Erectile dysfunction (also known as impotence) is a very common condition, which affects the majority of men at some point in their lives. Up to 50% of men aged 40 – 70 and up to 70% of men over the age of 70 suffer from erectile dysfunction.

There are several options, which are currently licensed for the treatment of erectile dysfunction in the UK.

Modern treatments are safe, affordable and effective and can help up to 80% of men treat erectile dysfunction.

What is Erectile Dysfunction?

Erectile dysfunction (ED), otherwise known as impotence, is the inability to achieve and maintain an erection for sexual performance. It is common, especially in men over the age of 40, and can be treated simply and effectively with treatments such as Viagra (Sildenafil) and Cialis (Tadalafil).

What causes Erectile Dysfunction?

Erectile dysfunction can occur as a result of several factors and it is important to address the root cause, which can be anything from a physical injury to a psychological issue or an unhealthy lifestyle choice that narrows the arteries.

Upon arousal, the brain signals are transmitted to the nerves, allowing the penis muscles to relax and the blood vessels dilate. Blood flows into the penis to erect it and is trapped there. When there is an interference with the blood circulation or the trigger from the brain signal transmissions, this causes erectile dysfunction.

Conditions affecting the blood circulation and blood flow to the penis such as:

• Cardiovascular disease, high blood pressure or diabetes
• Conditions affecting the nervous system (eg: Parkinson’s Disease, MS)
• Tissue damage or injury to the penis
• Depression and stress
• Unhealthy lifestyle including smoking, drinking excessively and obesity
• Decreased libido
• Conditions affecting the hormonal levels of testosterone (this is rare)

What are the treatments and how do they work?

Even though there are several drugs on the market for ED, the ones that are licensed in the UK all work in a similar way. Anti-impotence drugs Cialis, Viagra, Sildenafil, Vardenafil all increase the blood flow to the penis but will only work in combination with sexual stimulation. 

Sildenafil (Generic Viagra) & Viagra

What is Sildenafil and how does it work?

Sildenafil is used to help men who have trouble achieving or maintaining their erection. Its active ingredient sildenafil belongs to a group of medications known as phosphodiesterase type 5 inhibitors (PDE5). Sildenafil helps relax the blood vessels in the penis, which, in the presence of sexual stimulation, allows blood to flow into the penis and helps with achieving or maintaining an erection.

How do I take it?

The recommended starting dose is 50mg of the treatment once a day maximum (24 hours). For the best results swallow the medication whole with water on an empty stomach one hour before sexual activity as food will slow down the absorption of Sildenafil and meaning it will take slightly longer to work. Eating an hour after taking the pill will not affect its activity.

How long does it take to work? 

Sildenafil takes one hour to work. It will not work without sexual stimulation.

How long does it last?

Sildenafil works with sexual stimulation and its effects can last about four hours. This does not mean that you will have an erection for four hours, but that you have the potential for an improved erection as long as the drug lasts in your body.

What is the difference between Viagra and Sildenafil?

Viagra is a brand name for sildenafil citrate, which is also sold as a generic Sildenafil at different doses. They are the same treatment, with the generic medicine sold at a fraction of the cost but medically equivalent in its efficacy, quality, and strength.

Common Side Effects:

• pain in your back/muscles/head
• migraines
• getting flushed/going red
• indigestion
• feeling and or being sick
• getting a blocked or runny nose
• vision disturbances

Product information:

https://www.medicines.org.uk/emc/files/pil.3172.pdf

Tadalafil (Generic Cialis) & Cialis

 What is Tadalafil?

Tadalafil is the generic, unbranded version of Cialis, and both are treatments for erectile dysfunction in adult men. Cialis and Tadalafil contain the active ingredient tadalafil and so are medically equivalent. In comparison with other erectile dysfunction treatments, tadalafil has a longer lasting effect.

What is the difference between Tadalafil and Cialis?

Generic medications have the same active ingredient as their branded versions but available on the market at a lower price. Manufacturers of generic medicines have to show that the medicines are equally effective, that is, they have the same strength, quality, stability and efficacy.

What is Tadalafil Daily?

Tadalafil comes in two different forms:

Tadalafil 36-hour and tadalafil daily. While the former can be taken at least half an hour prior to planned sexual activity, tadalafil daily tablets are taken every day to give you the option to always be ready for sexual intercourse.

Since tadalafil daily is taken every day, it comes at lower strengths of 2.5mg and 5mg.

Tadalafil 36 hour comes in 10mg tablets and 20mg tablets.

What dose should I take?

Depending on your lifestyle and preference, it is up to you whether you take tadalafil 36 hour or tadalafil daily. However, if you have not tried the treatment before, it is recommended that you try the lower dose first and see how you react and if you have any side effects. If you find that the medicine is not sufficient, or not having the desired effect, discuss the options with your GP or local pharmacist, who will be able to either recommend a higher strength, or a more suitable treatment for you.

How does it work?

Tadalafil belongs to a group of medications called phosphodiesterase type 5 inhibitors (PDE5), which relaxes the blood vessels in the penis and allows the blood to flow. Combined with sexual stimulation, tadalafil helps to achieve and maintain the erectile function.

How do I take it?

Tadalafil 36-hour (10mg, 20mg) – Swallow a single pill with water at least half an hour before you plan to have intercourse. You should start with the lower dose of 10mg and you can increase or decrease the dose as required. Do not take more than one tablet in a day.

Tadalafil daily (2.5mg, 5mg) – Take one tablet with water every day at the same time of day. Do not take more than one tablet per day. The starting recommended dose for Tadalafil Daily is 5mg, which can be adjusted as required.

Please note that if you are taking either Tadalafil Daily or Cialis Daily, it is NOT recommended that you take any other erectile dysfunction at the same time. This includes Viagra, Sildenafil, Cialis 36-hour, Levitra, Vardenafil.

How long does it take to work?

Tadalafil is absorbed into the body quickly and so is fast-acting, allowing for sexual intercourse just 20 minutes to one hour after taking a tablet. It also needs sexual stimulation to be effective. The pill can be taken with or without food, but a large meal will slow the action of the medication, so it will take longer to work.

With Tadalafil Daily, the low dose of the treatment can take up to 5 days to build up to its full potential but after that time, the effect of the daily treatment is continuous. Therefore, you do not have to wait, and you will be ready for action whenever you like.

How long does it last?

A single tablet of tadalafil will stay in your body for 36 hours as the active ingredient has a longer lasting action on the body compared to other erectile dysfunction treatments. Since Tadalafil Daily is taken every day, the effect remains in the body, so you can be ready for sexual activity at any time.

Tadalafil Side Effects

Like all medications, Tadalafil has side effects that affect some men that take this medication. These occur for every 1 in 10-100 men. Some common side effects of Tadalafil are:

• Headaches
• Face Flushing
• Indigestion

Patient Information:

View the patient information leaflet for Tadalafil 10mg TEVA.

View the patient information leaflet for Tadalafil 2.5mg TEVA.

View the patient information leaflet for Tadalafil 20mg TEVA.

View the patient information leaflet for Tadalafil 5mg TEVA.

Vardenafil (Generic Levitra) & Levitra

What is Levitra and what is in it?

Levitra is a medication used to treat erectile dysfunction, that is, problems getting and maintaining an erection (ED) in adult men. It contains the active ingredient vardenafil.

How does it work?

Vardenafil is a phosphodiesterase type 5 inhibitor (PDT5) and works by relaxing the muscles in the penis to allow more blood to flow through the blood vessels. The extra blood in the penis results in a firm erection for sexual intercourse.

How do I take Levitra?

A tablet should be swallowed whole with water about 25-60 minutes before intended sexual activity. Levitra will not work without sexual stimulation. The recommended initial dose is 10mg once a day maximum, which can be adjusted according to how you respond to the medicine.

How long does Levitra take to work?

The drug acts with the presence of sexual stimulation 25-60 minutes after taking the dose.

How long does Levitra last?

Levitra remains in the body for around 4-5 hours.

Does food have an effect on its activity?

You can take a pill with or without food but eating a capsule with a high-fat meal can delay the action of the drug and reduce its effectiveness.

What are the risks of taking Levitra?

There are certain risks for those also taking alpha-blockers found in high blood pressure medication, nitrates used in cardiovascular drugs and other phosphodiesterase type 5 inhibitors including Viagra or Cialis.

What is the difference between Levitra and Viagra?

Both drugs work in the same way but have different active substances. Levitra has vardenafil as its prime ingredient and lasts about 5 hours while Viagra contains sildenafil and can last 4 hours.

Can I buy Levitra over the counter?

No. You can only buy Levitra from some UK pharmacies after a consultation with your pharmacist. However, not all pharmacists and pharmacies offer this service.

Side Effects

A headache is the most common side effect that occurs when taking Levitra, occurring in more than 1 in 10 users.

Other common side effects include:

• pain in your back/muscles/head
• migraines
• getting flushed/going red
• indigestion
• feeling and or being sick
• getting a blocked or runny nose
• vision disturbances

Product Information

View the patient information leaflet for Levitra 5mg.

View the patient information leaflet for Levitra 10mg.

View the patient information leaflet for Levitra 10mg Orodispersible.

View the patient information leaflet for Levitra 20mg.

Service details

Price: Small charge

Frequency: When required…

Leaflet: Page one

Availability

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