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Erectile dysfunction (ED) affects millions of men worldwide. Not only can ED get in the way of your sex life, but many people have difficulty coping with ED emotionally or mentally.
Fortunately there are a range of treatment options that allow you to take control over your sex life and feel more like yourself again. Some of these treatments include more invasive measures such as surgery and implants, while other, more commonly used treatments include prescription medications. The most well-known prescription medications used for ED are phosphodiesterase type 5 (PDE5) inhibitors, which improve blood flow to the penis. (National Institute of Diabetes and Digestive and Kidney Diseases, 2020)
PDE5s come in a few different forms, including oral and sublingual medications. But what are the key differences between oral and sublingual meds? How do sublingual medications work, and is one better than the other? Let’s take a deeper dive into prescription ED treatment options.
An Overview of Oral ED Medications
Sildenafil, tadalafil, and vardenafil are the most widely prescribed treatments for erectile dysfunction. In order for the body to process and use these medications, the drug first has to pass through the mouth, into the stomach, and eventually to the small intestine. Then the drug passes through the intestinal wall to travel to the liver, and finally, the bloodstream, which carries the drug to the target site. (Le, 2024)
With oral medications, the amount of the drug reaching the bloodstream is often decreased due to the body metabolizing the medication throughout this long digestive process. To make up for this, many oral medications will contain a larger dosage than they would have if given through an injection, sublingually, or through another method of administration. (Le, 2024)
What is Sublingual Medication?
Sublingual medication refers to any drug designed to be absorbed through the mucous membranes under the tongue, rather than ingested orally and passed through the digestive system. When a medication is administered sublingually, it dissolves quickly under the tongue and is absorbed directly into the bloodstream. (Le, 2024)
Sublingual medications are available in a few different forms, including tablets, wafers, sprays, drops, and more. In the context of ED treatment, sublingual medications have gained popularity due to their rapid onset, high bioavailability, and ease of use. For men seeking a more convenient and effective solution to ED, sublingual medications offer a promising alternative to traditional oral therapies.
How Does Sublingual Work for ED? 4 Benefits
Many sublingual ED medications utilize the same active ingredients found in common oral ED medications like sildenafil or tadalafil, but in a tablet or dissolvable strip that is designed to be placed under the tongue. These medications dissolve directly into the bloodstream through the mucous membranes in the mouth, bypassing the gastrointestinal tract and liver.
These PDE5 medications work by increasing blood flow to the penis during sexual stimulation. As a result, the blood vessels dilate and allow more blood to flow into the penis, leading to a longer-lasting and more effective erection.
Explore Rugiet’s approach to ED medication with our sublingual 3-in-1, fast-acting prescription. Rugiet Ready contains sildenafil, tadalafil, and another type of ED medication known as apomorphine (APO). APO is a dopamine agonist that has been shown to help prime the brain for sexual arousal. (Ribaric S, 2012) The addition of APO helps Rugiet Ready target both your body and your brain for sex, leading to a more satisfying erection and sexual experience.
Sublingual Medications Have a Faster Onset
Sublingual meds offer several key advantages over traditional oral routes. First, because the medication bypasses the digestive tract, it avoids the first-pass metabolism or drug destruction that occurs when a drug is swallowed and processed by the liver. (Herman, 2023) (Sublingual Administration) In contrast, sublingual medications are absorbed much more quickly, allowing the active ingredients to enter the bloodstream more directly and efficiently, often resulting in a faster onset of action. (Hua, 2019)
To give you a better idea of how this works, many traditional oral ED medications will take anywhere from 30 minutes to an hour to take effect (depending on the specific medication). (Cleveland Clinic, 2023) Meanwhile, sublingual tablets and strips often yield results within 15 to 20 minutes. (Deveci, 2004) This rapid onset can be especially helpful as there is less planning needed to prepare for sex.
Sublingual Meds & Bioavailability
Bioavailability refers to the proportion of a drug that enters the bloodstream and has an active effect. Oral medications for ED often experience a reduction in bioavailability due to the first-pass effect, which can diminish their effectiveness. (Herman, 2023)
Sublingual medications, on the other hand, offer superior bioavailability. Since they are absorbed directly into the bloodstream through the mucous membranes under the tongue, there is no first-pass effect to diminish their potency. This higher bioavailability can result in more efficient treatment, with lower doses potentially achieving the same effects as higher doses of oral medications. (Deveci, 2004)
This is particularly beneficial as a lower dosage may lead to fewer side effects, and is often a more cost-effective option.
Sublingual Meds May Lead to Fewer Side Effects
Like all medications, ED drugs can come with side effects. Some of the most common adverse effects include mild headache, flushing, abdominal pain, back pain, and dizziness. (Dhaliwal, 2023) While side effects can vary greatly, research shows that sublingual medications tend to cause fewer and less severe side effects than oral medications. (Deveci, 2004) This can be helpful if you are someone who has had adverse effects from oral ED medications before. Remember that side effects can vary, and you should always speak to a healthcare provider about your history with medications before taking a new drug.
Improved Convenience
Another advantage of sublingual ED medications is their convenience and discretion. As opposed to swallowing an oral tablet with water, which may not always be readily available or convenient, sublingual medications easily dissolve under the tongue. Because sublingual medications typically don’t require any water or liquid, they can be taken more quickly and discreetly. They can also be easily carried in a wallet or pocket, making them a practical and less intrusive solution for managing ED.
Find the ED Treatment That’s Best for You
If you’re struggling with ED, know that there is a long list of treatment options available for you. Sublingual medications offer an exciting advancement in the management of ED, offering faster onset times, improved bioavailability, fewer side effects, and greater convenience compared to traditional oral medications. Want to get connected to a provider today? Speak with a Rugiet board-certified doctor about Rugiet Ready.
At the end of the day, you should stick with whatever treatment method makes the most sense for you. Speak with your healthcare provider about your options for managing ED and try out different medications for yourself. Want to learn more about ED and sexual health? Explore the Rugiet Blog.
Citations:
National Institute of Diabetes and Digestive and Kidney Diseases. (July 2017). Erectile Dysfunction. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction
Jennifer Le. Merck Manuals. November 2024. Drug Administration. https://www.merckmanuals.com/home/drugs/administration-and-kinetics-of-drugs/drug-administration
Ribarič, S. (2012). The Pharmacological Properties and Therapeutic Use of Apomorphine. Molecules, 17(5), 5289-5309. https://doi.org/10.3390/molecules17055289
Herman TF, Santos C. First-Pass Effect. [Updated 2023 Nov 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551679/
ScienceDirect. Sublingual Administration. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/sublingual-administration
Hua S. (2019). Advances in Nanoparticulate Drug Delivery Approaches for Sublingual and Buccal Administration. Frontiers in pharmacology, 10, 1328. https://doi.org/10.3389/fphar.2019.01328
Cleveland Clinic. Erectile Dysfunction. August 2023. Retrieved from https://my.clevelandclinic.org/health/diseases/10035-erectile-dysfunction
Deveci, S., Peşkircioğlu, L., Aygün, C., Tekin, M. I., Dirim, A., & Ozkardeş, H. (2004). Sublingual sildenafil in the treatment of erectile dysfunction: faster onset of action with less dose. International journal of urology : official journal of the Japanese Urological Association, 11(11), 989–992. https://doi.org/10.1111/j.1442-2042.2004.00933.x
Dhaliwal A, Gupta M. PDE5 Inhibitors. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/
