What Is BlueChew? Side Effects, Safety & GOLD (Doctor-Reviewed)

BlueChew is a telehealth service that connects men with licensed providers who can prescribe compounded erectile dysfunction (ED) medications, delivered discreetly. 

For most healthy men, these medications are safe, and their most common side effects, like headache and flushing, are mild and short-lived. 

Here's what BlueChew is, what side effects to expect from each formula (including GOLD), and who shouldn't take it.

• BlueChew offers seven prescription formulas containing sildenafil, tadalafil, or vardenafil, the active ingredients in Viagra, Cialis, and Levitra. GOLD also adds apomorphine and oxytocin.
• All formulas are sublingual tablets that dissolve under the tongue, except DailyTAD, which is chewable.
• The most common side effects are headache, flushing, indigestion, nasal congestion, and muscle or back pain. They're usually mild and fade as the medication wears off.
• GOLD's apomorphine can also cause nausea, dizziness, or lightheadedness, especially the first time you take it.
• Serious side effects are rare, but chest pain, sudden vision or hearing changes, or an erection lasting more than 4 hours need emergency care.
• Don't take BlueChew if you use nitrates for chest pain, because the combination can cause a dangerous drop in blood pressure.

BlueChew is an online telehealth service that connects you with licensed providers in your state who can prescribe compounded ED medications after reviewing your online intake. A provider usually reviews your intake within 24 hours, and approved orders ship within 24 hours. For how the service works and what it costs, see What Is BlueChew?

BlueChew's seven formulas are:

• SIL: sildenafil, the active ingredient in Viagra
• VAR: vardenafil, the active ingredient in Levitra
• TAD: tadalafil, the active ingredient in Cialis
• MAX: sildenafil + tadalafil
• VMAX: vardenafil + tadalafil
• GOLD: sildenafil, tadalafil, apomorphine, and oxytocin
• DailyTAD: low-dose tadalafil plus 7 essential vitamins, a chewable taken daily

Sildenafil, tadalafil, and vardenafil are PDE5 inhibitors, which increase blood flow to the penis so it's easier to get and keep an erection when you're aroused. Compounded medications are made in state-licensed pharmacies and prescribed by licensed providers, but they aren't FDA-approved.

For most healthy men, yes. BlueChew's active ingredients have been used for decades, and most side effects are mild. In one study of 979 men taking sildenafil, only 1.1% stopped treatment because of side effects. Serious side effects have been reported in fewer than 1 in 1,000 people, and a study of men with cardiovascular disease found serious cardiovascular events were no more common with sildenafil than with placebo.

BlueChew isn't safe for everyone, though. It isn't safe if you take nitrates, and it may not be right if you have certain heart, blood pressure, eye, or blood conditions. That's why a licensed provider reviews your health history and medications before prescribing.

Because BlueChew's formulas share the same active ingredients, their common side effects overlap. Combination formulas carry the side effects of each ingredient they contain.

For most men, these side effects are mild and short-lived.

Headache

Headache is one of the most common side effects of every BlueChew formula, including GOLD. It happens because the medication widens blood vessels, including those in your head. It's usually mild and fades as the medication wears off. Staying hydrated and avoiding alcohol can help, and a provider can lower your dose or switch your formula if headaches keep happening.

Heartburn and Upset Stomach

PDE5 inhibitors can relax the muscle at the top of your stomach, which can cause heartburn or indigestion. Taking your dose on a relatively empty stomach and avoiding heavy or spicy meals beforehand may help.

Flushing and Stuffy Nose

Wider blood vessels can cause warmth or redness in your face, neck, or chest, and a stuffy or runny nose. Both are usually brief.

Back and Muscle Pain

Back and muscle aches are more common with tadalafil, so they're more likely with TAD, DailyTAD, MAX, VMAX, and GOLD. They usually resolve on their own within a day or two.

GOLD combines sildenafil and tadalafil with apomorphine and oxytocin. It can cause any of the common PDE5 side effects above, plus a few related to apomorphine, which acts on dopamine receptors in the brain involved in arousal.

GOLD-specific side effects:

• Nausea
• Dizziness or lightheadedness
• Drowsiness or yawning
• Feeling faint, especially if you stand up quickly

These effects are most likely the first time you take GOLD or after a dose increase, and they often become milder with continued use. GOLD comes in three strengths (Base, High, and Extra), and starting at a lower strength can help. See what to expect your first time taking GOLD.

GOLD is safe for most healthy men a provider approves for it. Because apomorphine can add to the blood pressure-lowering effect of sildenafil and tadalafil, tell your provider if you've ever had low blood pressure, fainting, or dizziness when standing. Don't take GOLD if you use nitrates, and avoid alcohol, which can make dizziness worse.

It can. Headache is the most common side effect of the sildenafil and tadalafil in GOLD. If headaches are frequent or severe, a provider may suggest a lower strength or a different formula.

Serious side effects are rare, but they can happen. Get emergency medical care if you have:

• Chest pain or pressure, a fast heartbeat, or a heartbeat that doesn't feel normal
• Fainting or severe dizziness
• A very bad headache
• Signs of a stroke: weakness on one side of the body, trouble speaking or thinking, a drooping face, or a change in balance
• Sudden vision changes or vision loss
• Ringing in the ears, sudden hearing loss, or other hearing changes
• Trouble breathing that's new or worse
• An erection that lasts more than 4 hours or is painful (priapism), even when you're not having sex

Allergic reactions are also rare. Seek emergency care for swelling of the mouth, face, lips, tongue, or throat; hives, rash, or itching; red, blistered, or peeling skin; wheezing or chest tightness; or trouble breathing, swallowing, or talking.

For the full list, see our safety information page.

Most side effects fade as the medication wears off:

• SIL and VAR (sildenafil and vardenafil): side effects usually last a few hours.
• TAD, MAX, VMAX, and GOLD (tadalafil): because tadalafil lasts up to 36 hours, side effects like back or muscle aches can last longer, often a day or two.
• DailyTAD: with daily use, side effects are often mildest after the first few weeks.

If side effects last longer than this, keep coming back, or get worse, message the BlueChew medical team.

PDE5 inhibitors don't only act on the penis. By blocking the PDE5 enzyme, they relax and widen blood vessels throughout the body. That's what causes flushing, headache, and a stuffy nose. It can also slightly lower blood pressure, which is why combining these medications with other drugs that lower blood pressure can be dangerous.

Taking more than your prescribed dose raises your risk of side effects, so never take more than your provider recommends.

Don't take BlueChew if you:

• Take nitrates for chest pain (angina), such as nitroglycerin, isosorbide mononitrate, or isosorbide dinitrate, or use "poppers" (amyl or butyl nitrite)
• Take a guanylate cyclase stimulator, such as riociguat
• Have had an allergic reaction to sildenafil, tadalafil, vardenafil, or any of GOLD's ingredients

Combining BlueChew with nitrates or guanylate cyclase stimulators can cause a sudden, dangerous drop in blood pressure.

Tell your provider if you:

• Have heart problems, such as a recent heart attack, irregular heartbeat, angina, aortic valve narrowing, or heart failure
• Have had heart surgery or a stroke
• Have low blood pressure or high blood pressure that isn't controlled
• Have pulmonary hypertension
• Have Peyronie's disease or another condition that changes the shape of the penis
• Have had an erection that lasted more than 4 hours
• Have a blood cell condition, such as sickle cell anemia, multiple myeloma, or leukemia
• Have retinitis pigmentosa or have had severe vision loss, including NAION
• Have bleeding problems, stomach ulcers, liver problems, or kidney problems, including dialysis

Share every medication you take in your intake, including:

• Alpha-blockers for high blood pressure or an enlarged prostate, like doxazosin, prazosin, and terazosin, which can add to BlueChew's blood pressure-lowering effect
• Other blood pressure medications
• HIV medications, such as ritonavir
• Certain antifungals, such as itraconazole and ketoconazole
• Certain antibiotics, such as erythromycin and clarithromycin

Your provider will use your full medical history to decide whether BlueChew is safe for you.

If you have mild side effects like headache, congestion, or back pain, message the BlueChew medical team. Your provider may:

• Lower your dose or strength
• Switch you to a different formula, since side effects vary by ingredient
• Suggest practical steps, like staying hydrated, limiting alcohol, and avoiding heavy meals before your dose

Ask your provider before taking any over-the-counter medication to manage side effects, especially decongestants if you have high blood pressure.

Not sure which formula fits you? See our side-by-side comparison. For severe side effects like chest pain or a painful erection, get emergency medical care right away.

Choose a plan, complete an online medical intake, and a licensed provider usually reviews it within 24 hours. 

If treatment is appropriate, your prescription ships discreetly within 24 hours. 

Plans start at $30/month. See what BlueChew costs or read real reviews.

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What is BlueChew? 

BlueChew is a telehealth service that connects men with licensed providers who can prescribe compounded ED medications containing sildenafil, tadalafil, or vardenafil, the active ingredients in Viagra, Cialis, and Levitra. GOLD also includes apomorphine and oxytocin. All formulas are sublingual except DailyTAD, which is chewable.

Is BlueChew safe? 

For most healthy men, yes. Its active ingredients have decades of research behind them, and most side effects are mild. It isn't safe with nitrates, and certain heart, blood pressure, eye, and blood conditions may rule it out. A licensed provider reviews your health history before prescribing.

What are the most common side effects of BlueChew? 

Headache, flushing, heartburn or upset stomach, a stuffy or runny nose, and muscle or back pain. They're usually mild and fade as the medication wears off.

What are the side effects of BlueChew GOLD? 

GOLD can cause the same side effects as sildenafil and tadalafil, plus nausea, dizziness, lightheadedness, or drowsiness from apomorphine. These are most likely the first time you take it.

Is BlueChew GOLD safe? 

GOLD is safe for most healthy men a provider approves for it. Tell your provider about any history of low blood pressure or fainting, don't take it with nitrates, and avoid alcohol, which can worsen dizziness.

How long do BlueChew side effects last? 

Side effects from sildenafil and vardenafil formulas usually last a few hours. Tadalafil formulas, including TAD, MAX, VMAX, and GOLD, can cause side effects that last a day or two.

Is BlueChew safe with high blood pressure? 

It depends. BlueChew's active ingredients can slightly lower blood pressure, so they may not be safe if your blood pressure is uncontrolled or if you take certain blood pressure medications, like alpha-blockers. Many men with well-controlled blood pressure can take PDE5 inhibitors, but your provider has to review your medications and health history first.

Does BlueChew raise your blood pressure? 

No. PDE5 inhibitors tend to slightly lower blood pressure, not raise it. That's why combining them with nitrates or some blood pressure medications can be dangerous.

Can BlueChew cause heartburn? 

Yes. Heartburn and indigestion are common side effects. Avoiding heavy or spicy meals before your dose may help.

Who shouldn't take BlueChew? 

Anyone who takes nitrates or guanylate cyclase stimulators, or who is allergic to its ingredients. People with certain heart conditions, uncontrolled blood pressure, blood cell disorders, retinitis pigmentosa, or severe liver or kidney problems should talk with a provider first.