Severe liver disease. There were some reports of headaches and nausea, however. If you do, you may save money with online pharmacies that accept yours. Topicals tend to have a lower risk of side effects compared to oral medications, Dr. BlueChew — Best Chewable Tablets BlueChew is a telemedicine service that provides discreet monthly subscriptions for chewable tablets of sildenafil the active ingredient in Viagra , tadalafil the active ingredient in Cialis , or vardenafil the active ingredient in Levitra. When choosing one, tell your doctor or other health care professional what your preferences are, such as cost, ease of use, how long the drug’s effects last and side effects.The new over-the-counter treatment that could replace Viagra Most men struggle to get an erection occasionally, but now a new easy-to-use, over-the-counter gel is promising an almost instant fix. A list of the best over the counter viagra alternatives. Find erectile dysfunction pills that work for you. Sildenafil (Viagra). Tadalafil (Cialis). Vardenafil. These medicines are called PDE5 inhibitors. They enhance the effects of a chemical the body makes that relaxes muscles in the penis, called nitric oxide. This boosts blood flow and helps you get an erection from sexual activity.