BlueChew vs Roman: Where should you get ED meds?

Erectile dysfunction is incredibly common — probably even more so than you think. Up to one-third of all men will experience it at some point in their lives,1 including more than 25% of men under 40.2 But ED isn’t the death sentence for your sex life that it might have been in the 20th century. Today, there are several well-regarded medications that are known to be effective at helping men with ED to get an erection.

Access to those medications has also gotten easier, with online companies offering a private and convenient way to get a prescription medication and have it shipped to your door. BlueChew and Roman are two such companies that deliver low-cost generic versions of drugs like Viagra and Cialis.

But what are the important differences between these two companies? Our team has been covering their activities for years, and we’ve put together this guide to help you choose between the two. For those in a hurry, right now we feel the majority of men tackling ED will do best with BlueChew.

Whichever ED drug you choose, you'll pay less for it through BlueChew. Many of Roman's non-ED offerings, like some of its hair loss drugs, are among the best priced in their sector, but the company needs to compete more regarding the cost of ED treatments.

Here’s a quick comparison:

As you can see, BlueChew’s doses are much less expensive than Roman’s, and this is true even at similar strengths. Roman recently introduced a sublingual tablet (it dissolves under your tongue) to compete with BlueChew’s convenience, but the product is currently very limited in scope, which we’ll cover more a little later.

We pit BlueChew and Roman against one another head-to-head in several key categories we’ve found are most important among men seeking ED medications. Specifically, we looked at cost, available medications, convenience, and safety. Roman offers treatments and services for many other health concerns, while BlueChew focuses specifically on ED treatments. This analysis focuses on comparing the two companies in how they help you treat ED.

Let’s see how the two companies compared in each criterion.

Cost

Winner: BlueChew

Sometimes, when we’re calculating potential costs for a consumer, we have to go pretty deep into our comparisons before a winner emerges. This was not one of those times. BlueChew’s medications are less expensive per dose than those offered by Roman — and this is true of every medication at every dosage in any quantity the companies offer.

Frankly, we can’t find a justification for this difference in cost. Even compared to other telehealth companies also offering these meds in tablet form (not chewables like BlueChew), Roman is more expensive.

It’s also worth noting that neither of these companies accepts insurance for their ED medications, so you won’t be able to use any pharmacy benefits to offset higher costs where they occur.

Available meds

Winner: BlueChew

Roman is a little more competitive when you start comparing medication lists, including available doses, but it loses that edge a bit for lack of variety, even with a relatively original compounded option.

Here’s a simplified breakdown:

After a quick look at this chart, you might conclude that Roman would get the win for available medications. But the picture is a little more complicated than that.

Yes, Roman has branded Cialis and Viagra, which BlueChew does not. But those branded meds are obscenely expensive compared to their generic counterparts, and they’re therapeutically equivalent, so there’s next to no reason to opt for them.

It’s also true that Roman offers a compounded sublingual tablet, which BlueChew does not. But that tablet is a combination of 55mg of sildenafil and 22mg of tadalafil. That’s an average sildenafil dose but a rather large tadalafil dose. Combined, it’s likely more than many men would need, and side effect risks could become more pronounced at higher doses (it’s also one of Roman’s most expensive ED medications).3

Ultimately, we gave this category to BlueChew because, of its three available medications, each comes in doses and quantities that are suitable for more men, providing variety and efficacy where Roman’s perceived variety fails simple tests for practicality.

Convenience

Winner: BlueChew

In terms of acquiring a prescription and having the medication shipped to you, both BlueChew and Roman deliver about the same experience. Where the companies ultimately differ is in how you take the medicines themselves.

With BlueChew, all three medications are chewable and individually wrapped, so you can take them without water and carry one or two in your pocket with ease. Roman mostly offers more traditional tablets, which come in typical prescription bottles. If you wanted to bring one or two out with you to a bar or a club, you’d have to find something to carry them in for protection.

Roman has one ED product delivered in individually wrapped doses, but the product itself is less convenient than BlueChew's chewables. Roman's Spark combines sildenafil and tadalafil compounded into a sublingual tablet. To take it, you put it under your tongue and let it dissolve. Theoretically, this can get the medication into your bloodstream more quickly by passing through oral membranes rather than being digested.16 The issue is that it takes about ten minutes for the tablets to dissolve fully, which means you have to hold the tablet somewhat uncomfortably under your tongue for that long, presumably during foreplay. That would prevent you from being able to kiss or even really speak until the tablet dissolved.

Safety

Winner: Roman

Studies looking into the medications available from BlueChew and Roman mostly reveal excellent safety profiles. There are some risks for men with certain heart conditions, and each of these medications has the potential to cause visual disturbances or muscle pain.4

Between the two providers, there isn't much to distinguish one's safety profile from the other. Some Roman ED medications are available at lower doses than the same meds from BlueChew, and since the best dose of any medication is the lowest effective dose, you may encounter fewer side effects if you find success at a dose below what BlueChew offers. At the same time, Roman’s Spark tablet only comes in one dosage right now, and it seems likely to be higher than what many men would need.

Both companies have medical support available if you encounter any side effects that are mild enough not to require urgent care or an emergency room visit.

Both BlueChew and Roman offer medications called PDE-5 inhibitors.5 This is the class of medications that include Viagra and Cialis. To understand how they work, it helps to know a bit about the mechanics of an erection and the common physiological symptoms of ED.6

When you get aroused, your body releases cyclic guanosine monophosphate (cGMP), which relaxes the smooth muscle tissue in the penis and allows it to engorge with blood. That added blood expands the penis, resulting in an erection.

But what if your erection didn’t go away after climax? That would certainly have posed a problem for our ancestors trying to outrun bears. So, humans developed an off-switch called phosphodiesterase-5 (PDE-5).

PDE-5 is an enzyme that causes the breakdown of cGMP, and as your body runs low on cGMP, those muscles in the penis constrict, and blood flow reduces — your erection goes away. With many ED cases, there is either too little cGMP produced upon arousal or PDE-5 is too abundant or being released too early (before climax). PDE-5 inhibitors prevent the enzymatic activity of PDE-5 and allow cGMP to continue to build up and do its job, maintaining relaxed smooth muscles and the blood flow needed for a healthy erection.7

This is why the common misconceptions that Viagra will actively cause an erection or result in hours-long erections are incorrect.8 Viagra and other PDE-5 inhibitors allow you to respond to arousal with an erection and to keep that erection long enough to enjoy penetrative sex to climax. After climax, your body’s PDE-5 production picks up dramatically, typically with more intensity than PDE-5 inhibitors are designed to counteract. That way, you won’t have an erection for hours after intercourse (if you do, this is a reason to call your doctor).

Winner: BlueChew

Sildenafil is the active ingredient in Viagra, and it’s therapeutically identical to Viagra in its generic form. Both will take around an hour to kick in and should last for 4-6 hours.9 Both have the same side effect profile, with some cardiovascular risks and the potential for visual disturbances and muscle pain.

But generic sildenafil is a lot less expensive than branded Viagra (though the costs of sildenafil from BlueChew and Roman are not identical).

The lowest you’ll pay per dose from Roman is $4 for tablets that each contain 25mg. BlueChew’s sildenafil comes in 30mg or 40mg doses. For the 30mg dose, you can pay as little as $2.65. You’d have to opt for BlueChew’s monthly 34-pack to get that low of a price, which is a considerable amount of sexual activity, but you can also pay as little as $2.94 per dose when opting for just 17 chews per month. And even if you’re not as active as that, you can always pause your subscription and resume when you need more.

Here’s how the two companies’ sildenafil offerings compare:

Ultimately, this paints a picture in which you’re bound to pay less and get more from BlueChew than you will from Roman. You do have one higher dose option with Roman, but we wouldn’t suggest anyone start out a sildenafil regimen with a dose that high. If you find that 45mg of sildenafil from BlueChew isn’t enough, you can seek out a higher dose from Roman, but you’ll save money and have a more convenient experience by starting with a lower dose from BlueChew.

Winner: BlueChew

As with sildenafil, the tadalafil comparison between these two companies undeniably favors BlueChew, which offers chewable tablets that are well-priced and individually packed. Roman only offers tadalafil as a tablet, and the prices are among the highest in its class. The only advantage Roman offers here is the availability of low-dose daily tadalafil.

You can either take tadalafil as needed or as a daily medication. When taken as needed, it will last in the body for anywhere from 12-36 hours, depending on things like dosage, your metabolism, and whether you took it on an empty stomach.10 Like sildenafil, it can take up to an hour to start working.

When taken daily, tadalafil builds up in your system and is always there if you happen to need it.11 But if you aren’t especially sexually active, taking a daily medication might not be your best course of action.

BlueChew doesn’t recommend that you use its tadalafil as a daily medication, mainly because of its dose. Daily tadalafil typically comes in 2.5mg and 5mg doses, but BlueChew’s lowest tadalafil dose is 6mg. If you’ve taken 5mg daily in the past and you think 6mg daily would be just as safe and effective, you can get up to 28 tadalafil tablets per month from BlueChew at what comes out to the company’s lowest cost per dose. But you’d need to consult your doctor before doing so, just to make sure it’s safe for you.

Here's a comparison of BlueChew and Roman on the tadalafil front:

Once again, BlueChew has Roman beaten on price. However, men new to tadalafil may prefer to start at a lower dose (2.5mg or 5mg). But you should note that Roman’s 2.5mg doses are only available for daily use, so they don’t come in quantities less than 30. That comes out to $240/month when you could get 28 of the 6mg chews from BlueChew for just $90/month.

Winner: BlueChew

This category might be somewhat unfair to Roman; though the company does offer brand-name Cialis and Viagra alongside sildenafil and tadalafil, the medication in the brand-name offerings is the same as in the generics. (It's all either sildenafil or tadalafil.) Meanwhile, BlueChew does offer a third, unique medication: vardenafil, the active ingredient in Levitra.

Tadalafil lasts in the body for up to 36 hours, but Viagra and sildenafil have a much more focused window of action, lasting around 4-6 hours. Vardenafil does the same.12

Like sildenafil and tadalafil, vardenafil is a PDE-5 inhibitor. But, as a newer drug than sildenafil, its activity on PDE-5 enzymes is more precise. Sildenafil has been known to inhibit other PDE enzymes, including PDEs 6 and 11.13 Inhibiting those enzymes is what leads to certain side effects, like vision disturbances or muscle pain. By better targeting PDE-5, vardenafil serves as an alternative for men who’ve tried sildenafil and experienced unwanted side effects.

Vardenafil from BlueChew only comes in an 8mg dose. We’ve seen studies citing success at doses ranging from 5-20mg with only mild, transient adverse effects, so it would seem the 8mg dose would be effective for most men.14 Vardenafil also costs about the same as sildenafil, with the lowest cost per dose being $4 and the highest being $5.

Winner: Roman

Like the Viagra alternatives category, there could only be one winner here, as BlueChew doesn't offer compounded drug combinations. The first major player we saw do this was Rugiet, with its custom-compounded lozenges. This combined sildenafil, tadalafil, and a less-used ED treatment called apomorphine.

With Rugiet, you could customize the dose of each ingredient, leave some out, and otherwise tailor the medication to your exact needs. Roman’s not as flexible with its compounded drug, as it can only contain 55mg of sildenafil and 22mg of tadalafil. There is no room for customization.

One study looking at this combination found no increase in adverse effects compared to monotherapy controls, but the combinations included 50mg of sildenafil with only 5mg of tadalafil, far less than the 22mg of the latter found in Roman’s combination.15 Given that many studies cap tadalafil ranges at 20mg, putting more tadalafil together with a relatively high dose of sildenafil seems at least a little dangerous.

The nice thing about these medications is that they’re delivered as a sublingual tablet that dissolves under your tongue and can theoretically start working faster than drugs absorbed in the gut. But with a relatively high and inflexible dose, a 10-minute wait for the tablet to dissolve, and a high price tag ($12 per dose), it’s not going to be an ideal solution for many men.

In all but two of the various categories covered above, BlueChew is clearly a superior pick to Roman for most men. But what about options other than these two providers?

There are a handful of trustworthy telehealth companies that can provide prescriptions for ED medications, and we’ve spent a considerable amount of time evaluating each of them. Here’s a quick snapshot:

In addition to other companies offering PDE-5 inhibitors, there are several approaches to treating or working around erectile dysfunction that are worth considering. Some of these can be used in conjunction with PDE-5 medications, but be sure to speak with your doctor first. They include:

• Nutritional supplements
• Penis pumps
• Penis sleeves
• Shockwave therapy

Laid out next to one another, nearly every parameter of these two companies reveals that BlueChew is the superior option. Men interested in low-dose daily tadalafil will want to look to Roman, but men in nearly every other situation would do better to start their treatment with BlueChew.