Last updated 14 September 2023
On 14 March 2023, the UK Medicines regulator approved an application to reclassify the erectile dysfunction medication Cialis. When marketed asCialis Together(tadalafil 10mg), it will be a ‘P’ (pharmacy) medication, and so available ‘over the counter’ in pharmacies – see. This follows the 2018, ‘P’ classification of (sildenafil 50mg) which has been available OTC, without a prescription, since then.
This decision is good news for men’s health …. Erectile dysfunction can be a debilitating condition, so it’s important men feel they have fast access to quality and legitimate care
Dr Laura Squire, MHRA’s Chief Officer for Healthcare, Quality and Access
Unfortunately, there is a strong black market in the UK for ED medicines, which are often unlicensed or counterfeit. UK Border Force and the MHRA seize millions of pounds of these fake products from criminals annually. This new classification of tadalafil 10mg will enable men who suffer from ED to obtain it safely from a local pharmacy.
Sanofi, the drug manufacturer, is expected to launch Cialis Together later in 2023. Cialis Together will be available to purchase in pharmacies without a prescription by men over 18 with erectile dysfunction. Cialis Together tablets will contain 10mg tadalafil and the maximum pack size will be 8 tablets. Other doses and pack sizes of Cialis and tadalafil will still be available on prescription through doctors and specially trained pharmacists. Before purchase in a pharmacy there must be an assessment with a pharmacist, who will check that Cialis Together is appropriate and safe, or whether consultation with a GP is necessary.
Men suffering with ED will have another treatment option with the convenience of purchasing it in their local pharmacy, including pharmacies found inside supermarkets (eg. Tesco, Asda, Sainsbury’s). The pharmacist will ask some health questions, may check blood pressure, and will advise on treatment with Cialis Together or Viagra Connect, or the need to consult a GP. Pharmacies usually have a private room for such discussions.
Cialis Together is a 10mg tadalafil product for use at least 30 minutes prior to anticipated sexual activity. Its effects can last. It is not recommended for daily use. The maximum recommended dose of Cialis Together will be one tablet in 24 hours. Prescription Cialis and tadalafil will still be available at different doses.
Dr Fox welcomes the wider access to ED medication for men that Cialis Together classified as a ‘P’ OTC medication will provide. We at Dr Fox are aware of the difficulties men have in discussing ED with their GPs and in accessing ED medication. We know that Cialis is effective and safe for most men and this change provides another option for obtaining ED treatment. Pharmacists are health professionals who are able to give ED advice but they will also know when to refer men who would benefit from a doctor’s assessment. ‘P’ medicines can also be supplied on prescription, and we will offer Cialis Together, when available, alongside our other competitively priced ED products.
Dr Claire Pugh, Dr Fox Medical Director
In the UK have 3 categories:
Viagra has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.
Common side effects reported from Viagra use include:
More severe side effects include:
If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.
As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Viagra. Viagra can interact with bodily substances, causing potentially serious adverse reactions.
Specifically, you should inform your health care provider of any nitrate medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.
In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.
These include low levels of blood pressure, diet, or alcohol, and any other changes to your health. Viagra can interact with these aforementioned items, and should you experience any of them, contact your health care provider soon. As with all prescription medications, inform your doctor of any medical conditions nitrates are known to be available in, such as low levels of blood pressure, diet, or alcohol, and any other changes to your health.In addition, let your doctor know if you have recently had heart surgery or are experiencing chest pain during sex. If you experience changes in your heartbeat or chest pain during sex, contact your health care provider soon.
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As with any prescription medication, inform your doctor of any medical conditions you currently manage. These include conditions like heart disease, stroke, low blood pressure, or liver problems, as these medications are also presided over by the
os. If you are using any form of erectile dysfunction medication, including Levitra, consult your doctor before starting.
If you’re taking an anti-impotence drug that you might have heard of, you probably are.
“If they want to bring that down, they’ll do it on their own,” said Dr. Marc E. Belin, a urologist at the New York University School of Medicine and an assistant professor of urology at Tulane University Medical Center.
The Food and Drug Administration says it doesn’t know if Viagra and other anti-impotence drugs will reduce the risk of stroke or heart attack, but it’s probably safe to take.
“If you take these medications, you’re at a higher risk of getting a stroke,” said Dr. Belin, who also studies blood pressure. “It’s important to know that this risk doesn’t increase as much as you might think.”
Viagra and other anti-impotence drugs are the same drug that causes erections in men. But they aren’t the same drug in the same dosage because they’re sold over-the-counter.
Erections happen when an enzyme known as phosphodiesterase type 5 is inactivated. This means that the penis is less rigid and, in some cases, can become erect. If you don’t have erections, the penis will become erect and hard enough for sex.
Viagra has been shown to have similar effects when you take it to help you get and keep an erection.
But it doesn’t work if you’re under the influence of alcohol or certain drugs, said Belin, who specializes in sexual medicine at Tulane.
“The more you take, the less the effect of the medication is,” he said.
Alcohol is considered a drug that may increase the risk of heart attack and stroke. If you’re taking Viagra, you might experience a heart attack or stroke if you drink alcohol.
“I’ve been using them for four years and I’ve not seen a major increase in my risk of that in my general practice,” said Dr. Belin. “I can’t say there’s no significant difference between the risk of heart attack and stroke.”
But if you’re taking Viagra, you’re at a higher risk of having a heart attack.
Viagra may increase the risk of a heart attack because it’s an inhibitor of PDE-5, a chemical in your body that breaks down hormones.
It’s also called vasodilation, or blood flow to the body.
The FDA says it hasn’t been able to say if Viagra will increase the risk of a heart attack, but it has said that it does not know the risk of a heart attack.
“When you get into a state of shock, you’re more likely to die in your life than someone who has just taken Viagra,” said Dr.
Viagra is the only medication that’s been shown to lower the chance of a heart attack or stroke.
The FDA says it doesn’t know whether the drug will cause a heart attack or stroke in the first place.
Dr. Belin said he’s not sure that Viagra will decrease the risk of a heart attack or stroke.
But doctors and other health care providers can tell you about the risk of a heart attack and stroke in men who’ve taken the drug.
Viagra, which has the FDA’s blessing, was approved for use in men who had a heart attack or stroke in the past three months.
If you take it and are at an increased risk of a heart attack or stroke, doctors will likely start a lab test to look at the risk of that kind of heart attack or stroke.
“The risk of a heart attack in men who’ve already had a heart attack or stroke is very low,” Dr. Belin said.
If you’re taking Viagra, be sure to talk to your doctor about your health history and if you’ve been drinking alcohol.
Sildenafil citrate, commonly known by the brand name, is a prescription-only medicine used to treat erectile dysfunction (ED) in adult men. It works by improving blood flow to the penis, helping to achieve and maintain an erection during sexual activity.
Sildenafil is available in 25mg, 50mg, and 100mg strengths.
Sildenafil has been shown to be effective in up to 80% of men with ED, with effects typically noticeable within 30 to 60 minutes, and lasting for up to 4–5 hours.
Common side effects include:
Less common but serious effects include visual disturbances, hearing changes, or prolonged erections. Seek medical attention if severe or persistent side effects occur.
Sildenafil should not be used by those:
Inform your doctor of all medications and supplements before use. Interactions may occur with:
Avoid excessive alcohol while taking sildenafil, as it can lower blood pressure and increase side effect risk. Use with caution if you have any heart-related conditions.
Sildenafil is available by prescription only in the UK.
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