All of these medicines work by relaxing smooth muscles and increasing blood flow in the penis during sexual stimulation. You should not take any of these medicines to treat ED if you are taking nitrates to treat a heart condition. Nitrates widen and relax your blood vessels. The combination can lead to a sudden drop in blood pressure, which may cause you to become faint or dizzy, or fall, leading to possible injuries.
However, you might actually be better off going one step back in the chain reaction and taking an L-citrulline supplement. While your body converts L-arginine to nitric oxide, it also metabolizes it too fast when the amino acid is taken in an oral supplement, according to a 2011 study from the University of Foggia in Italy. L-citrulline, which the body converts to L-arginine, is actually a better option to follow the same metabolic pathway and serve as a treatment for ED, the same study found.
Nitric oxide is made internally from L-arginine, which is an amino acid found in red meat, poultry, fish, and dairy products. In other words, L-arginine is the building block for nitric oxide, which is essential for erections. A lack of one can lead to a lack of the other. However, there’s a problem when it comes to treating L-arginine deficiency with supplements.
When experiencing difficulty in achieving an erection, it’s important to figure out if you are able to achieve an erection at all or if this happens only when you are with your partner. If you are unable to achieve an erection on your own, this may be more related to a medical and/or physical condition. Examples of this could include heart conditions, neuromuscular disorders, or pelvic pain. To evaluate if this is the cause of your condition, you should follow-up with your physician to examine your cardiovascular, neurological, and musculoskeletal system. From here, they may recommend medications such as Viagra or Cialis, or sometimes a referral to a urologist.

a) Some Vegetarians and Vegans.  It should be pointed out that certain animal-based foods are known for being the highest providers of niacin. So does this mean that animal-emphasized diets will result in increased blood flow over vegetarians?  My experience on the Peak Testosterone Forum has been the opposite and this is the subject of my book The Peak Erectile Strength Diet. Basically, a great many plant foods directly stimulate nitric oxide and will increase blood flow while lowering blood pressure. In fact, some plant foods can lower blood pressure as much as modern hypertension medications. See my page on Flaxseed and Blood Pressure for an example of that. High nitrate foods, such as spinach, arugula and beets, are yet another example.
Most human studies completed thus-far examine the impact of oral yohimbine consumption on erectile dysfunction (ED) in males. A meta-analysis of seven randomized, placebo-controlled trials found that yohimbine is significantly more effective in treating ED compared to placebo. [11] These findings did not compare yohimbine to prescription medications like Viagra®, which are designed to treat ED.
Shindel, A. W., Xin, Z.-C., Lin, G., Fandel, T. M., Huang, Y.-C., Banie, L., … Lue, T. F. (2010, February 5). Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The Journal of Sexual Medicine, 7(4), 1518-1528. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2009.01699.x/full
Erectile dysfunction supplements and other natural remedies have long been used in Chinese, African and other cultures. But unlike prescription medications for erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca) and avanafil (Stendra), erectile dysfunction herbs and supplements haven't been well-studied or tested. Some can cause side effects or interact with other medications. And the amount of the active ingredient can vary greatly from product to product.
When a man becomes sexually excited, muscles in their penis relax. This relaxation allows for increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa. As the chambers fill with blood, the penis grows rigid. Erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.
Our bodies are designed to be active and in motion. By keeping active and engaging in regular aerobic exercise, you increase the blood flow to your muscles, and your penis along the way. One of the most interesting things about increasing your blood flow is that it becomes a signal to your blood vessels to grow and get wider. It benefits your brain, your heart, and your erection. The principle of "use it or lose it" is the best advise one can follow. In fact, if you don't engage in sexual activity at least once or twice a week, it would be beneficial to masturbate. This not only helps with prostate health, but encourages the blood vessels that contribute to your erection to maintain their patency and flow. 
Cavallini, G., Modenini, F., Vitali, G., & Koverech, A. (2005, November). Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology, 66(5), 1080-5. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429505006515

Sildenafil, vardenafil and tadalafil increase the amount of nitric oxide in your body. Your body contains nitric oxide naturally, which is a gas that relaxes blood vessels. Medications to treat erectile dysfunction relax blood vessels in a man’s penis to help obtain and maintain an erection. Some medications that treat high blood pressure, high cholesterol and heart disease also relax your blood vessels. If you take niacin while you also take medications to treat erectile dysfunction, your blood pressure could drop drastically. You could faint or develop other health problems.
Because the study included only subjects with dyslipidemia, the results may not be applicable to those with ED who have a normal serum lipid profile. Furthermore, patients using aspirin or NSAIDs were excluded to avoid the effect of these drugs in inhibiting prostaglandin D production, which may be one of the potential mechanisms for the effects of niacin on ED. It should be noted that it is quite common for ED patients to have coexisting cardiovascular disease that requires the use of aspirin. Therefore, further study on the interaction of aspirin and niacin in ED patients may be needed to establish the role of niacin in clinical usage.
Despite the name, horny goat weed actually helps improve your erection, not libido.  Botanically known as epimedium, this herb has been used by the Chinese for centuries to treat, among other things, low libido and erectile dysfunction. “A growing body of research shows that isolated icariin—the extract of epimedium—inhibits the enzyme phosphodiesterase-5 (PDE-5) and significantly increases nitric oxide synthase, helping to improve erectile function,” says Fisch. In fact, this is the same mechanism that Viagra works through (but the herb comes with a way better name).

Medicines like I-Arginine and viagra, can fix your problems for hours but vitamins and amino acids will cure erection problems for long term. Remember, not to take vitamins and medications (I-Arginine) at the same time as it can react in your body. Discuss your doctor before adding any vitamin to your routine. Apart for I-Arginine and other pills, here we have given some vitamins to quick fix your problem and have a better sex life.
Yohimbe can interact with several drugs and medications, so it’s not safe for everybody to use. Don’t take yohimbe bark if you’re currently taking any ACE inhibitor drug, beta blocker, SSRI drug, MAOI, stimulants or caffeine-containing drugs, or tricyclic antidepressant drugs. Those who have any of the conditions listed below should not take herbal treatments like yohimbe without speaking with a doctor first. This is because it may affect things like blood pressure, heart health, kidney function and neurotransmitter functions:
Yohimbe bark (pronounced yoh-heem-buh) is an herbal supplement associated with anti-aging effects. It is used to naturally treat erectile dysfunction, low libido, hormonal imbalances and symptoms like low energy. Yohimbe has a long history of use in Western Africa, where the plant originates. It’s still grown there today, especially for its apparent aphrodisiac abilities.
Sildenafil, vardenafil and tadalafil increase the amount of nitric oxide in your body. Your body contains nitric oxide naturally, which is a gas that relaxes blood vessels. Medications to treat erectile dysfunction relax blood vessels in a man’s penis to help obtain and maintain an erection. Some medications that treat high blood pressure, high cholesterol and heart disease also relax your blood vessels. If you take niacin while you also take medications to treat erectile dysfunction, your blood pressure could drop drastically. You could faint or develop other health problems.
While eating magnesium-rich foods or taking a magnesium supplement at the proper dosage is safe for most men, the mineral can interfere or interact with some medications. Discuss the benefits and risks of altering your daily magnesium intake with your doctor, particularly if you take blood pressure medications, diuretics, diabetes medications or antibiotics. Men diagnosed with erectile dysfunction often require changes in other minerals and vitamins or even prescription medication. Ensuring a proper daily intake of magnesium may help maintain healthy erectile function, but magnesium alone is unlikely to cause a significant reduction in ED symptoms. Magnesium levels can also be affected by excess weight, chronic stress and excessive amounts of alcohol. These factors may also be partially responsible for erectile problems.
Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.
Zinc is a trace metallic element that occurs naturally in the earth. Certain vegetables, meats, and seafood have more zinc content than others. This makes it fairly easy to obtain zinc through a varied diet. An extreme zinc deficiency is rare in the United States, as most people get some zinc through the foods that they eat. However, when levels of zinc fall below the recommended threshold, problems begin.
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