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ED treatment

In stockDaily Tadalafil
CompoundedDaily TadalafilLow daily dose for everyday readiness
From$65/mo*
Get Started

* Daily or tablet, in 3, 6 or 12 month plans. Prices may vary.

Compounded in the USAFSA and HSA eligiblePay over time withKlarnaAfterpayAffirm
  • A low daily dose for everyday readiness
  • Same-day doctor visits and prescriptions
  • Free expedited shipping, all 50 states
  • No hidden fees, no surprise charges

A low daily dose of tadalafil (the active in Cialis) that keeps you ready around the clock, so intimacy does not have to be timed. It also eases urinary symptoms from an enlarged prostate.

Who it's for: Men who have sex often or prefer spontaneity over planning a dose.

  • Tadalafil 5 mg, a low daily strength for steady, all-day blood-flow support
  • A 24/7 care team, day or night
  • Physician visits and follow-ups
  • Dose adjusted as you progress
  • Help with side effects
  • Medication from a US pharmacy
  • Free expedited shipping, all 50 states

Cancel anytime, online in your account. No call, no form, no fee.

Canceling does not stop an order already sent to the pharmacy. If one is on its way, write to [email protected] and we will help.

Five ways, one visit

As needed or every day, fast or long lasting. Find the one that fits your life, and switch anytime.

Sildenafil
Prescription
SildenafilFrom $65/mo

Best for: Planned moments.

FormTablet
TakenAs needed, 30 to 60 min before
Works onBlood flow
Get started
Daily tadalafil
Prescription
Daily tadalafilFrom $65/mo

Best for: Spontaneity, no planning.

FormTablet
TakenOnce a day, every day
Works onBlood flow
Get started
Vardenafil
Prescription
VardenafilFrom $55/mo

Best for: An alternative to sildenafil.

FormTablet
TakenAs needed, about an hour before
Works onBlood flow
Get started
Apex
Compounded
ApexFrom $85/mo

Best for: A fast start and a long window.

FormTroche, melts under the tongue
TakenAs needed
Works onBlood flow
Get started
PT-141
Compounded
PT-141From $175/mo

Best for: Low desire, not blood flow.

FormInjection
TakenAbout 45 min before
Works onDesire, in the brain
Get started

Personalized medicine,
in three simple steps

Submit your application
and meet with a doctor
Step1

Complete a quick form and meet a licensed provider 100% online. They'll see if a treatment plan is right for you.

Choosing what you are interested in on the Sipra intake
Get your medication
delivered at home
Step2

Once approved, your prescription ships directly to your door, fast and free.

Your Sipra box delivered to your door
Receive 24/7 support
and ongoing care
Step3

Regular check-ins and on-demand medical support to keep you on track.

24/7 support and ongoing care
sipra
Sexual wellness
You do not have to bring this up out loud. Start in your account.
Create your account, choose what fits in the Sexual Wellness section, and check out. The health questions come at checkout.

More than a prescription

Most online programs ship a box. Sipra stays with you.

Sipra compared with a typical online program
sipraTypical online programs
No membership feeNo feeOften a monthly fee
The Sipra PromisePay only if a physician approves.$0 todayOften charged at checkout
Leave anytimeCancel online. No call, no form.AnytimeSteps may vary
One price, shipping includedVisits and support too.IncludedFees may vary
US-licensed pharmaciesURAC, ACHC and LegitScript accreditedAccreditedMay vary
Tested before it shipsPotency, plus sterility for injectionsYesTesting may vary
Dosing set by your physicianIncludedFollow-up may be limited
Side effect supportIncludedMay vary
Care team messaging, day or nightAnytimeHours may be limited
Start my visit

Nothing is charged until a physician approvesFSA and HSA eligible

How it works

An erection is blood flow. These medicines keep the signal on longer.

ArousalA signal starts in the brain
Nitric oxideReleased in the tissue
cGMPRelaxes the vessel walls
Blood flowFills and holds
PDE5 is the off switchSildenafil, tadalafil and vardenafil pause it, so the signal lasts.
PT-141 works upstreamOn desire, in the brain. Useful when wanting it is the issue, not blood flow.

When it works

See how long each option keeps you ready, from the moment you take it.

Take it1 hr4 hrs12 hrs24 hrs36 hrs
SildenafilTablet
about 4 hours
about 4 hours
Daily tadalafilDaily tablet
every day, steady
every day, steady
VardenafilTablet
4 to 5 hours
4 to 5 hours
ApexTroche
up to 36 hours
up to 36 hours
PT-141Injection
desire, several hours
desire, several hours
Blood flow, as neededDaily, always onDesire

Heard from our members

Real members, in their own words, on what changed after their first visit.

Filling in the form was my big step.

I’d put off getting help for a long time. Even filling out the form felt like a big step. But the questions were straightforward, and the doctor put me at ease. We talked through the options and what to expect. That was what I needed: a clear conversation about something I’d spent months avoiding.

Daniel R. · TexasTreated with Sildenafil
Verified member

I had room to ask.

I thought an online appointment would be pretty quick, and I worried I’d forget something important. I had a few questions written down, including ones that probably sounded basic. The doctor went through them with me without making me feel like I was holding things up. I left knowing what we’d discussed and what I still needed to think about.

Anthony J. · OhioTreated with Daily tadalafil
Verified member

We started with what mattered to me.

I wasn’t sure how to explain what I wanted to be different. It wasn’t as simple as wanting more desire, and I didn’t want someone assuming it was. The doctor gave me room to explain it in my own words. We talked about what mattered to me before getting into the options.

Marcus D. · North CarolinaTreated with PT-141
Verified member

It wasn’t awkward the way I feared.

I rehearsed what I’d say for days. The questions did most of the work, and the doctor picked up from there in a matter of fact way. By the end it felt like any other health conversation.

Kevin L. · NevadaTreated with Sildenafil
Verified member

Daily made more sense for us.

I didn’t like planning around a pill. The doctor asked how our weeks actually go and explained the difference between an as needed dose and a daily one. Choosing together made it simple.

Luis R. · CaliforniaTreated with Daily tadalafil
Verified member

He asked about my heart medication.

I take a blood pressure pill and assumed that ruled me out. The doctor went through my medications one by one and explained what was safe together and why.

Steve B. · PennsylvaniaTreated with Vardenafil
Verified member

The box gave nothing away.

My roommate gets the mail. It came in a plain box with nothing on the outside, and the label inside was just for me. That was half my worry, gone.

Derek F. · OregonTreated with Sildenafil
Verified member

I could ask the follow up questions.

After my first try I had questions I hadn’t thought of before. I messaged from my account and the answer came back clear and kind, with a small change to try.

Nate H. · MichiganTreated with Apex
Verified member

Nobody rushed me to decide.

I wanted to understand the options before committing to one. The doctor laid them out side by side and let me take a day to think. No pressure at all.

Carlos V. · TexasTreated with Daily tadalafil
Verified member

Talking about it got easier.

I was more stressed about the conversation than the problem. Being asked plainly, by someone who clearly hears it every day, took the weight off.

Will J. · ColoradoTreated with Sildenafil
Verified member

The pharmacy behind your treatment

Licensed 503A pharmacy

Your treatment ships to all 50 states

Compounded in the USA

Made for you, never mass-produced

Tested before it ships

Sterility, endotoxin, and potency, under USP 795 and 797

Independently accredited

URAC, ACHC, and LegitScript

From your visit to your door

Exactly what happens after your visit, who handles it, and when you pay. Nothing is charged until a physician approves.

Start my visit
  1. 01Online visit

    A few questions, no charge

  2. 02Physician review

    A licensed US physician

  3. 03Approval

    Charged only if approved

  4. 04Pharmacy

    Prepared in the US

  5. 05Delivery

    Expedited shipping included

  6. 06Ongoing care

    Check-ins and dose changes

Care between visits

Message your physician from your account. Refills arrive before you run out.

CT
Your care team
Thanks. Your physician checks it against this treatment and messages you before anything ships.
Today 9:41 AM Can I take it with my blood pressure pill?9:41 AM · Delivered Good question. Which one do you take?Thanks. Your physician checks it against this treatment and messages you before anything ships.9:52 AM
Message your care team ...

Refills, on their own

  1. Scheduled for youYour next box is set before your supply runs out.
  2. A heads-up emailIt says a shipment is coming, never what is in it.
  3. Ships in a plain boxNothing outside says what is inside.
  4. Yours to changeSkip it, or move it up to 7 days. Pause up to three months.

Your prescription covers a full year, so a refill needs no new visit. Cancel online, anytime. No call needed.

Dr. Jillian Foglesong Stabile, Sipra Medical Reviewer
Sipra Medical Reviewer

“ED is common, and it is often a sign worth listening to. What matters is a careful review of your heart health and medications, then the option that fits how you live.”

Dr. Jillian Foglesong StabileMD, FAAFP, DABOM

Board-certified family physician and Diplomate of the American Board of Obesity Medicine.

American Board of Family Medicine
American Board of Obesity Medicine
Wake Forest University School of Medicine

ED questions, answered

Sildenafil, tadalafil, and vardenafil relax blood vessels in the penis so blood can flow in more easily when you are aroused. They do not cause an erection on their own, and they do not raise desire. Your physician picks the one that fits your health and routine.

Some medications are taken before sex, and their effect lasts for a set window. Daily tadalafil is taken at a regular time, so you do not have to plan around the moment. Your physician helps you choose based on how often you want to be ready.

A troche is a small dissolving tablet that sits under the tongue or in the cheek rather than being swallowed. It is made by a licensed pharmacy and combines tadalafil and sildenafil in one dose. Your physician decides whether it makes sense for you.

PT-141, also called bremelanotide, works on pathways in the brain tied to sexual desire, rather than on blood flow. It is sometimes considered when the usual ED pills are not a good fit. It is compounded, which means it is not FDA-approved, and your physician decides if it is appropriate.

Common ones include headache, flushing, stuffy nose, upset stomach, and dizziness. PT-141 can also cause nausea and a short rise in blood pressure. A very long erection, sudden vision loss, or sudden hearing loss needs emergency care right away.

Anyone taking nitrate medicines, including some chest pain medications, should not take these drugs, because the combination can drop blood pressure dangerously. Heart disease, low blood pressure, and some other medications also need careful review. Be complete on your intake, and your physician decides what is safe.

No office visit is needed. A licensed US physician reviews your online intake, including your health history and medications. If they want blood work or a blood pressure reading, they will tell you.

A compounded medication is prepared by a licensed pharmacy for a specific patient, which allows different formats or ingredient combinations. Compounded medications are not FDA-approved, and they are not the same as any brand-name product. Your plan shows exactly what you receive, and it ships from a licensed US 503A pharmacy that tests it first.

Plans are billed per plan term, and the price does not change with your dose. Shipping is included, and you pay nothing unless a physician approves your treatment. It is cash pay with no insurance needed, and FSA and HSA funds can be used.

Yes. You can cancel online at any time, with no phone call and no form. If something is not working, message your care team first, since a change in medication or timing can help.

Explore your ED treatment options

  • Online evaluation by a licensed clinician
  • Treatment based on your health and goals
  • Clear pricing before you commit
A smiling man with a short beard in a beige henley shirt
From$39/mo

From price shown is the 12-month plan rate. Prices may vary.