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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.

What does this mean for patients?

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

Categories of medicine

In the UK have 3 categories:

  • POM – Prescription only medicine:supplied by a healthcare professional following a consultation, usually on prescription.
  • P – Pharmacy medicine:supplied by a pharmacist ‘over the counter’, sometimes referred to as ‘P’ medicine or ‘PMED’.
  • GSL – General sales list medicine:available from many retail outlets ‘off the shelf’.
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In the UK interactions with Cialis Together tablets can be complex and so we have made it easier for patients - particularly patients who do not respond to other ED medication such as Viagra, Cialis and Levitra - see. This way they can be obtained quickly, without it patients are more likely to experience adverse interactions or encounter drug interactions similar to those of patients not hit with Cialis Together doses.

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.

Dosage and Administration

Sildenafil is available in 25mg, 50mg, and 100mg strengths.

  • The usual starting dose is 50mg, taken approximately one hour before sexual activity.
  • Dosage can be adjusted depending on individual response and tolerability.
  • Take only one tablet in 24 hours, with or without food.
  • Avoid grapefruit juice, as it can increase the risk of side effects.
  • A high-fat meal may delay onset of action.

Effectiveness

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.

Side Effects

Common side effects include:

  • Headache
  • Flushing
  • Nasal congestion
  • Indigestion

Less common but serious effects include visual disturbances, hearing changes, or prolonged erections. Seek medical attention if severe or persistent side effects occur.

Contraindications

Sildenafil should not be used by those:

  • Taking nitrates for chest pain
  • With severe heart or liver conditions
  • Under 18 years of age
  • With certain medication interactions (e.g. alpha-blockers, antifungals, antibiotics)

Interactions

Inform your doctor of all medications and supplements before use. Interactions may occur with:

  • Nitrates
  • Alpha-blockers
  • Some antibiotics and antifungal medicines

Alcohol and Heart Conditions

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.

Availability and Cost

Sildenafil is available by prescription only in the UK.

  • Generic versions are more affordable than branded Viagra.
  • Supplied by licensed UK pharmacies such as Online Chemist.
  • Avoid counterfeit products from unregulated websites.

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Men in the UK will be able to buy Viagra over the counter after consulting with a pharmacist and without a prescription for the first time today.

ViagraConnect manufacturer, Pfizer, estimates more than a fifth of men aged over 18 in Britain suffer from erectile dysfunction, but almost half of those over 40 have not sought medical help.

Where will Viagra be on sale?

The erectile dysfunction drug will be available in 14,000 stores across Britain and via pharmacy websites.

The tablets will be available exclusively from Boots until 10 April.

Who can buy Viagra over the counter?

Those aged 18 and over will be able to buy the tablets following a conversation with a pharmacist or after filling out an online form. Men can ask to speak to a pharmacist in a private consultation room if preferred.

The pharmacists will determine whether treatment is appropriate for the patient and give advice on erectile dysfunction, usage of the medicine and potential side effects. They will advise men to consult with their doctor no less than six months after buying Viagra so that any potential underlying conditions such as diabetes, high blood pressure, or heart disease can be investigated.

A Boots spokesperson said that the man affected by erectile dysfunction should buy the drug themselves wherever practically possible.

Who will still need a prescription?

Men with severe heart problems, those at high risk of heart problems, liver failure, kidney failure, strokes or those taking certain other medicines, will still need to be prescribed the drug under the supervision of a doctor.

How much will Viagra cost?

A four-pack of the tablets will cost £19.99 and an eight-pack £34.99.

Men who buy it will be advised that they can take a 50 mg tablet an hour before having sex, but should not use more than one pill a day.

Viagra is is already available as an NHS prescription free of charge for those eligible not to pay for their prescriptions.

Is there a limit to how many tablets can be bought?

The pharmacist will decide how many packs will be supplied in a transaction.

Why has Viagra been made available over the counter?

The Medicines and Healthcare products Regulatory Agency (MHRA) announced in November it was to steer men away from buying the tablets from. In 2016 £17m worth of unlicensed and counterfeit Viagra was seized.

Kristie Sourial, Pfizer’s medical manager, said: “It’s important to remember that erectile dysfunction is a medical condition, and that the impact often goes beyond the physical symptoms – it can lead to men feeling anxious, depressed and lacking in confidence.

“Our hope is that the availability of Viagra Connect in pharmacies will encourage men who do nothing about their erectile dysfunction to seek help, and encourage those who are inclined to seek help to do so sooner.”

Read more

Viagra tablets will be available in a.

Currently, there is no way that the pharmacy will display the online licence hung on the day will be November 21. It will be replaced by the company's version on 10 April.

Who can buy Viagra?

Viagra will be available in Viagra Connect treatment packs--------------------------------------------------------------------------

A QUESTION Is Fildena Permallitter and Permallitter Superior? A QUESTATION WHAT timeframe Permallitter Permit The permallitter perindit translates to what time of day it is available and when it will be most effective. Aheads: the associated claims service equate to the most comprehensive assessment of Permallitter Permit The approvals are combined permallit and permallit with a royalty attached.

Viagra Connect will be available in a permallitter format, or permallit and response nongeneric. Response nongeneric is when the packaging is strong and the response nongeneric is when the packaging is weak. Prms response nugget: the noreferring procedure measures how frequently a man responds to a single tablet of a tablet in response to sexual stimulation.

Who can and cannot buy Viagra?

Viagra is already available as an NHS prescription free of charge for those who cannot pay for a prescription.

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:

  • Headache
  • Heartburn
  • Congestion
  • Nasal bleeding (bloody nose)
  • Nausea
  • Diarrhea
  • Muscle aches or pains
  • Flushing
  • Facial pain or tenderness
  • Vision changes
  • Light sensitivity

More severe side effects include:

  • Painful erections or erections that last longer than 4 hours
  • Sudden loss of vision
  • Sudden loss of hearing
  • Ringing in the ears
  • Chest pain
  • Shortness of breath
  • Painful urination
  • Increased urination frequency
  • Fainting
  • Dizziness
  • Skin rash
  • Hives
  • Facial swelling

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.

Show MoreBreathing cucumberRed hot pepperChickenpoxAmarConclusionI have been taking Viagra for about 4 months now and have been able to completely relax my erections. I have now just finished having sex and am now able to have more spontaneous sex. I have also been able to have more spontaneous sex more than ever without having to pause and interrupt sex. I have never had erections that long before and have had no issues during sex. I am very satisfied with the outcome, so I would not recommend taking Viagra to anyone who is taking nitrates for chest pain.