Prescription medicine, not a herbal pill. Here is how to tell, and what it costs.

It is a United States telehealth service, not a supplement. You complete a medical intake form, a physician licensed in your state reviews it, and if a prescription is appropriate, generic sildenafil or tadalafil is dispensed by Manifest Pharmacy in Greer, South Carolina. The site carries a LegitScript certification seal you can verify independently.

Generic Viagra, which is sildenafil, at 50 mg and 100 mg; generic Cialis, which is tadalafil, at 10 mg and 20 mg; and generic daily Cialis at 2.5 mg and 5 mg. These are prescription medicines, so what you receive depends on the clinician's judgement rather than what you select.

For sildenafil or tadalafil as needed: $60 a month for 6 pills, $153 for three months at 18 pills a shipment, $288 for six months at 36 a shipment, or $432 for twelve months at 72 a shipment. For daily tadalafil: $90, $261.90, $432 or $648 across the same terms, delivering 30 to 360 pills. The lowest published per-pill price is $1.80 on the twelve-month daily plan.

Yes. The service describes a monthly subscription and its policy explains you can log in to change your address or payment method or cancel before your next shipment. Note also that a comment in the page source states the displayed prices assume enrolment in a VIP programme carrying a recurring monthly discount, which the visible page does not explain. Confirm what recurs, and at what price, before you pay.

Not on the medication. The company's own policy says state and federal regulations do not allow the return of prescription medications once dispensed, so after your payment is taken and the package is handed to the carrier, all sales are final. Unopened non-prescription items can be returned within 30 days with you paying return shipping. Any 60-day satisfaction guarantee you see advertised for this service contradicts that policy.

The service's own intake form states it plainly: death can result if ED medications are used together with nitrates, which are often prescribed for chest pain or angina. If you take nitrates or nitroglycerin in any form, including recreational poppers, you must disclose it on the intake and you should not take these medicines. This is the single most important thing on this page.

The service states it operates in every state except Alaska, and that erectile dysfunction treatment is not offered in South Carolina. Because prescribing rules are set by each state's medical board, availability can change.