Yohimbine hydrochloride review
What men were prescribed before Viagra — and why they stopped
Our overall score
Written by J. Porter, MPH
Medically reviewed by R. Okafor, PharmD
Last reviewed
The short version
Yohimbine hydrochloride is a prescription drug that was the main oral treatment for erectile dysfunction before PDE5 inhibitors arrived. It is still on the market. The AUA does not recommend it: the evidence is weak, the dosing is three times a day rather than on demand, and it carries cardiac and neurological risks that sildenafil does not. It is also not the same thing as the yohimbe bark sold in supplement shops, though the two get confused constantly.
Best for: Very few people. It is here for completeness, and because the supplement version is sold to millions who do not know what it is.
What works
- A genuine prescription drug with pharmacological activity, unlike most things marketed for ED
- Inexpensive
- Does not act through the PDE5 pathway, so it is an option of last resort where those are unsuitable
What to watch
- The AUA does not recommend it for erectile dysfunction
- Evidence is limited to small, mostly older trials with modest effects
- Three-times-daily dosing rather than taking something before sex
- Anxiety, tremor, raised blood pressure and heart rate are common
- Associated with arrhythmia, hypertensive episodes, and seizures
- Dangerous with MAOI antidepressants and in cardiac disease
Get emergency help for these
- An erection lasting more than 4 hours — this can cause permanent damage
- Sudden loss of vision or hearing
- Chest pain during or after sex — tell responders you took a PDE5 inhibitor
At a glance
- Generic name
- Yohimbine hydrochloride
- Brand name
- Yocon
- Drug class
- Alpha-2 adrenergic antagonist
- FDA approved
- Predates modern FDA efficacy review
- Typical doses
- 5.4 mg tablets
- Usual starting dose
- One 5.4 mg tablet three times daily, under medical supervision
- Onset
- Not an on-demand drug — taken on a standing schedule
- Duration
- Short half-life, hence the three-times-daily dosing
- Half-life
- Roughly half an hour to a few hours, varying widely between individuals
- Effect of food
- Not well characterised
- Generic available
- Yes
- Typical cost
- Inexpensive, but cost is not the reason to choose or avoid itChecked July 30, 2026. Prices vary widely by pharmacy — treat as a ballpark, not a quote.
What it is, and what it is not
Yohimbine is an alpha-2 adrenergic antagonist derived from the bark of the West African yohimbe tree. Blocking alpha-2 receptors reduces the sympathetic tone that keeps the penis flaccid — the same broad principle as the phentolamine component of Trimix, but taken orally and far less potently.
Before 1998 it was one of the few things a doctor could offer for erectile dysfunction. Sildenafil arrived and the reason to prescribe it largely evaporated.
Why guidance moved on
The AUA's guidance on erectile dysfunction does not recommend yohimbine, on the basis of the available data and panel consensus. Three things drive that.
- 1The evidence is thin. The trials are small, mostly old, and show modest effects that do not approach what PDE5 inhibitors deliver.
- 2The dosing is impractical. Three tablets a day, every day, rather than one before sex. That is a heavy commitment for a modest benefit.
- 3The risk profile is worse. Sildenafil's common side effects are headache and flushing. Yohimbine's include anxiety, tremor, raised blood pressure and heart rate — and it has been associated with arrhythmia, hypertensive episodes, and seizures.
Who should avoid it entirely
There is an irony worth naming: erectile dysfunction is frequently the first sign of cardiovascular disease. A drug that raises blood pressure and heart rate is a poor fit for a population that disproportionately has undiagnosed vascular problems. See why new ED warrants a cardiovascular check.
Is there any case for it?
A narrow one. It does not act through the PDE5 pathway, so in principle it remains an option where those drugs are unsuitable and the alternatives have been exhausted. In practice, if PDE5 inhibitors are off the table, injection therapy, a vacuum device, and Eroxon all have better evidence and better safety than yohimbine.
It stays on this site because the name circulates widely, in a supplement form far more dangerous than the prescription one, and people deserve to know what it actually is.
Common questions
Does yohimbine work for ED?
Small, mostly older trials show modest effects, and the AUA does not recommend it for erectile dysfunction. It works by a different mechanism from PDE5 inhibitors but far less effectively, and it requires three-times-daily dosing rather than a tablet before sex.
Is prescription yohimbine safer than yohimbe supplements?
It is more predictable, which matters a great deal — a prescription tablet contains a measured 5.4 mg, while supplement yohimbine content has been found to vary wildly from the label. The prescription drug still carries real cardiac and neurological risks, so "more predictable" is not the same as "safe".
Can I take yohimbine with Viagra?
Do not combine them on your own. Both affect blood pressure, in different and not straightforwardly additive ways, and there is no good evidence the combination helps. If a PDE5 inhibitor alone is not working, that is a reason to be reassessed rather than to start layering drugs.
Why is it still available if it isn't recommended?
It is an old drug that predates modern efficacy review and remains on the market. Being available is not the same as being recommended — the AUA guidance advises against it, and there are several better-evidenced options for people who cannot take PDE5 inhibitors.
Sources
- 1.The Management of Erectile Dysfunction: AUA Guideline — American Urological Association
- 2.Yohimbe: Usefulness and Safety — National Center for Complementary and Integrative Health (NIH)