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Sildenafil citrate, known generically as Viagra, is a phosphodiesterase type 5 (PDE5) inhibitor used to treat erectile dysfunction (ED). It works by increasing blood flow to the penis, enabling a man to achieve and maintain an erection during sexual activity. This medication is available in various dosages, including 25 mg, 50 mg, and 100 mg. It is important to note that sildenafil does not have the same potency as other PDE5 inhibitors, such as tadalafil (Cialis), vardenafil (Levitra), or avanafil (Stendra).

Sildenafil is also used to treat pulmonary arterial hypertension (high blood pressure in the lungs). It works by relaxing the blood vessels in the lungs, allowing for easier access to blood and oxygen. It may be prescribed for other uses, such as in people with ED or those who have not previously experienced this effect.

Sildenafil is classified as a PDE5 inhibitor. It is used to treat erectile dysfunction in men. It works by increasing blood flow to the penis, enabling a man to achieve and maintain an erection during sexual stimulation.

Sildenafil is available in the following dosage forms: 25 mg, 50 mg, 100 mg, and 100 mg. Each dosage form may vary in terms of strength, effectiveness, and potential side effects. It is important to note that sildenafil should not be taken more than once per day.

Sildenafil is available in the following dosage forms: 25 mg, 50 mg, and 100 mg.

The recommended dose of sildenafil for erectile dysfunction is 25 mg, 50 mg, and 100 mg, taken orally, approximately 30 minutes to 1 hour before sexual activity. The maximum recommended dose of sildenafil is 100 mg per day. It is important to follow the dosage instructions provided by your healthcare provider to achieve the best results. It is generally advised to take sildenafil at least 2 hours before sexual activity to help achieve the best results. It is important to take sildenafil at least 1 hour before sexual activity and not more than once a day.

The recommended dose of sildenafil for pulmonary arterial hypertension is 50 mg, taken orally, approximately 30 minutes to 1 hour before sexual activity.

The recommended dose of sildenafil for erectile dysfunction is 50 mg, taken orally, approximately 30 minutes to 1 hour before sexual activity.

Cialis 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 Cialis use include:

  • Headache
  • Indigestion
  • Heartburn
  • Upset stomach
  • Gas
  • Nausea
  • Flushing

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 Cialis. Cialis can interact with bodily substances, causing potentially serious adverse reactions.

Specifically, you should inform your health care provider of any alpha-blocker, antifungal, HIV protease inhibitor, or high blood pressure 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.

Read More What is Cialis and how it works 'Cialis' is a prescription medication used to treat erectile dysfunction (ED) in men. Cialis is a prescription drug that works by increasing blood flow to the penis.How is Cialis different from other ED medications 'Pfizer’ is a natural, low-dose version of tadalafil. Unlike Cialis, which is available in generic forms, Cialis can be taken with or without food.What is the best medicine to take during sex to keep blood flow to the penis low? Cialis can help keep blood flowing better than other ED medications, making it easier to achieve and maintain an erection. Cialis may also help keep blood flowing harder, which could mean that you may not have ED until sexual activity is complete. What to avoid 'Pfizer’ is a prescription medication that works by relaxing the blood vessels in your penis, allowing for increased blood flow and enabling an erection when you want one. Cialis can also cause side effects such as:As with any medication, Cialis can cause some side effects. The most common side effects are headache, back pain, muscle aches, nausea, and dizziness.

More serious, more than 1 out of 3 men will experience an adverse reaction, making Cialis potentially beneficial for treating ED. Sexual activity can increase the risk of developing an adverse reaction if:

  • You have had an allergic reaction to Cialis or any other tadalafil component of the medication
  • You have a history of heart attack or stroke
  • You use medications that can increase blood flow to the penis, such as nitrates
  • You have ever had a vision change or a blue tinge to your vision
  • You have a history of liver problems
  • You have a history of bleeding or blood clotting problems
  • You have any other risk factors for ED

Cialis can cause potentially serious adverse reactions that require immediate medical attention.

What are the risks of taking Cialis 'Pfizer’?

Tadalafil (Cialis®)

Pregnancy

The effects of tadalafil in pregnancy have not been established. Therefore, this medicine should be used during pregnancy only if the benefits outweigh the risks.

Contraindication

Cialisis contraindicated in pregnancy.

Side Effects

Flushing, headaches, nausea, stuffy nose, and dizziness have been reported. Do not take tadalafil or any of the other ingredients of this medicine.

Warnings

Do not use tadalafil or the other ingredients of this medicine, if:

  • you have an allergy to tadalafil or any of the other ingredients of this medicine
  • you have ever had an allergic reaction to tadalafil or any of the other ingredients of this medicine
  • you are taking any nitrate drug for chest pain or heart problems,if tadalafil is used for chest pain

Before You Start Tadalafil (Cialis®)

Taking

The drug should not be taken with other medicines containing sildenafil. This medicine should not be used in combination with another medicine containing sildenafil, as it can cause an adverse effect in some people. Also, this medicine should not be used in patients under 18 years of age, as this medicine may cause permanent discolouration of the teeth.

Read the Medication Guide
  • Before taking this medicine, inform your doctor if you have ever had an erection that lasted more than 4 hours. If you do, you may experience some mild side effects. Consult your doctor before taking this medicine if you are taking any type of medicine.
  • Inform your doctor if you have any of the following medical conditions:A heart condition called’angina’, heart attack, stroke, chest pain or pressure, or if you have chest pain or difficulty breathing
  • Liver diseaseliver disease such as liver cirrhosis, or liver cancer
  • A blood disorder or abnormal levels of protein in your bloodblood disorders such as porphyria or a rare condition called porphyria-a rare condition where there is a family history of blood disorders such as anemia, sickle cell anemia, multiple myeloma, or leukemia
  • Alcohol usealcoholism
  • Kidney diseaseprostate disease or kidney failure
  • An unusual or allergic reactionin your blooda serious side effect that may include a high potassium blood test
  • this medicine may harm your unborn baby. There have been reports of abortion in babies born to mothers using this medicine during pregnancy. It has not been studied in pregnant women. If you plan to become pregnant, talk to your doctor about whether you should continue to take this medicine while pregnant. If you are a nursing mother, you must talk to your doctor about the use of this medicine during the nursing process. In addition, pregnant women should not take this medicine if they are pregnant.

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’.
Prescription medicines are supplied by a pharmacy - how are medicines sold available to buy without a prescription?

Often men will opt to prescription medicines as part of their attempts at sexual activity, particularly when ‘P’ medicine or ‘GSL’ is in issue. However that can vary and is often done in combination with P – Pharmacy treatment. You can buy general sales list medicines from well-known online prescription providers ‘from25%’.

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