication. You’ll take it 30-60 minutes before sexual activity may occur, and after that waiting period, the medication will be effective for a period of 4-6 hours. On the one hand, the fact that it’s the longest-studied ED medication can give people some peace of mind, and it’s still the first path that many prescribing doctors explore with patients. On the other hand, years of research also reveal that sildenafil seems capable of causing certain side effects that a couple newer options like vardenafil and avanafil likely won’t. Avanafil — the active ingredient in Stendra and the newest PDE5 for ED — is a relatively costly medication offered by Hims but not BlueChew. It’s the most selective PDE5 inhibitor and less likely to cause side effects.7 Sildenafil’s most common side effects are mild and include:8 Dyspepsia (discomfort in the upper abdomen caused by stomach upset) Vision changes (such as a blue-green tint, temporarily blurred vision, or difficulty with color perception) Side effects involving vision disturbances arise due to the fact that sildenafil also collaterally inhibits PDE6. Of course, this isn’t the purpose of taking sildenafil; the goal is to inhibit PDE5 in order to facilitate erections. PDE6 isn’t associated with erections but, instead, with certain visual processing pathways. People who experience vision-related side effects often successfully avoid them in the future by switching to tadalafil. Switching to vardenafil sometimes solves this problem as well; though vardenafil also weakly inhibits PDE6, research indicates that men who experience vision-related side effects from sildenafil may avoid those side effects when using vardenafil.9 Also, these mild visual changes are not to be confused with a very rare but serious side effect (described later) involving total loss of vision in one or both eyes. It’s rare, but if it happens, seek medical attention. Whereas sildenafil and vardenafil are similar in molecular structure, tadalafil (the active ingredient in Cialis) is quite different from them.3 There’s a waiting period of about 30-60 minutes before a dose starts working, but tadalafil is a much longer-acting drug than either sildenafil or vardenafil. Because tadalafil remains active for 18-36 hours, it can be prescribed either as an as-needed medication or a once-daily medication. As-needed BlueChew tadalafil comes in 6mg or 9mg doses, while daily tadalafil from BlueChew is 9mg. Tadalafil is a longer-acting sildenafil pfizer 100g drug than either of BlueChew’s other treatments. Despite its differences, as it’s a PDE5 inhibitor, tadalafil is capable of causing several of the same side effects as the two other BlueChew medications.
The most common side effects of tadalafil are mild and include:11 Dyspepsia (discomfort in the upper abdomen caused by stomach upset) Nasal congestion, runny nose, and/or sneezing Notice that this list differs from sildenafil’s side effects in a couple meaningful ways. First, visual side effects aren’t likely to occur with tadalafil because tadalafil doesn’t inhibit PDE6. But unlike sildenafil, tadalafil may cause back pain and muscle aches.
All of BlueChew’s medications are PDE5 inhibitors, a class that also includes relative newcomer avanafil (Stendra), which BlueChew does not yet offer. PDE5 stands for “phosphodiesterase type 5.” (You can see why people use the abbreviation.) Phosphodiesterases are a superfamily of enzymes that act as regulators of signals being sent within cells. As the number in PDE5 would suggest, there are numerous families of phosphodiesterase that have been identified — 11, to be precise (PDE1 through PDE11) — and they all have different effects on the human body.3 Scientists further divide these families into subtypes and splice variants. As BlueChew’s medications are all PDE5 inhibitors, they all temporarily prevent PDE5 from doing what it normally would do in your body… which makes it useful to understand what PDE5 ordinarily does. You may sildenafil 100mg lowest price or may not have heard of the chemical, nitric oxide (NO).
Some people take dietary supplements to increase NO in their bodies, typically with goals involving exercise performance, sexual performance, or general cardiovascular health. This is because NO, vascularly downstream of where it is released in the body, causes the conversion of GTP (guanosine triphosphate) into cGMP (cyclic guanosine monophosphate). cGMP relaxes the smooth muscles in the walls of blood vessels, which is what causes them to widen — something called vasodilation.4 So, NO can promote increased blood flow. When it is released vascularly upstream from the spongy tissues of the penis, NO leads to more cGMP in those tissues, which enables the increase in blood flow and accumulation of blood there, causing an erection.5 What causes an erection to stop, meanwhile, is PDE5; when the body feels that it’s time for an erection to end, PDE5 is released to bind to the cGMP, causing smooth muscles in the blood vessels to return to normal.6 This means less blood flow to the penis, and the erection goes away. Inhibiting PDE5 is an effective way to allow many (but not all) men with ED to get erections strong enough for the sexual activity they want.
And the reason these treatments don’t cause spontaneous erections is that arousal is still necessary for the brain to signal to the cavernous nerve (a nerve in the penis) to release NO there.6 (Remember, NO has the aforementioned effects vascularly downstream of where it is released.) None of the PDE5 medications that BlueChew offers are completely selective for PDE5. In other words, they can inhibit other families of PDE as well. To the limited extent that they do collaterally inhibit other PDE families, they can produce different side effects corresponding to those PDE families and what their normal jobs are in our bodies. And while all three of the medications share a small set of common potential side effects — headache, nasal congestion, and dyspepsia — most adverse side effects happen because of the medications inhibiting other PDE families aside from PDE5.35 Sildenafil and vardenafil collaterally inhibit PDE1 over the counter drugs containing sildenafil and PDE6. Tadalafil, meanwhile, doesn’t cause that kind of collateral effect, but it does collaterally inhibit PDE11.6 This provides some explanation for why these medications differ in the side effects they're most likely to cause. This is owing to the fact that tadalafil inhibits PDE11 — something that sildenafil and vardenafil do not do.10 If you’re already susceptible to back pain, this might make you prefer those other two medications rather than tadalafil.
As the active ingredient in Viagra, sildenafil is probably the most common and certainly the longest-studied ED medication on the market today. It’s the one that started them all, the only one introduced in the 20th century; if you’re old enough, you may remember Bob Dole as a spokesman for it following his presidential campaign in the late ‘90s. Like vardenafil, sildenafil is an as-needed medication. You’ll take it 30-60 minutes before sexual activity may occur, and after that waiting period, the medication will be effective for a period of 4-6 hours. On the one hand, the fact that it’s the longest-studied ED medication can give people some peace of mind, and it’s still the first path that many prescribing doctors explore with patients.
On the other hand, years of research also reveal that sildenafil seems capable of causing certain side effects that a couple newer options like vardenafil and avanafil likely won’t. Avanafil — the active ingredient in Stendra and the newest PDE5 for ED — is a relatively costly medication offered by Hims but not BlueChew. It’s the most selective PDE5 inhibitor and less likely to cause side effects.7 Sildenafil’s most common side effects are mild and include:8 Dyspepsia (discomfort in the upper abdomen caused by stomach upset) Vision changes (such as a blue-green tint, temporarily blurred vision, or difficulty with color perception) Side effects involving vision disturbances arise due to the fact that sildenafil also collaterally inhibits PDE6. Of course, this isn’t the purpose of taking sildenafil; the goal is to inhibit PDE5 in order to facilitate erections. PDE6 isn’t associated with erections but, instead, with certain visual processing pathways.
People who experience vision-related side effects often successfully avoid them in the future by switching to tadalafil. Switching to vardenafil sometimes solves this problem as well; though vardenafil also weakly inhibits PDE6, research indicates that men who experience vision-related side effects from sildenafil may avoid those side effects when using vardenafil.9 Also, these mild visual changes are not to be confused with a very rare but serious side effect (described later) involving total loss of vision in one or both eyes. It’s rare, but if it happens, seek medical attention. Whereas sildenafil and vardenafil are similar in molecular structure, tadalafil (the active ingredient in Cialis) is quite different from them.3 There’s a waiting period of about 30-60 minutes before a dose starts working, but tadalafil is a much longer-acting drug than either sildenafil or vardenafil. Because tadalafil remains active for 18-36 hours, it can be prescribed either as an as-needed medication or a once-daily medication. Though the majority of people do not experience anything but potentially mild side effects, 2-3% do contend with more significant back pain and myalgia.12 You might look at these lists of side effects and conclude that, since its list is shorter, BlueChew tadalafil doesn’t pose the same risk of side effects as the other BlueChew medications. However, studies indicate that tadalafil users experience side effects at least as often as users of other PDE5 inhibitors.3 And tadalafil, particularly at higher doses, can produce side effects that last longer than those of sildenafil or vardenafil.23 Research suggests that 53% of tadalafil users may experience side effects in the first year of treatment, while that number rises to 73% by the end of year two.