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About ED

Erectile dysfunction (ED) is the inability to get or maintain an erection adequate for sex. There are many different causes, but ED ultimately occurs when there is too little blood flow into the penis and too much blood flow out, partially due to an enzyme called PDE5.

What causes ED?

There are many common causes of ED, including heart disease, blood vessel disease, diabetes, certain medications, obesity, cigarette smoking, depression, anxiety, stress, and more. Sometimes ED is caused by a combination of factors, and sometimes a specific cause is never determined.

Can ED be treated?

Yes, there are several options for treating ED. Before starting any kind of treatment, it’s important to be evaluated by a healthcare professional for possible underlying causes that might also require treatment.

When should I seek in-person treatment?

You should see an in-person healthcare professional if you are experiencing other worrisome symptoms or if you have other health conditions that might be related to ED, such as heart disease or diabetes.

52% of men experience some form of erectile dysfunction in their life. Source.

Treatments for ED

We offer prescription medications clinically proven to help improve erections.
Requires prescription through online visit with a US-licensed healthcare practitioner

Sildenafil

Viagra

Cialis

What to expect

How you take the medication depends on your prescribed treatment plan. Your provider can help you decide which treatment is appropriate.

Sildenafil citrate (in Viagra and Sildenafil) should be taken 30 minutes to 4 hours prior to sexual activity and usually starts working within 30–60 minutes.

Next, we will ask some questions about your symptoms and medical history to see if treatment is right for you.

Results

Our treatments are backed by real data and trusted by real medical professionals. No snake oil, no gimmicks.
74% of patients taking the 50 mg dose of Viagra reported an improvement in their erections (Source)

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”

“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!”

“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.”

These are the recorded side effects for PDE5 inhibitors, the class of drug which each of our treatments fall under.

Before taking any PDE5 inhibitor, you should know: People who are taking organic nitrates (e.g., Im-Dur, Nitrobid, Isordil) or nitrites should not take PDE5 inhibitors, as the combination can reduce blood pressure to dangerously low levels. People with cardiovascular conditions who have been advised by a healthcare professional to avoid sexual activity should not take PDE5 inhibitors, as they can worsen cardiovascular conditions.

found in Viagra, generic Viagra, and sildenafil

Mild to moderate side effects

Severe Side Effects

Erections that last several hours. Tell your doctor right away if you have an erection that lasts more than 4 hours

Decreased eyesight or loss of sight in one or both eyes.

Sudden decrease or loss of hearing

Heart attack, stroke, irregular heartbeats, and death. Most of these happened in people who already had heart problems

More shortness of breath than usual

Low blood pressure. Symptoms of low blood pressure include feeling faint or dizzy

If any of these severe side effects occur, seek medical care immediately.

These are not all the possible side effects of
sildenafil citrate. See Important Safety Information for more.

found in Cialis and generic Cialis

Mild to moderate side effects

Pharyngitis (sore throat)

Severe Side Effects

Heart attack, stroke, irregular heartbeats and death have happened rarely. Most, but not all, of these men had heart problems before taking Cialis. It is not known if Cialis caused these problems.

Abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision.

If any of these severe side effects occur, seek medical care immediately.

These are not all the possible side effects of tadalafil. See the Important Safety Information for more.

Discuss it all with your healthcare provider

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 1 dose of sildenafil (active ingredient in Viagra)* $2
  • Your first visit with a doctor Free
  • 2-day shipping on medications Free
  • All future visits with your doctor Free
  • 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 (discreetly 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

Is Roman legit?

5 Million Virtual Visits

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

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Roman is a cloud pharmacy for erectile dysfunction

That prescription can be filled anywhere, or at Roman’s in-house cloud pharmacy …

Mens health tech creates shame-free ways to get treatment

About 50 percent of men have erectile dysfunction. That’s not to say that half of all men around you at any given time have ED. The statistic is …

Next, we will ask some questions about your symptoms and medical history to see if treatment is right for you.

For any additional questions, please reach out to [email protected]. We can also be reached by phone at (888) 798-8686, Monday – Friday, 9:30am-5pm EST.

Is ED medication effective?

According to Viagra’s FDA-approved prescribing information, between 63% and 82% of patients reported an improvement in their erections after taking Viagra. Other PDE5 inhibitors work in a similar way in the body and are also effective. In fact, PDE5 inhibitors are considered one of the mainstays of ED treatment by the American Urological Association.

It’s important to note that ED medication doesn’t work for everyone and everyone’s reaction to a medication is unique. If you don’t see results right away, your doctor or nurse practitioner may recommend trying the medication multiple times under different circumstances. They may also change your dosage depending on your reaction to the medication and any side effects.

What is the difference between Viagra, generic Viagra, and sildenafil?

Viagra, generic Viagra, and sildenafil all have the same active ingredient: sildenafil citrate. All three medications work similarly in the body and have similar side effects. However, they differ in terms of dose and price.

Viagra and generic Viagra come in doses of 25 mg, 50 mg, and 100 mg. Generic Viagra is cheaper than Viagra, but some men may prefer taking the branded version.

Sildenafil is the generic form of a medication called Revatio. Revatio is FDA-approved for the treatment of pulmonary arterial hypertension, a type of high blood pressure in the lungs. The active ingredient in Revatio is sildenafil citrate, which is the same as the active ingredient in Viagra and generic Viagra. However, generic Revatio comes in doses of 20 mg. This allows healthcare professionals to prescribe generic Revatio off-label at doses of 20 mg, 40 mg, 60 mg, 80 mg, and 100 mg. This closely approximates the doses of Viagra and generic Viagra but allows for more options. Generic Revatio is also the cheapest form of sildenafil citrate available.

What is the difference between sildenafil citrate and tadalafil?

Sildenafil citrate is the active ingredient in Viagra, generic Viagra, and sildenafil. Tadalafil is the active ingredient in Cialis and generic Cialis. The main difference between the medications is how long they last. Sildenafil citrate usually takes about 30 minutes to one hour to start working and then lasts for about four hours. This is good for patients who are able to plan when they engage in sexual activity. Tadalafil usually takes 30 minutes to two hours to start working and then lasts for about 36 hours. This is good for patients who want more spontaneity when it comes to sexual activity.

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.

Can I take ED medication more than once per day?

ED medication should not be taken more than once in a 24-hour period.

Is ED medication affected by food?

Eating fatty food can reduce the rate and total amount of absorption of Viagra and other forms of sildenafil citrate. Therefore, it is recommended that Viagra/sildenafil citrate be taken on an empty stomach to achieve the best effect. Food does not have a similar effect on Cialis or other forms of tadalafil.

Can I use ED medication with alcohol?

Mixing ED medication with alcohol is not recommended and can increase the risk of side effects.

Will ED medication automatically give me an erection?

No, ED medication will not automatically give you an erection. You still need to be sexually aroused or stimulated to achieve an erection—ED medication simply makes this process easier when the time is right.

Do you offer alternative treatments for ED?

Oral ED medications are extremely effective, but they don’t work for everyone. Other treatment options for ED include lifestyle modifications (e.g., exercise, dietary changes, quitting smoking, limiting alcohol use), surgery, penile vacuum pumps, and other ED medications. Every treatment comes with risks and benefits that you should fully understand before moving forward with any treatment plan.

Currently, the only ED treatment Roman offers are oral PDE5 inhibitors in the form of sildenafil citrate and tadalafil. If you’d like to pursue alternative ED treatment, we recommend speaking with a healthcare professional in person.

What is the difference between Cialis and generic Cialis?

Cialis and generic Cialis have the same active ingredient: tadalafil. Both medications work similarly in the body and have similar side effects. However, they differ in terms of price. Generic Cialis is cheaper than Cialis, but some men may prefer taking the branded version.

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 sildenafil citrate taken?

Viagra, generic Viagra, and sildenafil are meant to be taken as needed for sexual activity. The medication should be taken approximately 30 minutes to one hour before sexual activity and the effects last for approximately four hours. Viagra, generic Viagra, and sildenafil should be taken on an empty stomach for the best effect. You should not take more than one dose in a 24-hour period.

How is sildenafil citrate taken?

Cialis and generic Cialis can be taken as needed or daily. When it is taken daily, only the lower doses (2.5 mg and 5 mg) are prescribed. You should only take the medication as prescribed for you.

When used as needed, the medication should be taken at least 30 minutes to two hours before sexual activity and the effects last for approximately 36 hours. When used daily, the medication should be taken around the same time every day. You should not take more than one dose in a 24-hour period.

Will ED medication make me want to have sex?

Taking ED medication alone will not necessarily make you want to have sex. This is because ED medication doesn’t directly affect your sex drive, or libido. That being said, having a stronger erection may make some men feel more confident—and this increased confidence may make men more willing and excited to engage in sex.

When used as needed, the medication should be taken at least 30 minutes to two hours before sexual activity and the effects last for approximately 36 hours. When used daily, the medication should be taken around the same time every day. You should not take more than one dose in a 24-hour period.

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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