Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy NAION. They enhance the effects of a chemical the body makes that relaxes muscles in the penis, called nitric oxide. Severe liver disease. Such patients must not apply any out-of-pocket expenses incurred using this Savings Offer toward any government insurance benefit out-of-pocket spending calculations, such as Medicare Part D true out-of-pocket TrOOP costs You are responsible for reporting use of this Savings Offer to any private insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using this Savings Offer, as may be required. Recent heart or blood vessel problems. Side effects Side effects of oral ED medicines are often mild.Yes, penile pumps (also known as ED pumps) are over-the-counter devices that work to treat erectile dysfunction (), similar to Viagra. Viagra is usually the first-line therapy for . Sildenafil (Viagra). Tadalafil (Cialis). Vardenafil. These medicines are called PDE5 inhibitors. They enhance the effects of a chemical the body makes that relaxes muscles . Key takeaways: Muse, Caverject, and Trimix can be good substitutes for Viagra (sildenafil). But they require insertion or injection into the penis. There’s some evidence that L .