People with heart conditions should never take ED medications without consulting a doctor. If approved, the provider will issue a prescription. Your health information should remain between your provider and yourself. These include itraconazole Sporanox, Tolsura , ketoconazole Extina, Ketozole, others and ritonavir Norvir. A phone or video consultation is sometimes required for legal purposes. If you have erectile dysfunction, the enzyme phosphodiesterase type 5 PDE5 often works too quickly to make your penis flaccid, which can make it difficult for you to get an erection in the first place or keep one for long enough to ejaculate. Most online providers require a picture of a valid ID, a selfie showing your face, and a recent blood pressure reading taken with a home blood pressure monitor or by a medical provider.Sildenafil is best known as a treatment for ED, the inability to get or keep an erection. Sildenafil is meant to be taken before having sex, with the understanding that its effects . Oral medicines for ED usually work well and cause few side effects. The four main medicines taken by mouth for erectile dysfunction are: Avanafil (Stendra). Sildenafil . Men’s Health Guide. Diet and Fitness. When samples of milligram Viagra tablets purchased online were tested, only 10% were even close to the advertised strength.