Photo by Innerbody Research
Erectile dysfunction (ED) afflicts enough men in the world that none should feel any shame around it — no matter their age.1 2 And ED medications like Viagra, Cialis, and their much less expensive generics (sildenafil and tadalafil) can make an enormous difference. While most companies provide these medications in pill form, a few providers have alternative delivery methods that are more convenient.
Rugiet Ready contains both sildenafil and tadalafil, as well as a third ED medication called apomorphine, delivered in a sublingual lozenge you can take without needing water.
Rugiet Ready offers a novel delivery method and a customizable combination of well-researched drugs that is likely a safe and effective option for most users. It’s more expensive than traditional pills, and the lozenges melt a bit too easily at high temperatures. We find Rugiet Ready to be an excellent choice for two specific groups of men:
Other men — particularly budget-conscious men — seem like less obvious candidates. There are more affordable, singular medications that would be equally effective for many men with ED — including chewable tablets from BlueChew, which is consistently a top recommendation among our editors for its affordability and convenience.
BlueChew lets men with ED get effective prescription treatments affordably and discreetly — no trips to the doctor’s office or pharmacy.
These are unique chewable forms of sildenafil and tadalafil (same active ingredients in Viagra® and Cialis®), which are proven to work for most men with ED. You won't need to rush for a glass of water when the mood is right.
Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions involving staying healthy and living healthier lifestyles. We extensively test each health service or product we review, including ED medication services like Rugiet.
Our team has spent countless hours researching and writing about erectile dysfunction, compiling a database of over 100 clinical studies, speaking with men who use ED medications and their partners, and conferring with urologists and other clinicians about the latest and best treatment options. We’ve ordered medication through Rugiet to test the company’s customer service and discretion, and we put the lozenges to the test with rigorous experiments designed to assess their convenience and reliability. For medical reasons, no members of the testing team consumed the medication themselves.
Additionally, like all health-related content on this website, this review was thoroughly vetted by one or more members of our Medical Review Board for accuracy. As research continues, we will continuously revisit and update this content.
Our evaluation of Rugiet Ready required us to pit it head-to-head with a handful of comparable services providing prescriptions and delivery of ED medications through streamlined online platforms. Because the actual products these companies offer are often so similar, cost became one of the most direct ways to evaluate where Rugiet stands in the landscape.
When we look more closely at the medications online providers have in their catalogs, there are some important differences that arise after you account for Viagra, Cialis, and their respective generics. For that reason, we put a little extra emphasis on available medications, taking dose options into account, as well. Most providers like Rugiet do an admirable job protecting users’ privacy and offering convenient subscription services with good customer support. Still, there are important differences among them, and we considered those here as well.
Let’s gain a deeper understanding by looking more closely at each major factor.
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Rugiet lays its costs out very plainly for you to see, which is not always the case with ED medication providers. We appreciate that, but those costs are among the highest you’ll find. If you’re serious about trying Rugiet Ready, we recommend opting for the monthly or quarterly subscription plan right out of the gate. You’ll unlock free shipping and save $70 per order compared to making a one-time purchase.
Here’s what the quarterly subscription can save:
|Cost||Cost per dose||Monthly cost with quarterly subscription||Cost per dose with quarterly subscription|
To make sense of whether Rugiet presents a good deal, let’s compare its combination therapy (with the quarterly subscription discount) with the best prices we can find for similar doses of its components purchased individually.
For $9.45, you get a dose of Rugiet containing 40mg sildenafil, 14mg tadalafil, and 2mg apomorphine. A single 45mg dose of sildenafil from BlueChew costs $2.94. And a 15mg dose of tadalafil from Hims costs, at best, $10.17. As for apomorphine, generic sublinguals are rare, and branded Kynmobi (apomorphine hydrochloride) can cost up to $75 with insurance. The key price difference here seems to come from the apomorphine.
All those individual costs add up to make $9.45 seem like a steal, but it’s critical to remember that most men find either sildenafil or tadalafil effective on their own. And if you’re willing to go down to 9mg of tadalafil instead of 15mg, you can get those doses from BlueChew for around $3.57 per dose. In other words, if one form of medication or a smaller dosage of a combination would work for you, then you can save money by starting there.
Most online ED prescribers offer sildenafil and tadalafil, and some go further with medications like avanafil or vardenafil. And since you can’t easily get sildenafil or tadalafil on their own from Rugiet, it’d be easier — and likely less expensive — to look for them elsewhere. But Rugiet offers apomorphine as part of its combination therapy, a drug that none of its competitors sell in any form. When you consult with a Rugiet doctor, you can discuss whether to include one, two, or all three medications in your initial prescription.
For the men whose erectile performance gets a big boost from apomorphine, they’ll undeniably benefit from Rugiet’s offering. It’s generally well-tolerated, but it can induce some nausea. That makes Rugiet a less desirable choice if you’ve been drinking heavily while out on a date or looking to meet someone.3 There’s a small chance that added nausea could put you over the edge if you’re already close to feeling sick.
At the end of the day, we appreciate Rugiet’s use of a relatively novel drug in the fight against ED, but if it were easier to divide its available drugs from one another in each user’s formula, we’d be able to rate them a little higher. Currently, you have to make that request to your consulting physician, but there’s no mention of that path as an option on the website, so most customers might mistakenly believe that it’s all three medications or nothing.
It’s hard to say if this is more of an issue with Rugiet having an inadequate website experience or if the company is deliberately trying to steer consumers away from this path. But if you want a Rugiet lozenge with, for example, sildenafil and apomorphine but not tadalafil in it, you might not even think to ask for it without first reading something like this article.
In theory, Rugiet’s product should be extremely convenient. It’s a lozenge that dissolves under your tongue and kicks in faster than other ED medications delivered in pill form. The company offers flexible dosing, consultations with a doctor that are simple and free, and subscriptions that are easy to understand and manage once you’ve settled on a dosage. All of that works in its favor.
Where the model falls short is in the sensitivity of its lozenges to temperature. If you live in a cold climate, this might not be as much of an issue. But above 70 degrees Fahrenheit, those lozenges start to soften. Rugiet advises you to keep them in a fridge or freezer, and they’re shipped along with ice packs to keep them cool. If you pop the pack of lozenges in your pants pocket at the beginning of a hot summer’s night out, they might be too soft to get them out of the package by the time you need them. And exposure to significant temperatures, such as those seen in a hot car, can completely liquify the lozenges within an hour. If there were a safe and effective way to stabilize them against higher temperatures, we’d be able to recommend them much more strongly.
Being able to take one of BlueChew’s individually wrapped doses or even just taking a pill out of a bottle and putting it in a little pill case or tiny Ziploc bag would be preferable to a melted lozenge.
In our testing, we also found that the online system for subscription cancellation appears to be broken, at least at the time of this writing. The system mandates that you select a reason for why you wish to cancel, but the submission button on that form does not work. We had to cancel our subscriptions by phone. Our cancellation experiences with every one of Rugiet’s competitors, from BlueChew to Hims, were much smoother.
Rugiet mostly conforms to the same privacy standards set across the industry, with discreet shipping boxes and billing practices. And all of your medical data is protected by HIPAA, so there’s no concern about your private health information getting shared with others. That legal restriction forms the bulk of our rating here.
As far as your digital footprint is concerned, Rugiet does what just about every other website does by using cookies and web beacons to track the way your IP address uses its site. This information is more closely tied to your WiFi connection than it is to you as a person, but there are features of the data collected that can be used to identify, or at least close in on, the user in question. Most people are comfortable with this level of data collection, but companies often give people the option to opt out and explicitly not have their data shared or sold to third parties.
There are many potential causes of erectile dysfunction. In addition to genetic predisposition, men can suffer from ED due to any of the following:
Cardiovascular issues are the top physiological cause of ED, so much so that the dysfunction itself can serve as an early warning for men susceptible to serious cardiovascular complications either from genetic predisposition or a poor diet and lack of exercise.4
It’s essential to address any of these underlying issues along with any ED medication you might seek. Not only could treating these issues alleviate the majority of your ED symptoms, but it could, in turn, eliminate the need for ED meds in the first place. That would cut down on your risk of complications or adverse effects and remove any prescription medications’ practical and financial burden on you. While you attempt to remedy those underlying issues, however, there’s no shame in reaching for a little prescription assistance in your sex life.
Whatever the cause of erectile dysfunction, the physical processes remain constant: the body fails to deliver adequate blood to the corpora cavernosa.5 (That’s the spongy tissue that makes up the bulk of your penis.) Without a rush of blood to this tissue, the penis will not expand and harden.
Most ED medications — prescription and non-prescription — seek to relax the blood vessels in this area of the body and increase blood flow in general. That creates an environment where physical and psychological arousal can result in a healthy erection that sustains long enough for satisfactory sex.
Rugiet Health is an online telehealth service that delivers its ED medications as a sublingual troche — also known as a lozenge — that dissolves under your tongue. This allows the drugs to absorb much more efficiently than in pill form.
Photo by Innerbody Research
Sublingual absorption means the medications start working in around 15 minutes, compared to the average 30-60 minutes seen in pills. The time you save can make a big difference if you’re taking them for immediate use not long before intimacy. For people new to ED treatments, this added convenience is a considerable selling point. But if you’re already accustomed to taking your ED meds an hour or so before intercourse begins and can pick up on subtle signals, it might not have as much of an impact.
Unlike most prescription ED treatments that provide a single drug, Rugiet Ready utilizes a trio of key ingredients, boasting a large amount of clinical research demonstrating safety and efficacy. There are some caveats for potential users with specific medical conditions, but the treatment should be acceptable for most men.
The three ED medications available to combine in Rugiet Ready treatments are:
If you become a member, you and the doctors at Rugiet Health will determine your optimal combination of these three. The doctors can prescribe one, two, or all three to be included in your dissolvable treatment.
Let’s look at each of these ingredients to paint a clear picture of how Rugiet Ready fights ED.
Sildenafil is the key ingredient in Viagra.6 It’s a prescription PDE-5 inhibitor, which reduces the activity of the enzyme phosphodiesterase type 5. Blocking the activities of this enzyme means that the blood vessels running through the penis relax and stay relaxed, allowing for improved blood flow in response to arousal.
Typically, sildenafil starts working within 30 minutes, and its effect can last 4-6 hours.7 If you take traditional sildenafil after a heavy meal, though, you might wait closer to an hour or even two hours before feeling the full effects. Rugiet Ready is generally less affected by meal type or size thanks to its sublingual absorption.
Sildenafil has been studied extensively and prescribed widely, but it can be dangerous if you have cardiovascular issues, especially if you’re taking medication for conditions like high blood pressure. During your doctor’s consultation, you’ll need to provide a recent blood pressure reading, and you’ll want to divulge any cardiovascular diagnoses you’ve received and discuss whether PDE-5 inhibitors would be safe for you.
Other potential side effects of sildenafil include:
Typical sildenafil doses range from 25mg to 100mg. Rugiet Ready is available with 40mg, 65mg, 80mg, and 110mg doses.
Like sildenafil, tadalafil — the key ingredient in Cialis — is a PDE-5 inhibitor, but it works a little differently than sildenafil.8 Though it has a similar side effect profile, its primary effects last longer. So, while sildenafil is active in your system for about 4-6 hours, tadalafil remains effective for 24-36 hours. That makes it a more convenient choice for a lot of users.9 It also takes about the same amount of time to activate as sildenafil, but it isn’t affected by meals.
Those conveniences come at a price, however. Tadalafil may have more pronounced contraindications than sildenafil, especially when combined with medicines that control blood pressure. Make sure your consulting doctor is aware of any medications you take for blood pressure or any heart conditions you may have before you take tadalafil. Beyond cardiovascular complications, one of the most frequently reported side effects of tadalafil is muscle pain, often located in the lower back.10
Tadalafil is sometimes prescribed for daily use, often starting at a lower dose so new patients can determine over time whether they need something stronger if they take it daily. Daily use is extremely convenient compared to making sure you have a pill on you just before sex, but it can seem like overmedication to men who have sex once per week or less.
Rugiet Ready provides tadalafil in combination with its other two medications at 14mg and 22mg doses. Both of these doses are on the high side for tadalafil, which is usually prescribed somewhere between 2.5mg and 20mg. Also, Rugiet Ready is not intended for daily use the way that lower doses of tadalafil sometimes are. Even if you had Rugiet make specialized lozenges of just tadalafil, its doses and prices are too high for it to make financial sense. Men interested in daily tadalafil should look to a service like Hims or Roman.
Apomorphine is a less common ED medication than tadalafil or sildenafil. It’s not a PDE-5 inhibitor like those two are. Instead, apomorphine is a dopamine agonist, which means it helps stimulate dopamine activity in the brain. Specifically, the apomorphine in Rugiet Ready stimulates the D2 dopamine receptor (among others), which studies have concluded is directly involved with erectile function.11 Collaterally stimulated dopamine activity may help with psychological issues that can contribute to erectile dysfunction, as dopamine reuptake inhibitors can be prescribed in cases of mild depression as Wellbutrin.
This is one of the most compelling aspects of Rugiet Ready, as none of its major competitors offer apomorphine either as a standalone treatment or in combination with other drugs. Rugiet’s multi-faceted approach can yield more reliable results without contributing too heavily to the product’s side effect profile.
That said, apomorphine is more commonly used as a treatment for Parkinson’s disease. Those patients receive the drug via intramuscular injection in an average dose of 3mg. They often experience significant nausea as a side effect — so much so that most of them also consume an antiemetic to fight it off.
Interestingly, the oral dose of apomorphine that shows the most promise with relatively low side effects is also 3mg.12 Rugiet Health provides a 3mg dose of apomorphine in its standard dosing configurations, though it’s possible to have a lower 2mg dose as part of your ideal combination. While these doses are close to what Parkinson’s patients receive, it’s important to remember that they take their medication as an injection, which enters the bloodstream much more quickly than a lozenge. As a result, the nausea side effect for Rugiet Ready users is largely curtailed.
Potential side effects of apomorphine include:
Hypoactivity is also common in rat models, but often at doses well above the minimum at which successful erectile performance is achieved. Still, if you notice signs of a depressed nervous system, such as fatigue or lack of motivation, it might be worth mentioning to your doctor.
Ultimately, we consider Rugiet Ready to be your best option if you fit into a small subset of ED sufferers who have tried monotherapies in the past (e.g., sildenafil or tadalafil on their own) and found those to be insufficient even at high doses. For these men, a combination of drugs might be more effective, especially with the inclusion of apomorphine, which most ED patients will not have tried yet.
We typically don’t recommend that men start with drug combinations if they haven’t previously sought treatment for ED. But some men, especially those interested in the lozenge delivery format, will still want to start here first. Rugiet’s ability to tailor the medication to meet your needs and wants — including making lozenges that only contain one of the three drugs available through its system — could give you access to lozenges that make more sense for some first-time patients.
If you’ve never taken medication for ED, you should probably start somewhere else in your search for treatment; the increased risk from combining medications is less justifiable, considering the positive track records that sildenafil and tadalafil offer. Not only that, but you will be paying more for the combination than for a single medication alone. With companies like BlueChew and Hims offering effective medications with lower side effect profiles and lower prices, it’s hard to argue in favor of Rugiet Ready until you’ve exhausted those options.
And, of course, if you do not have erectile dysfunction, you shouldn’t try to take ED medications. Taking these medications recreationally is highly inadvisable; using ED medications when you don’t need them has been shown to result in psychogenic erectile dysfunction.25
We went through the same ordering process any customer would when we decided to perform hands-on testing of Rugiet’s products. It’s a pretty straightforward process involving a short questionnaire and photos of your face, as well as the front and back of your driver’s license.
Here’s a quick look at the questionnaire:
After hearing from so many users who had their shipments arrive liquified, we decided to take it upon ourselves to determine at what temperatures and in what situations a Rugiet Ready lozenge might begin to soften and melt. The most important part of our findings was that the lozenges are somewhat soft at room temperature (clocked at 71 degrees Fahrenheit in our testing space).
Like some other medications or cough drops, the lozenges come in punch-out packages, often called blister packs. But those products are completely solid at room temperature, and when you push against them, they easily tear through the thin aluminum backing. Softened Rugiet Ready lozenges absorb the pressure from your fingers, deforming in their packaging and requiring a little more finesse to get them out. If you keep them in the fridge or keep your thermostat lower than we do, you might not have this problem.
So, how are packages arriving to customers with melted lozenges? Well, Rugiet packs its lozenges with a small ice pack in a thermally resistant envelope. But that ice pack is pretty small, and if the package is on a hot delivery truck, it might not be enough to prevent melting. In our testing, lozenges began to soften significantly at about 100 degrees Fahrenheit, and they liquified completely at around 120 degrees.
According to the CDC, a car parked in the sun on an 80-degree day can reach an internal temperature of 123 degrees within 60 minutes.26 That’s three degrees over our tested melting point. When liquified, the lozenges won’t pierce their blister packs. You’ll have to bring them back to a stable temperature first.
Photo by Innerbody Research
Our testing team found it took about 10 minutes in a 37-degree refrigerator and about 20 minutes at our 71-degree room temperature for the lozenges to return to their normal state. But once they’ve melted, the lozenges are deformed in their packaging. Typically, the lozenges are slightly smaller than their blister pack sections, and that difference in size helps you punch them through the aluminum backing easily. But once they’ve melted and reformed, they take on the full width of the blister section, making them more difficult to remove. Our testers had to peel away the blister pack backing and pry out lozenges that had previously melted, often getting loose lozenge material stuck under their fingernails.
Insider Tip: If your lozenges melt, reconstitute them upside-down, with the plastic top of the blister pack facing down. This will prevent the lozenges from sticking to the aluminum backing and help you get them out with greater ease.
It’s hard to say whether Rugiet Ready’s combination of ED medications is as safe as each individual medication by itself. Studies into combination therapies are lacking and often include participants on a daily dose of tadalafil who take sildenafil as needed.13
ED medications like sildenafil and tadalafil are quite safe for most men as long as they don’t have an underlying cardiovascular condition. In practice, the lowest effective dose of any medicine is the safest — that’s how you minimize adverse effects, and it’s why Rugiet Health doctors advise people to start by taking half of a sublingual dose at the outset to see how it affects them.
But if sildenafil or tadalafil work well enough on their own, there’s no need to combine them. You’re not going to get extended performance out of either, and you certainly won’t get any kind of special erection from the combination.
The biggest risks associated with sildenafil or tadalafil come from cardiovascular complications.14 PDE-5 inhibitors widen blood vessels, which lowers blood pressure. Men on nitrates or other medications that affect blood pressure could experience dangerous drops. Though it’s not a PDE-5 inhibitor, apomorphine has shown similar side effects, including fainting from low blood pressure in several studies. Your doctor will extensively review your medical history and require you to submit a recent blood pressure reading before providing you with a prescription.
Apomorphine has similar blood pressure implications to those of PDE-5 inhibitors, but it is also associated with a high incidence of nausea. In oral doses, this nausea is far less intense than what we see in Parkinson’s trials using subcutaneously injected doses that enter the bloodstream faster than Rugiet Ready. Thankfully, any nausea you might feel from oral administration appears to fade with continued use.15
In cases of severe ED in which a high dose of sildenafil or tadalafil barely works or stops working, it’s worth exploring the combination. Some men with diabetes, PTSD, or prostatectomies find that traditional ED prescriptions stop working as effectively. For these people, a combination often succeeds where the prior prescription has failed. Despite the fact that there haven’t been a lot of studies on the combination of PDE-5 inhibitors, the few studies that exist typically showed greater reported satisfaction levels among participants with no noticeable uptick in side effects compared to PDE-5 inhibitors taken in isolation.16
Ultimately, more studies on the combination of these medications would be helpful.
Rugiet Ready isn’t intended for daily use, and the doctors at Rugiet Health will never advise you to take these treatments as a daily routine.
Doctors do prescribe tadalafil for daily consumption, but these situations typically involve much lower doses than what is present in Rugiet Ready. If a daily routine is what you’re seeking, then Rugiet Ready isn’t for you. Even before considering the presence of sildenafil and apomorphine, it may be unsafe (and expensive) to consume Rugiet Ready’s tadalafil dose daily.
Hims is likely the best place to acquire tadalafil for daily use, particularly if you know your way around its somewhat complex pricing structure. Our review of its ED services goes into more detail.
Rugiet offers its treatments in four dose mixtures. Here’s a simple chart to show you how much of each you’ll get in each:
You and your doctor can decide together how many doses you would need in a month, but the standard package comes with six. If you opt for 90-day automatic refills, the company will take $70 off each shipment. Remember that $70 comes off a three-month supply, which can cost anywhere between $240 and $420 per shipment.
You can also talk to your doctor about creating dose mixtures not advertised on the Rugiet website. For example, there is no 110/14/2mg combination listed for sildenafil, tadalafil, and apomorphine, respectively. But if you and your consulting physician have reason to believe this or any other unlisted combination would be best for your needs, the company will formulate it and provide it at a reasonable price within its cost structure.
But if standalone sildenafil or tadalafil would have done the same job for you as the combination medicine, then Rugiet Ready is undoubtedly more expensive than providers like BlueChew.
Here’s a look at how the cost breaks down per dose between BlueChew and Rugiet Ready’s most affordable combination:
|Cost||Dose count||Cost per dose|
|Rugiet Ready S40/T14/APO2||$80||6||$13.33|
|BlueChew sildenafil 45mg||$30||6||$5.00|
|BlueChew tadalafil 9mg||$30||4||$7.50|
Rugiet Health accepts payments via credit cards only. Shipping for Rugiet Ready for a one-time purchase isn’t free ($10), but it is fast. However, 30-day or 90-day membership plans do offer free shipping, and most men will find themselves subscribing to whatever ED medication proves effective for them.
It’s also worth considering that Rugiet has to ship its product cold. Your package will contain reusable ice packs to keep the doses cool in transit, but don’t freeze the doses when they arrive. Rugiet advises that you keep them in the refrigerator if the temperature in your home regularly exceeds 74 degrees, as high temperatures can melt the treatments. After all, they’re designed to melt at body temperature.
If you live in a warm climate, BlueChew might be a better option as its individually packed doses offer similar portability but without the concern for temperature.
Insider Tip: If your treatments ship in particularly hot weather or you happen to let them melt in your home or even in your pocket, don’t despair. The medicine in them is still good; you’ll have to get them cold enough to harden in their packaging, but they’re still safe and effective.
Rugiet Ready is available in 49 of the 50 states in the United States. Telemedicine rules prohibit its prescribing or shipping to certain locations. Until recently, there were nine states that could not receive Rugiet Ready, but that list has shrunk. Currently, only South Carolina residents can’t use Rugiet’s services. This is typical of telehealth ED prescribers, as the state’s laws around ED prescriptions are among the nation’s strictest. Rugiet can also ship to Washington, D.C.
The company is upfront about the fact that it doesn't work directly with insurers and that customers would have to put in claims for out-of-network reimbursement. It also clearly states that you’re welcome to try an HSA or FSA card to make your purchase but that most such attempts are declined. We encourage you not to get your hopes up about insurance reimbursement. More insurance companies have begun covering Viagra, Cialis, and their authorized generics, but Rugiet Ready’s components are not authorized generics, and its combination makes them even less likely to be covered for reimbursement.
Most telehealth platforms offering generic ED medications are in the same boat. Hims is one of the few to offer an authorized generic — for Viagra’s sildenafil — but even then, there’s no guarantee you’ll get coverage.
Privacy is vital when it comes to sexual health, both online and in person. You can rest assured that Rugiet Health takes your privacy and security seriously. While the company will track your activity on its site using cookies, beacons, and other trackers, it protects all significant personal data. You can opt out of data sharing, but Rugiet doesn’t make this process as easy as some of its competitors do.
Rugiet Health is a HIPAA-compliant “covered entity,” and it defines the pharmacies and medical groups it uses as “business associates” under HIPAA guidelines. That ensures your medical information is protected under the strictest standards, as we’d expect.
Your shipment also provides added privacy. The medication comes in a box whose only identifying markers are your address and the return address of the issuing pharmacy. Nothing about the shipment would inform anyone, from parcel carriers to neighbors, about what’s inside. This is commendable but not unusual for services like these. The top telehealth providers of ED medications ship and bill discreetly.
Rugiet is a somewhat unusual player in the ED telehealth space, specifically for its use of combined therapies. Most other online ED treatment companies offer sildenafil, tadalafil, and others, but almost never in combination with one another. As a result, Rugiet Ready is comparably much more expensive than other standalone treatments.
If you’re just starting out on your ED treatment journey, you might be tempted to reach for Rugiet first because its combination of ingredients could increase the chances that it will help you. But that also increases the odds of adverse reactions. We often recommend men start out with a monotherapy approach before reaching for a combination like Rugiet Ready.
Fortunately, there are a lot of excellent places to get these single therapies, and some of them offer convenience and portability comparable to Rugiet’s lozenges.
Then, of course, there are approaches to treating ED that have nothing to do with prescription medication. We’ll look at those briefly, but we feel the most useful information to give you here is where else you might go for a less expensive, equally effective prescription.
BlueChew is currently our favorite provider of sildenafil and tadalafil for as-needed use. It also happens to be one of the most comparable to Rugiet, not in terms of cost or drug combination, but in terms of how it delivers medication. BlueChew offers its medicines in a convenient chewable tablet that gives you a level of convenience that we believe trumps Rugiet’s lozenges. The chewables don’t need to be kept at a specific temperature, and they’re individually wrapped to maximize portability.
Given the higher cost of Rugiet’s combination of drugs, as well as the potentially heightened probability of side effects, we recommend starting with sildenafil or tadalafil on their own if you’re trying ED medication for the first time.
BlueChew also gives our readers a free trial of its Active Plan for either sildenafil or tadalafil, or $20 off the first month of any other plan or dose level. Here’s what that looks like in practice.
|Active Plan||Busy Plan||Popular Plan||Pro Plan|
And for sildenafil:
|Active Plan||Busy Plan||Popular Plan||Pro Plan|
BlueChew has expanded its offering in recent years to include vardenafil. Essentially, sildenafil and vardenafil have the same effect, but vardenafil is a little more selective in its targeting of PDE-5, whereas sildenafil has a greater impact on PDE-6.17 That impact leads to a visual disturbance in some men that prevents them from differentiating between blue and green colors. There are also some men who simply respond better to vardenafil in general, though there isn’t a sufficient clinical explanation for this difference.
For more information, check out our comprehensive BlueChew review.
Hims is a more expansive telehealth provider than either Rugiet or BlueChew. It has an entire section of its business dedicated to treating ED, but it also offers treatments for hair loss, premature ejaculation, mental health and primary care, and even skincare.
For the most part, Hims has inferior prices to Bluechew, but its prices still beat out Rugiet’s if you’re open to trying monotherapies instead of Rugiet’s combination. It’s also a great place to go if you’re looking for a single platform that can handle multiple health-related issues.
We also recommend Hims to men interested in daily tadalafil. Rugiet is not intended for daily use, but doctors often prescribe a once-daily regimen of a low tadalafil dose for men who are consistently sexually active enough to engage with daily medication. This is one place where you can take advantage of Hims’ overly complicated pricing structure.
Hims charges the same for daily tadalafil subscriptions (30 pills per month) whether you take it at the 2.5mg or 5mg level. And that cost is significantly less than the same pill prescribed for as-needed use. You stand to save even more when billing quarterly.
Here’s a quick look at the difference between daily tadalafil and as-needed tadalafil billed quarterly:
|Doses||Quarterly cost||Cost per dose|
|Daily tadalafil 2.5mg OR 5mg||90||$267||$2.97|
|Tadalafil 5mg or 10mg||16||$342||$7.13|
|Tadalafil 15mg OR 20mg||10||$318||$10.60|
As you can see, the initial investment and the cost per dose are both significantly lower with daily tadalafil than as needed. Many men will acquire a prescription for daily tadalafil use, receive their prescription in the mail, and take it as needed. And since there’s no penalty for stopping and starting your subscription, you can use those 90 pills as needed until you’re close to running out, then restart your subscription and do it all over again.
Hims is also one of the few telehealth providers of Stendra 100mg. Stendra is a fast-acting alternative to sildenafil that studies suggest has a slightly different side effect profile, causing less nasal congestion and headache but more myalgia.18 Stendra is a brand-name medication, so it isn’t cheap, but it is a lot less expensive than branded Viagra or Cialis.
Male enhancement pills are non-prescription nutritional supplements designed to address various men’s sexual health concerns, often centered on erectile performance. As a sector of the supplement landscape, they have some of the least trustworthy actors around, suffering from both predatory manufacturers looking to capitalize on men’s insecurities and counterfeiters creating dangerous goods often sold through third parties like Amazon.
There are some companies making worthwhile products in the male enhancement space, and these are often the ones that don't pretend their products will make your penis bigger or cure any degree of ED. These supplements often contain a mix of ingredients that haven’t been evaluated collectively as a formula by any clinical research, but individual ingredients within the formula have. In most cases, the doses of those ingredients are far below what we see in successful research trials, but the fact that the companies are combining ingredients might make up for those lower doses.
Here’s a look at some of the few male enhancement products we can recommend:
This is our top-rated male enhancement pill. It contains 6g of ginseng and 500mg of ashwagandha, the latter of which has been shown to boost testosterone levels and reduce anxiety in slightly larger doses.19
Semenax is part of a subsection of male enhancement known as volume pills, which are intended to improve the quantity and quality of ejaculate. They often contain ingredients that also improve erectile performance in some studies.20 Semenax is one of our top-rated volume pills, thanks to a long list of potentially effective ingredients.
Ultraload is another volume pill, but its ingredient list is far shorter than that of Semenax. A generous dose of zinc — which boosts testosterone levels in several studies — is the main attraction here.21
Keep in mind that none of these male enhancement pills can work as well as prescription ED medications. They’re mainly for men with very mild or rare struggles with ED who are wary of prescription medication. They also tend to cost a lot more than prescriptions, especially compared to generic options, and you have to take them daily, which may be less convenient for men who prefer the ease of as-needed use with pills like sildenafil.
Here’s a quick comparison between the costs of the male enhancement pills mentioned above and a few generic prescription options, including Rugiet:
|Performer 8 30ct||$65||Free|
|Rugiet Ready Most Popular 6ct||$120||$10 (free with subscription)|
|BlueChew sildenafil 45mg 10ct||$40||$5|
|BlueChew tadalafil 9mg 7ct||$40||$5|
There are a couple of possible advantages to using male enhancement pills if they work for you. Like daily tadalafil, they’re pills that you simply take once per day. You don’t have to carry them with you to a club or wait up to an hour after taking them for them to kick in. If the ingredients are circulating through your body at all times, you can theoretically get an erection whenever you’re aroused. It’s just nowhere near as likely that male enhancement pills will work compared to prescription medications.
Most male enhancement companies also offer free shipping, which only marginally brings their cost closer to generic prescriptions, but it’s worth mentioning. If these pills don’t work for you, the companies often offer money-back guarantees, which you won’t get with prescriptions.
Low levels of testosterone can often cause performance issues in the bedroom. Before you start down the path of prescription medications, getting your testosterone levels checked may be worth it. You have a whole host of treatment options if they’re low, from prescription testosterone replacement to nutritional supplements. You can go through your doctor to test your testosterone levels, but it’s just as easy to get your levels tested at home with a simple kit.
Like male enhancement pills, testosterone boosters likely won’t work wonders, and you might not notice any effect unless you have low testosterone levels or are deficient in one or more of the ingredients included in a given supplement. We have a comprehensive guide to testosterone boosters, but here’s a quick look at some of our favorites:
Testo Prime is currently our top-rated booster, thanks to relatively high doses of zinc and ashwagandha. It also has a high dose of D-aspartic acid, but studies into that ingredient are often contradictory.22
Testogen offers both capsules and sublingual drops that you can stack and take together to maximize the potential benefits. Its doses are a little lower than Testo Prime’s, and there’s no ashwagandha, but you do get some ingredients Testo Prime lacks, like vitamin K1 and L-arginine.23
For the record, exposing your scrotum to UV radiation — A.K.A. “tanning your testicles” — does not increase testosterone production any more than tanning any part of your body might as a result of increased vitamin D. The one study implying that scrotal UV exposure increases testosterone was performed in 1939 on just five institutionalized patients at a mental hospital, all of whom suffered from depression and psychosis.24
These men were likely subjected to any manner of additional treatments over the years, including electro-shock therapy, and we feel we can safely assume their nutritional deficits were abundant. The study bears no clinical or statistical significance, and the participant baseline compared to the normal populace is incomprehensible.
Innerbody uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Kloner, R. A., Goggin, P., Goldstein, I., Hackett, G., Kirby, M. G., Osterloh, I., Parker, J. D., & Sadovsky, R. (2018). A New Perspective on the Nitrate-Phosphodiesterase Type 5 Inhibitor Interaction. Journal of Cardiovascular Pharmacology and Therapeutics, 23(5), 375–386.
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Cui, H., Liu, B., Song, Z., Fang, J., Deng, Y., Zhang, S., Wang, H., & Wang, Z. (2015). Efficacy and safety of long-term tadalafil 5 mg once daily combined with sildenafil 50 mg as needed at the early stage of treatment for patients with erectile dysfunction. Andrologia, 47(1), 20–24.
Morales, A. M., Mirone, V., Dean, J., & Costa, P. (2008). Vardenafil for the treatment of erectile dysfunction: an overview of the clinical evidence. Clinical Interventions in Aging, 4, 463-472.
Kumar, M., Pathade, A.D., Gupta, S.V., Goyal, S., Rath, D., Thakre, M., Sanmukhani, J. and Mittal, R. (2022). Efficacy and safety of avanafil as compared with sildenafil in the treatment of erectile dysfunction: A randomized, double blind, multicenter clinical trial. Int. J. Urol., 29: 351-359.
Lopresti, A. L., Drummond, P. D., & Smith, S. J. (2019). A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males. American Journal of Men's Health, 13(2).
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