However, it's important to note that most OTC products are not regulated by the FDA in the same way as prescription drugs, and their safety and efficacy may vary. Some may not contain the active ingredients they claim to, and others could have harmful side effects or interactions with other medications. Many Over the counter ED pills combine several herbs, amino acids, and other ingredients. While some of these ingredients may help improve circulation or sexual function, the overall effectiveness of these products is often not well-studied or consistent.