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Erectile Dysfunction (ED) Tablets & Cream

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Cialis 10mg Tablets
Pack Size: 4 tablets
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  • You should take one Cialis 10mg tablet at least 30 minutes before sex.
  • Cialis can take up to an hour to take effect in some men, with the greatest effect after a few hours.
  • Cialis can produce an effect for up to 36 hours.
  • You should never take more than one Cialis or other erectile dysfunction tablet in a 36-hour period.
  • You can take Cialis with or without food however you should try to limit your alcohol intake to ensure it remains effective.
Cialis does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Cialis 10mg at least 8 times before trying to increase the dose to Cialis 20mg. If you find Cialis effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Cialis ineffective you may wish to try a different medicine such as Viagra, Spedra, or Levitra.auri

Cialis 10mg tablets are available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Cialis 10mg tablets are used to treat erectile dysfunction (impotence) in men. Cialis contains the active ingredient Tadalafil, which is a phosphodiesterase type 5 inhibitor. Cialis 10mg tablets works to relax muscles in the walls of the blood vessels, allowing for greater blood flow to the penis. This will help result in achieving and maintaining a satisfactory erection.

An erection is achieved via a complex series of events. When a man is sexually stimulated it will cause a chemical enzyme called cGMP to be released within the tissues of the penis. cGMP will cause the blood vessels in the penis to dilate (widen), this allows more blood to enter the penis, resulting in the penis becoming rigid and erect.

cGmp is normally broken down by another chemical in the body called phosphodiesterase type 5. Cialis 10mg tablets work by inhibiting the action of phosphodiesterase type 5 by the active ingredient, tadalafil. This prevents the breakdown of cGMP, which allows the blood vessels to remain dilated for longer. This improves the blood flow to the penis, helping to maintain an erection.

The action of Cialis 10mg tablets can only work to enhance the chemical messengers that are released when a man becomes sexually stimulated. If these messengers aren’t present, Cialis will have nothing to act upon. This means sexual stimulation is necessary for Cialis to help produce an erection.

Cialis 10mg tablets can be taken with or without food and should be swallowed whole with a drink of water. Cialis 10mg tablets are used on a ‘when required’ basis for erectile dysfunction. On average it usually takes around thirty minutes for the effects to present, which is why it is recommended that the tablet be taken thirty minutes prior to sexual activity. One dose of Cialis 10mg can produce an erection in response to the necessary sexual stimulation for up to thirty-six hours. For this reason, Cialis 10mg tablets should be taken no more than once in a 36 hour period. 

If you do experience side effects from Cialis they may include headache, flushing, and rarely back pain. Cialis has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects. 

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Cialis 10mg Tablets may not be suitable for you if:

  • You suffer heart problems, such as angina, heart failure and irregular heartbeats.
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a hemophiliac
  • You suffer from sickle cell anemia or leukemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Cialis 10mg tablets will be safe for you to use.

When combined with nitrates or alpha-blockers, Cialis can cause a dangerous drop in blood pressure. You should have checked this during your consultation but if you are in any doubt do not take Cialis and contact us via your online account. You should also avoid using the recreational drug ‘Poppers’, also called ‘Aromas’ or ‘Room Odourisers’ as these also contain nitrates.   

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Cialis 2.5mg Tablets
Pack Size: 28 tablets
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Cialis Once Daily should be taken at a dose of 2.5mg once daily at the same time each day and adjusted accordingly. 

Cialis Once Daily is a new treatment for erectile dysfunction that is taken every day. It can help men achieve a ‘natural’ erection and removes the need to plan your medication around your sex life.

Please read the Patient Information Leaflet for side effects and additional information.

Pharmacist tip: Cialis Once Daily should be taken at a dose of 2.5mg once daily at the same time each day and adjusted accordingly. It will build up an effect over the first 5 days of treatment after which it should be effective when required. Its effects are unaffected by food.

If you do experience side effects from Cialis they may include headache, flushing, and rarely back pain. Cialis has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects. 

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Cialis 2.5mg Tablets may not be suitable for you if:

  • You suffer heart problems, such as angina, heart failure and irregular heartbeats.
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a hemophiliac
  • You suffer from sickle cell anemia or leukemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Cialis 10mg tablets will be safe for you to use.

When combined with nitrates or alpha-blockers, Cialis can cause a dangerous drop in blood pressure. You should have checked this during your consultation but if you are in any doubt do not take Cialis and contact us via your online account. You should also avoid using the recreational drug ‘Poppers’, also called ‘Aromas’ or ‘Room Odourisers’ as these also contain nitrates.   

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Cialis 20mg Tablets
Pack Size: 4 tablets
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  • You should take one Cialis 20mg tablet at least 30 minutes before sex.
  • Cialis can take up to an hour to take effect in some men, with the greatest effect after a few hours.
  • Cialis can produce an effect for up to 36 hours.
  • You should never take more than one Cialis ot other treatment for erectile dysfunction (Viagra, Spedra, or Levitra) in a 36-hour period.
  • You can take Cialis with or without food however you should try to limit your alcohol intake to ensure it remains effective.
Cialis does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Cialis 20mg at least 8 times before trying an alternative ED treatment. If you find Cialis effective and do not experience any serious side effects you can request a repeat order via your online account.

Cialis 20mg tablets are available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Cialis 20mg tablets are an ‘as required’ treatment for erectile dysfunction in men. Cialis is a branded treatment made by Lilly, containing the active ingredient tadalafil, a loner-lasting version of sildenafil contained in Viagra. Cialis (tadalafil), like Viagra, is known as a PDE-5 inhibitor and helps to relax the blood vessels that flow into the penis, allowing greater blood flow and a satisfactory erection to be achieved.

Cialis 20mg tablets are the highest strength of Cialis/tadalafil available and are used if a man has not achieved satisfactory results from the starting dose of Cialis 10mg tablets after a number of attempts. Cialis can have an effect in as little as 30 minutes in some men and the effects can last for up to 36 hours, allowing it to be used just before sex or taken discreetly well in advance. This flexibility in dosing makes it a popular choice with men looking for an ED treatment that fits into their life.

Cialis 20mg is not normally affected by food and should be taken with plenty of water. It is not affected by alcohol, however alcohol can be a contributor to ED so it is best avoided or consumed in moderation. Like all ED tablets, it may take a few attempts at taking Cialis before it becomes effective. If you have tried Cialis 20mg on 8 separate occasions and not achieved satisfactory results, you may wish to consider trying a different erectile dysfunction treatment such as Sildenafil, Spedra or Levitra.

Cialis 20mg tablets help to resolve the physical symptoms of erectile dysfunction. However, some cases of ED can be caused by psychological issues such as anxiety. Even if the cause of your ED is psychological, Cialis can help to break the cycle of anxiety associated with being unable achieve and maintain a satisfactory erection. If you think the cause of is psychological and you have tried Cialis with no effect you should see your GP as counselling may be more appropriate for you.

As with all medicines Cialis 20mg tablets can potentially cause side-effects. Fortunately, the few people who suffer side-effects will usually find them to be brief and mild. The most common side-effects for those taking Cialis 20mg tablets are:

  • Headache
  • Facial flushing
  • Indigestion
  • Nasal congestion
  • Dizziness

Other medicines can interact with Cialis 20mg tablets. You should not take Cialis if you are taking medicines called ‘nitrates’, which are often prescribed for chest pain. You should not use other erectile dysfunction medicines while taking Cialis. It is not recommended to drink excessive amounts of alcohol when taking Cialis 20mg Tablets. Drinking too much alcohol can increase the likelihood of experiencing side-effects, such as headaches and dizziness. It is important to seek medical advice immediately if you experiencing an erection that lasts more than four hours.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Cialis 20mg Tablets may not be suitable for you if:

  • You suffer heart problems, such as angina, heart failure and irregular heartbeats.
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a hemophiliac
  • You suffer from sickle cell anemia or leukemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Cialis 20mg tablets will be safe for you to use.

When combined with nitrates or alpha-blockers, Cialis can cause a dangerous drop in blood pressure. You should have checked this during your consultation but if you are in any doubt do not take Cialis and contact us via your online account. You should also avoid using the recreational drug ‘Poppers’, also called ‘Aromas’ or ‘Room Odourisers’ as these also contain nitrates.   

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Cialis 5mg Tablets
Pack Size: 28 tablets
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Cialis 5mg tablets are for oral use in men only and should be swallowed whole with water. The tablets can be taken with or without food.

Cialis 5mg tablets are used for the treatment of erectile dysfunction when purchased from The Independent Pharmacy Online Doctor.  They can also be used to treat other conditions such as benign prostatic hyperplasia at the discretion of your doctor. 

The recommended dose of Cialis is one 5 mg tablet taken once a day at approximately the same time of the day. Do not take CIALIS more than once a day. If you experience any side effects from taking Cialis daily you may find that a lower dose of 2.5mg daily is more appropriate.

When taken once a day Cialis allows you to obtain an erection, when sexually stimulated, at any time point during the 24 hours of the day. Once a day dosing of Cialis may be useful to men who anticipate having sexual activity two or more times per week. It is important to note that CIALIS does not work if there is no sexual stimulation. You and your partner will need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction.

Drinking alcohol may affect your ability to get an erection. Drinking alcohol may temporarily lower your blood pressure. If you have taken or are planning to take CIALIS, avoid excessive drinking (blood alcohol level of 0.08% or greater), since this may increase the risk of dizziness when standing up.

Cialis Once Daily is a new treatment for erectile dysfunction that is taken every day. It can help men achieve a ‘natural’ erection and removes the need to plan your medication around your sex life. 

Cialis 5mg tablets are used to treat erectile dysfunction (impotence) in men. Cialis contains the active ingredient Tadalafil, which is a phosphodiesterase type 5 inhibitor. Cialis 5mg tablets works to relax muscles in the walls of the blood vessels, allowing for greater blood flow to the penis. This will help result in achieving and maintaining a satisfactory erection.

Unlike higher strengths of Cialis and other erectile dysfunction treatments, such as Viagra, Cialis 5mg tablets are designed to be taken once-a-day, every day. This will enable you to get an erection and have sex whenever you wish, eliminating the need to time your dose to correspond with your sexual activity. Cialis 5mg tablets should not be taken more than once a day. Cialis 5mg tablets may be more suited to you if you anticipate taking Cialis on a regular basis (engaging in sexual activity more than twice a week).

An erection is achieved via a complex series of events. When a man is sexually stimulated it will cause a chemical enzyme called cGMP to be released within the tissues of the penis. cGMP will cause the blood vessels in the penis to dilate (widen), this allows more blood to enter the penis, resulting in the penis becoming rigid and erect.

cGmp is normally broken down by another chemical in the body called phosphodiesterase type 5. Cialis 5mg tablets works by inhibiting the action of phosphodiesterase type 5. This prevents the breakdown of cGMP, which allows the blood vessels to remain dilated for longer. This improves the blood flow to the penis, helping to maintain an erection.

The action of Cialis 5mg tablets can only work to enhance the chemical messengers that are released when a man becomes sexually stimulated. If these messengers aren’t present, Cialis will have nothing to act upon. This means sexual stimulation is necessary for Cialis to help produce an erection.

Pharmacist tip: Cialis Once Daily should be taken at a dose of 5mg once daily at the same time each day and adjusted accordingly. It will build up an effect over the first 5 days of treatment after which it should be effective when required. Its effects are unaffected by food.

As with all medicines Cialis 5mg tablets can potentially cause side-effects. Fortunately, the few people who suffer side-effects will usually find them to be brief and mild. The most common side-effects for those taking Cialis 5mg tablets are:

  • Headache
  • Facial flushing
  • Indigestion
  • Nasal congestion
  • Dizziness

Please read the Patient Information Leaflet enclosed with your treatment for a full list of possible side effects.

Cialis 5mg Tablets may not be suitable for you if:

  • You suffer heart problems, such as angina, heart failure and irregular heartbeats.
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a hemophiliac
  • You suffer from sickle cell anemia or leukemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to include this in your consultation notes so that your prescriber can judge whether Cialis 5mg tablets will be safe for you to use.

When combined with nitrates or alpha-blockers, Cialis can cause a dangerous drop in blood pressure. You should have checked this during your consultation but if you are in any doubt do not take Cialis and contact us via your online account. You should also avoid using the recreational drug ‘Poppers’, also called ‘Aromas’ or ‘Room Odourisers’ as these also contain nitrates.   

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Levitra Orodispersible offers the same results as Levitra without the need to swallow the tablet. They can be taken discreetly anywhere without the need for water.

Please read the Patient Information Leaflet for side effects and additional information.

Pharmacist tip: Levitra Orodispersible should be started at a dose of 10mg at least 30 minutes to 1 hour before sexual intercourse and adjusted accordingly. It lasts for 4 – 5 hours and you should try to avoid meals around the same time as it may reduce the effectiveness of Levitra.

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Levitra 10mg Tablets
Pack Size: 4 tablets
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  • You should take one tablet at least 25 minutes before sex.
  • Levitra can take up to an hour to take effect in some men, although it can take effect in as little as 15 – 20 minutes in some men.
  • Levitra can produce an effect for up to 4 – 5 hours, although occasionally it can last longer.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Levitra on an empty stomach or after a light meal and try to limit your alcohol intake to ensure it remains effective.
Levitra does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Levitra at least 8 times before trying an alternative dose or treatment. If you find Levitra effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Levitra ineffective you may wish to increase the strength, or alternatively try a different medicine such as Cialis or Viagra. 

Levitra 10mg tablets are available from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Levitra 10mg tablets are a medicine designed to treat erectile dysfunction (ED) in men. They contain the active ingredient Vardenafil HCl. It works by increasing the blood flow to the penis. Together with the necessary sexual stimulation this increased blood flow will help achieve and maintain a satisfactory erection.

Levitra belongs to a class of medicines called phosphodiesterase type 5 inhibitors. As with all erectile dysfunction oral treatments, Vardenafil is only effective with the appropriate sexual stimulation. This medication does not increase sexual desire or cause sexual arousal. It is a common misconception that erectile dysfunction treatments, such as Levitra have this effect. To fully understand how Levitra 10mg tablets work, it is first necessary to understand the mechanics of an erection. When a man becomes sexually stimulated, the nervous system in the erectile tissue of the penis starts to release nitric oxide. This release stimulates an enzyme (cGMP) that relaxes the smooth muscle cells of the penis. This muscle relaxation has two effects:

  • The arteries in the penis dilate, allowing blood to flow more easily
  • The erectile tissue fills with blood

It’s these two processes that results in a successful erection. Levitra 10mg tablets work by maintaining the levels of cGMP in the smooth muscle cells. However, if a man isn’t sexually stimulated then nitric oxide isn’t released and no cGMP will be produced, resulting in no erection. It’s important to note that Levitra isn’t always successful the first time you take it. Your prescriber will probably recommend attempting Levitra at least eight times before switching to a different medicine.

Levitra 10mg tablets will usually have an effect within 15 minutes of taking the tablet. With the necessary sexual arousal its effectiveness can last for up to 10 hours. The amount of time Levitra will take to work can vary slightly from person to person, it is recommended to start sexual activity at varying times after taking the tablet. This will help to determine the optimal time for your sexual activity. Levitra 10mg tablets are the starting dose for men who have never taken Levitra or other ED treatments before. Levitra 10mg are normally adequate to treat most cases of ED, however if you do not find Levitra effective the first time you try it, it is recommended that you take Levitra 10mg on 8 separate occassions before you switch to a higher strength (Levitra 20mg) or different ED treatment.

Levitra 10mg tablets can be taken with or without food. It is not recommended to consume excessive amounts of alcohol prior to taking Levitra. Drinking large quantities of alcohol can make it difficult to achieve an erection. Small to moderate alcohol consumption will not interfere with Levitra.

If you do experience side effects from Levitra they may include headache, flushing, and nasal congestion. Levitra has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Levitra 10mg tablets may not be suitable if any of the following apply:

  • You suffer from heart disease or heart rhythm problems
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a haemophiliac
  • You suffer from sickle cell anaemia or leukaemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Sildenafil 50mg tablets will be safe for you to use.

Levitra 10mg tablets can slightly lower the blood pressure. For most men this isn’t a concern. However, this effect on blood pressure can be exaggerated if Levitra is taken with a nitrate drug, such as Isosorbide or Glyceryl Trinitrate (GTN). If taking nitrate drugs then Levitra 10mg tablets should not be used. Levitra 10mg tablets should be used in caution if combined with alpha blockers due to the potenial hypotensive effects.   

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Levitra 20mg Tablets
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  • You should take one tablet at least 25 minutes before sex.
  • Levitra can take up to an hour to take effect in some men, although it can take effect in as little as 15 – 20 minutes in some men.
  • Levitra can produce an effect for up to 4 – 5 hours, although occasionally it can last longer.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Levitra on an empty stomach or after a light meal and try to limit your alcohol intake to ensure it remains effective.
Levitra does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Levitra at least 8 times before trying an alternative dose or treatment. If you find Levitra effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Levitra ineffective you may wish to increase the strength, or alternatively try a different medicine such as Cialis or Viagra. 

Levitra contains the active ingredient vardenafil, which is similar in action to sildenafil. They are taken when required for and in some cases can act within 25 minutes.

Please read the Patient Information Leaflet for side effects and additional information.

Pharmacist tip: Levitra should be started at a dose of 10mg at least 25 minutes to 1 hour before sexual intercourse and adjusted accordingly. It lasts for 4 – 5 hours and you should try to avoid large or high-fat meals around the same time as it may reduce the effectiveness of Levitra.

If you do experience side effects from Levitra they may include headache, flushing, and nasal congestion. Levitra has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

When combined with nitrates or alpha-blockers, Levitra can cause a dangerous drop in blood pressure. You should have checked this during your consultation but if you are in any doubt do not take Levitra and contact us via your online account. You should also avoid using the recreational drug ‘Poppers’, also called ‘Aromas’ or ‘Room Odourisers’ as these also contain nitrates.   

Levitra may be taken with alpha-blockers, provided there is at least a six-hour gap between the medicines, however it must never be taken with nitrates.

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Levitra 5mg Tablets
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  • You should take one tablet at least 25 minutes before sex.
  • Levitra can take up to an hour to take effect in some men, although it can take effect in as little as 15 – 20 minutes in some men.
  • Levitra can produce an effect for up to 4 – 5 hours, although occasionally it can last longer.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Levitra on an empty stomach or after a light meal and try to limit your alcohol intake to ensure it remains effective.
Levitra does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Levitra at least 8 times before trying an alternative dose or treatment. If you find Levitra effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Levitra ineffective you may wish to increase the strength, or alternatively try a different medicine such as Cialis or Viagra. 

Levitra 5mg tablets are available from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Levitra 5mg tablets are a medicine designed to treat erectile dysfunction (ED) in men. They contain the active ingredient Vardenafil HCl. It works by increasing the blood flow to the penis. Together with the necessary sexual stimulation this increased blood flow will help achieve and maintain a satisfactory erection.

Levitra belongs to a class of medicines called phosphodiesterase type 5 inhibitors. As with all erectile dysfunction oral treatments, Vardenafil is only effective with the appropriate sexual stimulation. This medication does not increase sexual desire or cause sexual arousal. It is a common misconception that erectile dysfunction treatments, such as Levitra have this effect. To fully understand how Levitra 5mg tablets work, it is first necessary to understand the mechanics of an erection. When a man becomes sexually stimulated, the nervous system in the erectile tissue of the penis starts to release nitric oxide. This release stimulates an enzyme (cGMP) that relaxes the smooth muscle cells of the penis. This muscle relaxation has two effects:

  • The arteries in the penis dilate, allowing blood to flow more easily
  • The erectile tissue fills with blood

It’s these two processes that results in a successful erection. Levitra 5mg tablets work by maintaining the levels of cGMP in the smooth muscle cells. However, if a man isn’t sexually stimulated then nitric oxide isn’t released and no cGMP will be produced, resulting in no erection. It’s important to note that Levitra isn’t always successful the first time you take it. Your prescriber will probably recommend attempting Levitra at least eight times before switching to a different medicine.

Levitra 5mg tablets will usually have an effect within 15 minutes of taking the tablet. With the necessary sexual arousal its effectiveness can last for up to 10 hours. The amount of time Levitra will take to work can vary slightly from person to person, it is recommended to start sexual activity at varying times after taking the tablet. This will help to determine the optimal time for your sexual activity. Levitra 5mg tablets are the lowest dose that are used by men who have taken Levitra 10mg or the starting dose of other ED treatments before and found that they produce too strong an effect or side effects.

Levitra 5mg tablets can be taken with or without food. It is not recommended to consume excessive amounts of alcohol prior to taking Levitra. Drinking large quantities of alcohol can make it difficult to achieve an erection. Small to moderate alcohol consumption will not interfere with Levitra.

As with all medicines Levitra 5mg tablets can potentially cause side-effects. Fortunately, the few people who suffer side-effects will usually find them to be brief and mild. The most common side-effects for those taking Levitra 5mg tablets are:

  • Headache
  • Facial flushing
  • Indigestion
  • Nasal congestion
  • Dizziness

Other medicines can interact with Levitra 5mg tablets. You should not take Levitra if you are taking medicines called ‘nitrates’, which are often prescribed for chest pain. You should not use other erectile dysfunction medicines while taking Levitra. It is not recommended to drink excessive amounts of alcohol when taking Levitra 5mg Tablets. Drinking too much alcohol can increase the likelihood of experiencing side-effects, such as headaches and dizziness. It is important to seek medical advice immediately if you experiencing an erection that lasts more than four hours.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Levitra 5mg tablets may not be suitable if any of the following apply:

  • You suffer from heart disease or heart rhythm problems
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a haemophiliac
  • You suffer from sickle cell anaemia or leukaemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Sildenafil 50mg tablets will be safe for you to use.

Levitra 5mg tablets can slightly lower the blood pressure. For most men this isn’t a concern. However, this effect on blood pressure can be exaggerated if Levitra is taken with a nitrate drug, such as Isosorbide or Glyceryl Trinitrate (GTN). If taking nitrate drugs then Levitra 5mg tablets should not be used. Levitra 5mg tablets should be used in caution if combined with alpha blockers due to the potenial hypotensive effects.   

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  • You should take one tablet at least 30 minutes before sex.
  • ED treatments can take up to an hour to take effect in some men, although they can take effect in as little as 15 – 20 minutes in some men.
  • Viagra & Levitracan produce an effect for up to 4 – 5 hours, although occasionally it can last longer. Cialis can have an effect for up to 36 hours.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • ED treatments can be affected by food and alcohol consumption. You shoud check the Patient Information Leaflets of the indivual drugs for more information.

Our Erectile Dyfunction Starter Pack contains the starting dose of each of the main brands of erectile dysfunction treatment. Erectile dysfunction treatments can produce differing effects depending on the individual; this Starter Pack allows patients to try each of the drugs to find the one that gives the best results without any undesirable effects.

The Erectile Dysfunction Starter Pack contains Viagra 50mg tablets x 4, Cialis 10mg tablets x 4 and Levitra 10mg tablets x 4.

Please read the Patient Information Leaflets for side effects and additional information about each medicine. 

Pharmacist tip: You should take a single tablet up to 1 hour before sexual intercourse. Depending on the drug, the effects can last up to 36 hours. You should not take more than 1 tablet of any erectile dysfunction treatment in a 36 hour period.

If you do experience side effects from ED treatments they may include headache, flushing, and nasal congestion. ED treatments has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

When combined with nitrates or alpha-blockers, ED treatments can cause a dangerous drop in blood pressure. You should have checked this during your consultation but if you are in any doubt do not take ED treatments and contact us via your online account. You should also avoid using the recreational drug ‘Poppers’, also called ‘Aromas’ or ‘Room Odourisers’ as these also contain nitrates.   

 

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  • You should take one Sildenafil 100mg tablet at least 1 hour before sex.
  • Sildenafil can take up to an hour to take effect in some men, although it can take effect in as little as 20 minutes in some men.
  • Sildenafil can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Sildenafil on an empty stomach and try to limit your alcohol intake to ensure it remains effective.
Sildenafil does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try your current dose of Sildenafil at least 8 times before trying an alternative treatment. If you find Sildenafil effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Sildenafil ineffective you may wish to try a different medicine such as Cialis, Spedra or Levitra. 

Sildenafil 100mg tablets are available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Sildenafil 100mg tablets are a generic treatment for erectile dysfunction (ED) in men. Sildenafil was first released under the well-known brand name Viagra, the ‘blue pill’ that has become iconic in the treatment of impotence. Once the patent on Viagra expired in 2013, generic treatments could be produced by drug manufacturers at a significant discount. Each manufacturer now produces different sizes and shapes of Sildenafil 50mg tablets, however they all contain the same active ingredient and should produce the same effect. Sildenafil is a PDE-5 inhibitor that treats erectile dysfunction by relaxing the blood vessels that feed blood to the penis, causing them to widen. This dilation allows a greater flow of blood to the penis, enabling it to become successfully erect.

Sildenafil 100mg tablets are the highest dose for patients who have tried Sildenafil or other erectile dysfunction treatments before, without achieving satisfactory results. Sildenafil 50mg is normally sufficient strength to treat some cases of ED however, increasing the strength to 100mg can improve symptoms where 50mg is ineffective. As with all ED medicines, Sildenafil isn’t always successful the first time you take it, it can take a few attempts for your body to get used to the treatment. It is recommended to take Sildenafil 100mg at least eight times to allow it to build up a full effect before switching to a different erectile dysfunction treatment.

Sildenafil increases the blood flow to the penis helping to achieve and maintain a satisfactory erection. Sildenafil will only help to produce an erection if you are sexually aroused, it will not help to get an erection without stimulation.

Sildenafil is the name of the drug contained in the branded medicine Viagra. Now that the patent on Viagra has expired other companies may make ‘generic’ versions of the drug, however they still must receive a product licence from the MHRA ensuring their safety. Due to increased competition ‘generic’ Sildenafil is available at a much lower price but still has the same effect and quality you would expect from a branded medication.

Pharmacist tip: Sildenafil should be taken 30 minutes to 1 hour before sexual intercourse. It lasts for 4 – 5 hours and you should try to avoid high fat meals around the same time as it may reduce the effectiveness of Sildenafil.

If you do experience side effects from Sildenafil they may include headache, flushing, light headedness and rarely a stuffy nose or indigestion. Sildenafil has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

 

Sildenafil 100mg tablets may not be suitable if any of the following apply:

  • You suffer from heart disease or heart rhythm problems
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a haemophiliac
  • You suffer from sickle cell anaemia or leukaemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Sildenafil 100mg tablets will be safe for you to use.

Sildenafil 100mg tablets can lower the blood pressure. For most men this isn’t a concern. However, this effect on blood pressure can be exaggerated if Sildenafil is taken with a nitrate drug, such as Isosorbide or Glyceryl Trinitrate (GTN). If taking nitrate drugs then Sildenafil 100mg tablets should not be used. Sildenafil 100mg tablets should be used in caution if combined with alpha blockers due to the potenial hypotensive effects.   

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  • You should take one Sildenafil 25mg tablet 30 minutes to 1 hour before sex.
  • Sildenafil can take up to an hour to take effect in some men, although in others it can take effect in as little as 20 minutes.
  • Sildenafil can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Sildenafil, Viagra, Cialis, Spedra, or Levitra) in a 24-hour period.
  • You should take Sildenafil on an empty stomach or after a low-fat meal and try to limit your alcohol intake to ensure it remains effective.

Sildenafil 25mg tablets are available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Sildenafil 25mg tablets are a generic medication prodcued by many different drug manufacturers to treat erectile dysfunction (impotence). Generic Sildenafil 25mg tablets are now availble following the patent expiry on branded Viagra, allowing other companies to produced the same unbranded treatment for a fraction of the cost. The active ingredient in Sildenafil is sildenafil. Sildenafil is technically classed as a Phosphodiesterase Type 5 inhibitor (PDE-5 inhibitor). Simply put, Sildenafil 25mg tablets work by relaxing blood vessels and allowing a greater flow of blood to the penis. This increased flow will enable the penis to successfully become erect when sexually stimulated. In the majority of cases Sildenafil 25mg will take effect within thirty minutes. If the tablet is taken after eating a heavy meal that is high in fat, it can take a little longer to take effect. Sildenafil 25mg tablets will usually remain effective between four to six hours.    

Sildenafil 25mg tablets are the lowest strength of Sildenfail/Viagra available. Sildenafil 25mg tablets are normally used in patients who have experienced side effects when taking the starting dose of Sildenafil or Viagra 50mg tablets. Although they are the lowest strength treatment, Sildenafil 25mg tablets can still successfully treat ED in many patients with the lowest chance of side effects.

Sildenafil 25mg tablets should, for those whom the 50mg strength are unsuitable, resolve the symptoms of erectile dysfunction. Even if the cause is psychological, its effect can help to break the cycle of anxiety associated with being unable achieve and maintain a satisfactory erection. 

Sildenafil 25mg tablets, as with all medicines has the potential to produce side-effects. Fortunately, these side effects are usually brief and mild, if experienced at all. The most common side-effects relating to Sildenafil 25mg tablets are; facial flushing and headache. Uncommon side effects can include; indigestion, a stuffy nose and a blue tint to the vision. As Sildenafil 25mg tablets are the lowest strength available, you are much less likely to experience side effects.

Sildenafil 25mg tablets may not be suitable if any of the following apply:

  • You suffer from heart disease or heart rhythm problems
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a haemophiliac
  • You suffer from sickle cell anaemia or leukaemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Sildenafil 25mg tablets will be safe for you to use.

Sildenafil 25mg tablets can slightly lower the blood pressure. For most men this isn’t a concern. However, this effect on blood pressure can be exaggerated if Sildenafil is taken with a nitrate drug, such as Isosorbide or Glyceryl Trinitrate (GTN). If taking nitrate drugs then Sildenafil 25mg tablets should not be used. Sildenafil 25 mg tablets should be used in caution if combined with alpha blockers due to the potenial hypotensive effects.   

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  • You should take one 50mg tablet 30 minutes to 1 hour before sex.
  • Sildenafil can take up to an hour to take effect in some men, although it can take effect in as little as 20 minutes in some men.
  • Sildenafil can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Sildenafil on an empty stomach and try to limit your alcohol intake to ensure it remains effective.

Sildenafil does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Sildenafil at least 8 times before trying an alternative dose or treatment. If you find Sildenafil effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Sildenafil ineffective you may wish to increase the strength, or alternatively try a different medicine such as Cialis or Levitra. 

Sildenafil 50mg tablets are available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Sildenafil 50mg tablets are a generic treatment for erectile dysfunction (ED) in men. Sildenafil was first released under the well-known brand name Viagra, the ‘blue pill’ that has become iconic in the treatment of impotence. Once the patent on Viagra expired in 2013, generic treatments could be produced by drug manufacturers at a significant discount. Each manufacturer now produces different sizes and shapes of Sildenafil 50mg tablets, however they all contain the same active ingredient and should produce the same effect. Sildenafil is a PDE-5 inhibitor that treats erectile dysfunction by relaxing the blood vessels that feed blood to the penis, causing them to widen. This dilation allows a greater flow of blood to the penis, enabling it to become successfully erect.

Sildenafil 50mg tablets are the starting dose for patients who have not taken Sildenafil or other erectile dysfunction treatments before. Sildenafil 50mg is normally sufficient strength to treat most cases of ED however, as with all ED medicines, Sildenafil isn’t always successful the first time you take it, it can take a few attempts for your body to get used to the treatment. It is recommended to take a particular dose of Sildenafil at least eight times before attempting to increase the dose or switch to a different erectile dysfunction treatment.

It’s important to note that Sildenafil does not itself cause sexual arousal, it increases; an erection cannot be achieved without the necessary sexual stimulation. To fully understand how Sildenafil 50mg tablets work, it is first necessary to understand the mechanics of an erection. When a man becomes sexually aroused, his nervous system will start to release nitric oxide into the erectile tissue of the penis. The nitric oxide interacts with an enzyme called cGMP. cGMP relaxes the smooth muscle cells of the penis, causing the arteries within to dilate and the erectile tissue to fill with blood. It is this process that results in an erection. Sildenafil 50mg tablets block the action of the chemical responsible for breaking down the enzyme cGMP. This allows for the arteries to remain dilated for longer and the flow of blood to the penis to continue. If a man isn’t sexually aroused in the first place then nitric oxide isn’t released hence no cGMP will be produced. This will result in no erection. So taking Sildenafil 50mg minus any arousal or sexual stimulation will not result in an erection or increased sexual performance.

Sildenafil 50mg tablets will, for most, resolve the symptoms of erectile dysfunction. Even if the cause is psychological, its effect can help to break the cycle of anxiety associated with being unable to achieve or maintain a satisfactory erection. 

If you do experience side effects from Sildenafil they may include headache, flushing, light headedness and rarely a stuffy nose or indigestion. Sildenafil has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Sildenafil 50mg tablets may not be suitable if any of the following apply:

  • You suffer from heart disease or heart rhythm problems
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a haemophiliac
  • You suffer from sickle cell anaemia or leukaemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Sildenafil 50mg tablets will be safe for you to use.

Sildenafil 50mg tablets can slightly lower the blood pressure. For most men this isn’t a concern. However, this effect on blood pressure can be exaggerated if Sildenafil is taken with a nitrate drug, such as Isosorbide or Glyceryl Trinitrate (GTN). If taking nitrate drugs then Sildenafil 50mg tablets should not be used. Sildenafil 50mg tablets should be used in caution if combined with alpha blockers due to the potenial hypotensive effects.   

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  • You should take one Spedra 100mg tablet around 30 minutes before sex.
  • Spedra can take up to 60 - 90 minutes to take effect in some men if it is taken on a full stomach after a large meal.
  • Spedra can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Spedra, Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Spedra on an empty stomach and try to limit your alcohol intake to ensure it remains effective.

Spedra does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Spedra at least 8 times before trying an alternative dose or treatment. If you find Spedra 100mg tablets effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Spedra 100mg ineffective you may wish to increase the strength to Spedra 200mg tablets, or alternatively try a different medicine such as Viagra, Cialis or Levitra. 

Spedra 100mg tablets are available from The Independent Pharmacy Online Doctor service, following a free consultation, to help treat erectile dysfunction (ED) in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Spedra 100mg tablets contain the drug, avanafil. It is the newest medicine in the class of PDE-5 inhibitors that include Viagra, Cialis & Levitra. Like the other ED treatments, Spedra works by increasing blood flow to the penis resulting in the increased ability to gain a satisfying erection when you are sexually excited. Spedra will only work in response to sexual stimulation so you and your partner will need to engage in foreplay – the same as if you were not taking the medicine.

Spedra 100mg tablets are the starting dose for patients who have not taken Spedra or other erectile dysfunction treatments before. Spedra 100mg is normally sufficient strength to treat most cases of ED however, as with all ED medicines, Spedra isn’t always successful the first time you take it, it can take a few attempts for your body to get used to the treatment. It is recommended to take a particular dose of Spedra at least eight times before attempting to increase the dose or switch to a different erectile dysfunction treatment.

Spedra 100mg tablets help to resolve the physical causes of erectile dysfunction, the result of poor blood flow to the penis due to narrowing or blocked arteries. If psychological issues such as problems in a relationship, depression or anxiety cause ED, Spedra can still help to improve the symptoms. However, to help to resolve the underlying condition in the long-term it may be advisable to discuss any issues with your GP or therapist.

Not everyone will experience side effects however, if you do experience side effects from Spedra 100mg tablets they may include headache, flushing, light headedness and rarely a stuffy nose or indigestion. Spedra has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

Stop taking Spedra and see a doctor straight away if you notice any of the following serious side effects – you may need urgent medical treatment:

  • an erection that will not go away (“priapism”). If you get an erection that lasts more than 4 hours, this must be treated as soon as possible or lasting damage can happen to your penis (including not being able to get erections).
  • blurred vision.
  • sudden decrease or loss of vision in one or both eyes.
  • sudden decrease or loss of hearing (sometimes you may also feel dizzy or have ringing in your ears).

Stop taking Spedra and see a doctor straight away, if you notice any of the serious side effects above.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Do not take Spedra:

  • If you are allergic to avanafil or any of the other ingredients of this medicine.
  • If you are taking “nitrate” medicines for chest pain (angina), such as amyl nitrite or glyceryl trinitrate. Spedra can increase the effects of these medicines and severely lower your blood pressure
  • If you are taking medicines for HIV or AIDS such as ritonavir, indinavir, saquinavir, nelfinavir or atazanavir
  • If you are taking medicines for fungal infections such as ketoconazole, itraconazole or voriconazole or certain antibiotics for bacterial infections, such as clarithromycin or telithromycin
  • If you have a serious cardiac problem
  • If you have had a stroke or heart attack in the last 6 months
  • If you have an irregular heartbeat (“arrhythmia”) or heart problems that run in your family, as shown on a heart tracing (ECG)
  • If you have low blood pressure or high blood pressure not controlled by medicines
  • If you have chest pain (angina) or you get chest pain during sexual intercourse
  • If you have a serious liver or kidney problem
  • If you have loss of vision in one eye due to not enough blood getting to your eye (non-arteritic ischemic optic neuropathy [NAION])
  • If certain serious eye problems run in your family (such as retinitis pigmentosa).

Do not take Spedra if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Spedra.

Warnings and precautions

Talk to your doctor or pharmacist before taking Spedra:

  • If you have heart trouble. It may be risky for you to have sexual intercourse
  • If you suffer from priapism, that is a persistent erection lasting 4 hours or more. This can happen in men with conditions like sickle cell disease, multiple myeloma or leukaemia.
  • If you have a physical condition that affects the shape of your penis (such as angulation, Peyronie’s disease or cavernosal fibrosis)
  • If you have any bleeding disorder or active peptic ulceration.

If any of the above apply to you talk to your doctor or pharmacist before taking Spedra. Check with your doctor or pharmacist if you are not sure.

Problems with your sight or hearing

Some men taking medicines like Spedra have had problems with their sight and hearing – see “Serious side effects” in section 4 for more details. It is not known if these problems are related directly to Spedra, other diseases that you may have or a combination of factors.

Spedra with food and alcohol

Grapefruit juice can increase exposure to the medicine and should be avoided within 24 hours prior to taking Spedra.

Drinking alcohol at the same time as taking Spedra may increase your heart rate and lower your blood pressure. You may feel dizzy (especially when standing), have a headache or feel your heart beating in your chest (palpitations). Drinking alcohol may also decrease your ability to get an erection.

 

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  • You should take one Spedra 200mg tablet around 30 minutes before sex.
  • Spedra can take up to 60 - 90 minutes to take effect in some men if it is taken on a full stomach after a large meal.
  • Spedra can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Spedra, Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Spedra on an empty stomach and try to limit your alcohol intake to ensure it remains effective.

Spedra does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Spedra at least 8 times before trying an alternative ED treatment. If you find Spedra 200mg tablets effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Spedra 100mg ineffective you may wish to increase the strength to Spedra 200mg tablets, or alternatively try a different medicine such as Viagra, Cialis or Levitra. 

Spedra 200mg tablets are available from The Independent Pharmacy Online Doctor service, following a free consultation, to help treat erectile dysfunction (ED) in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Spedra 200mg tablets contain the drug, avanafil. It is the newest medicine in the class of PDE-5 inhibitors that include Viagra, Cialis & Levitra. Like the other ED treatments, Spedra works by increasing blood flow to the penis resulting in the increased ability to gain a satisfying erection when you are sexually excited. Spedra will only work in response to sexual stimulation so you and your partner will need to engage in foreplay – the same as if you were not taking the medicine. Spedra claims to be the fastest acting Erectile Dysfunction treatment on the market and can take effect in as little as 20 minutes with effects lasting for up to 4-5 hours.

Spedra 200mg tablets are the highest dose for patients who have taken Spedra 100mg or other medium-strength erectile dysfunction treatments before and not had the results that they wanted. Spedra 200mg is normally sufficient strength to treat most cases of ED however, as with all ED medicines, Spedra isn’t always successful the first time you take it, it can take a few attempts for your body to get used to the treatment. It is recommended to take a particular dose of Spedra at least eight times before switching to a different erectile dysfunction treatment. If you experience side effects, such as flushing or headaches, they may subside after taking a few attempts or you may need to reduce the dose or switch to another ED treatment.

Spedra 200mg tablets help to resolve the physical causes of erectile dysfunction, the result of poor blood flow to the penis due to narrowing or blocked arteries. If psychological issues such as problems in a relationship, depression or anxiety cause ED, Spedra can still help to improve the symptoms. However, to help to resolve the underlying condition in the long-term it may be advisable to discuss any issues with your GP or therapist.

Not everyone will experience side effects from Spedra 200mg, although they are more likely if you have never taken Spedra before due to their high strength. If you do experience side effects from Spedra 200mg tablets they may include headache, flushing, light headedness and rarely a stuffy nose or indigestion. Spedra has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

Stop taking Spedra and see a doctor straight away if you notice any of the following serious side effects – you may need urgent medical treatment:

  • an erection that will not go away (“priapism”). If you get an erection that lasts more than 4 hours, this must be treated as soon as possible or lasting damage can happen to your penis (including not being able to get erections).
  • blurred vision.
  • sudden decrease or loss of vision in one or both eyes.
  • sudden decrease or loss of hearing (sometimes you may also feel dizzy or have ringing in your ears).

Stop taking Spedra and see a doctor straight away, if you notice any of the serious side effects above.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Do not take Spedra:

  • If you are allergic to avanafil or any of the other ingredients of this medicine (listed in section 6)
  • If you are taking “nitrate” medicines for chest pain (angina), such as amyl nitrite or glyceryl trinitrate. Spedra can increase the effects of these medicines and severely lower your blood pressure
  • If you are taking medicines for HIV or AIDS such as ritonavir, indinavir, saquinavir, nelfinavir or atazanavir
  • If you are taking medicines for fungal infections such as ketoconazole, itraconazole or voriconazole or certain antibiotics for bacterial infections, such as clarithromycin or telithromycin
  • If you have a serious cardiac problem
  • If you have had a stroke or heart attack in the last 6 months
  • If you have an irregular heartbeat (“arrhythmia”) or heart problems that run in your family, as shown on a heart tracing (ECG)
  • If you have low blood pressure or high blood pressure not controlled by medicines
  • If you have chest pain (angina) or you get chest pain during sexual intercourse
  • If you have a serious liver or kidney problem
  • If you have loss of vision in one eye due to not enough blood getting to your eye (non-arteritic ischemic optic neuropathy [NAION])
  • If certain serious eye problems run in your family (such as retinitis pigmentosa).

Do not take Spedra if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Spedra.

Warnings and precautions

Talk to your doctor or pharmacist before taking Spedra:

  • If you have heart trouble. It may be risky for you to have sexual intercourse
  • If you suffer from priapism, that is a persistent erection lasting 4 hours or more. This can happen in men with conditions like sickle cell disease, multiple myeloma or leukaemia.
  • If you have a physical condition that affects the shape of your penis (such as angulation, Peyronie’s disease or cavernosal fibrosis)
  • If you have any bleeding disorder or active peptic ulceration.

If any of the above apply to you talk to your doctor or pharmacist before taking Spedra. Check with your doctor or pharmacist if you are not sure.

Problems with your sight or hearing

Some men taking medicines like Spedra have had problems with their sight and hearing – see “Serious side effects” in section 4 for more details. It is not known if these problems are related directly to Spedra, other diseases that you may have or a combination of factors.

Spedra with food and alcohol

Grapefruit juice can increase exposure to the medicine and should be avoided within 24 hours prior to taking Spedra.

Drinking alcohol at the same time as taking Spedra may increase your heart rate and lower your blood pressure. You may feel dizzy (especially when standing), have a headache or feel your heart beating in your chest (palpitations). Drinking alcohol may also decrease your ability to get an erection.

 

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Spedra Tablets 50mg
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  • You should take one Spedra 50mg tablet around 30 minutes before sex.
  • Spedra can take up to 60 - 90 minutes to take effect in some men if it is taken on a full stomach after a large meal.
  • Spedra can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Spedra, Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Spedra on an empty stomach and try to limit your alcohol intake to ensure it remains effective.

Spedra does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Spedra at least 8 times before trying an alternative dose or treatment. If you find Spedra 50mg tablets effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Spedra 50mg ineffective you may wish to increase the strength to Spedra 100mg tablets, or alternatively try a different medicine such as Viagra, Cialis or Levitra. 

Spedra 50mg tablets are available from The Independent Pharmacy Online Doctor service, following a free consultation, to help treat erectile dysfunction (ED) in men. This is when you cannot get, or keep a hard, erect penis suitable for sexual activity. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Spedra contains the active substance avanafil. It is the newest medicine in the class of PDE-5 inhibitors that include Viagra, Cialis & Levitra. Like the other ED treatments, Spedra works by increasing blood flow to the penis resulting in the increased ability to gain a satisfying erection when you are sexually excited. Spedra will only work in response to sexual stimulation so you and your partner will need to engage in foreplay – the same as if you were not taking the medicine.

Spedra 50mg tablets are the lowest dose of Spedra on the market, for patients who have taken Spedra 100mg or other erectile dysfunction treatments before and found that they are too strong or produce unwanted side effects. Spedra 50mg is normally a sufficient strength to treat ED however, as with all ED medicines, Spedra isn’t always successful the first time you take it, it can take a few attempts for your body to get used to the treatment. It is recommended to take a particular dose of Spedra at least eight times before attempting to increase the dose or switch to a different erectile dysfunction treatment.

Spedra 50mg tablets help to resolve the physical causes of erectile dysfunction, the result of poor blood flow to the penis due to narrowing or blocked arteries. If psychological issues such as problems in a relationship, depression or anxiety cause ED, Spedra can still help to improve the symptoms. However, to help to resolve the underlying condition in the long-term it may be advisable to discuss any issues with your GP or therapist.

As Spedra 50mg tablets are the lowest strength Sperda available, they are least likely to produce side effects. Not everyone will experience side effects however, if you do experience side effects from Spedra 50mg tablets they are likely to be mild and may include headache, flushing, light headedness and rarely a stuffy nose or indigestion. Spedra has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

Stop taking Spedra and see a doctor straight away if you notice any of the following serious side effects – you may need urgent medical treatment:

  • an erection that will not go away (“priapism”). If you get an erection that lasts more than 4 hours, this must be treated as soon as possible or lasting damage can happen to your penis (including not being able to get erections).
  • blurred vision.
  • sudden decrease or loss of vision in one or both eyes.
  • sudden decrease or loss of hearing (sometimes you may also feel dizzy or have ringing in your ears).

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Do not take Spedra:

  • If you are allergic to avanafil or any of the other ingredients of this medicine (listed in section 6)
  • If you are taking “nitrate” medicines for chest pain (angina), such as amyl nitrite or glyceryl trinitrate. Spedra can increase the effects of these medicines and severely lower your blood pressure
  • If you are taking medicines for HIV or AIDS such as ritonavir, indinavir, saquinavir, nelfinavir or atazanavir
  • If you are taking medicines for fungal infections such as ketoconazole, itraconazole or voriconazole or certain antibiotics for bacterial infections, such as clarithromycin or telithromycin
  • If you have a serious cardiac problem
  • If you have had a stroke or heart attack in the last 6 months
  • If you have an irregular heartbeat (“arrhythmia”) or heart problems that run in your family, as shown on a heart tracing (ECG)
  • If you have low blood pressure or high blood pressure not controlled by medicines
  • If you have chest pain (angina) or you get chest pain during sexual intercourse
  • If you have a serious liver or kidney problem
  • If you have loss of vision in one eye due to not enough blood getting to your eye (non-arteritic ischemic optic neuropathy [NAION])
  • If certain serious eye problems run in your family (such as retinitis pigmentosa).

Do not take Spedra if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Spedra.

Warnings and precautions

Talk to your doctor or pharmacist before taking Spedra:

  • If you have heart trouble. It may be risky for you to have sexual intercourse
  • If you suffer from priapism, that is a persistent erection lasting 4 hours or more. This can happen in men with conditions like sickle cell disease, multiple myeloma or leukaemia.
  • If you have a physical condition that affects the shape of your penis (such as angulation, Peyronie’s disease or cavernosal fibrosis)
  • If you have any bleeding disorder or active peptic ulceration.

If any of the above apply to you talk to your doctor or pharmacist before taking Spedra. Check with your doctor or pharmacist if you are not sure.

Problems with your sight or hearing

Some men taking medicines like Spedra have had problems with their sight and hearing – see “Serious side effects” in section 4 for more details. It is not known if these problems are related directly to Spedra, other diseases that you may have or a combination of factors.

Spedra with food and alcohol

Grapefruit juice can increase exposure to the medicine and should be avoided within 24 hours prior to taking Spedra.

Drinking alcohol at the same time as taking Spedra may increase your heart rate and lower your blood pressure. You may feel dizzy (especially when standing), have a headache or feel your heart beating in your chest (palpitations). Drinking alcohol may also decrease your ability to get an erection.

 

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Viagra 100mg Tablets
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  • You should take one Viagra 100mg tablet at least 1 hour before sex.
  • Viagra can take up to an hour to take effect in some men, although it can take effect in as little as 20 minutes in some men.
  • Viagra can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Viagra on an empty stomach and try to limit your alcohol intake to ensure it remains effective.
Viagra does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Viagra 100mg at least 8 times before trying an alternative treatment such as Cialis, Spedra or Levitra. If you find Viagra effective and do not experience any serious side effects you can request a repeat order via your online account.

Viagra 100mg tablets are available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Viagra 100mg tablets are manufactured by Pfizer and are the best-known brand for the treatment of erectile dysfunction (ED). Viagra 100mg tablets have the strongest effect on the blood vessels that allow blood flow to the penis, causing the greatest expansion and hence increase in blood flow. This increase in blood flow to the penis is caused by the active ingredient sildenafil, and normally results in a satisfactory erection being achieved. Viagra 100mg tablets can take 30 – 60 minutes to take effect and last for around 4 – 5 hours. This allows them to be taken discreetly before they are required.

Viagra 100mg tablets are the highest dose of Viagra/sildenafil available and are generally used when patients have tried Viagra 50mg tablets at least 8 times with limited success. If treatment with 100mg Viagra is still unsuccessful after 8 attempts it is more appropriate to try a different erectile dysfunction treatment such as Cialis, Levitra or Spedra. Patients who find a strength of Viagra that works for them, may wish to consider switching to the generic ED treatment sildenafil, which is available at a significant discount following the expiry of Pfizer’s patent on Viagra. Many men do not notice a difference between taking Viagra and generic sildenafil tablets for ED.

Viagra 100mg tablets will, for most, resolve the symptoms of erectile dysfunction. As they open the blood vessels that supply blood to the penis, they are effective at treating the physical causes of erectile dysfunction. However, if the cause of ED is psychological, its effect can help to break the cycle of anxiety associated with being unable achieve and maintain a satisfactory erection. If you suffer with ED due to psychological causes it is recommended that you discuss your condition with your GP or a sexual health therapist.

Viagra 100mg tablets will not cause sexual arousal. It is a common misconception that erectile dysfunction treatments, such as Viagra have this effect. An erection cannot be achieved or maintained without the necessary sexual stimulation. To fully understand how Viagra works it is first necessary to understand the mechanics of an erection. When a man becomes sexually stimulated, the nervous system in the erectile tissue of the penis starts to release nitric oxide. This release stimulates an enzyme (cGMP) that relaxes the smooth muscle cells of the penis. This muscle relaxation has two effects:

  • The arteries in the penis dilate, allowing blood to flow more easily
  • The erectile tissue fills with blood

It’s these two processes that result in a successful erection. Viagra 100mg tablets work by maintaining the levels of cGMP in the smooth muscle cells. However, if a man isn’t sexually stimulated then nitric oxide isn’t released and no cGMP will be produced, resulting in no erection. It’s important to note that Viagra isn’t always successful the first time you take it. It is recommended to try taking Viagra at least eight times before trying to a different erectile dysfunction treatment such as Cialis, Spedra or Levitra. 

If you do experience side effects from Viagra they may include headache, flushing, light headedness and rarely a stuffy nose or indigestion. Viagra has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Viagra 100mg tablets may not be suitable if any of the following apply:

  • You suffer from heart disease or heart rhythm problems
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a haemophiliac
  • You suffer from sickle cell anaemia or leukaemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Viagra 100mg tablets will be safe for you to use.

Viagra 100mg tablets can lower the blood pressure. For most men this isn’t a concern. However, this effect on blood pressure can be exaggerated if Viagra is taken with a nitrate drug, such as Isosorbide or Glyceryl Trinitrate (GTN). If taking nitrate drugs then Viagra 50mg tablets should not be used. Viagra 100mg tablets should be used in caution if combined with alpha blockers due to the potenial hypotensive effects. Viagra may be taken with alpha-blockers, provided there is at least a six-hour gap between the medicines, however it must never be taken with nitrates.

You should avoid using the recreational drug ‘Poppers’, also called ‘Aromas’ or ‘Room Odourisers’ when you are taking Viagra as these also contain nitrates and can have dangerous effects on blood pressure.

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  • You should take one Viagra 25mg tablet 30 minutes to 1 hour before sex.
  • Viagra can take up to an hour to take effect in some men, although in others it can take effect in as little as 20 minutes.
  • Viagra can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Viagra on an empty stomach or after a low-fat meal and try to limit your alcohol intake to ensure it remains effective.

Viagra 25mg tablets are available from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Viagra 25mg tablets are a branded medication from Pfizer designed to treat erectile dysfunction (impotence). The active ingredient in Viagra is Sildenafil. Sildenafil is technically classed as a Phosphodiesterase Type 5 inhibitor (PDE-5 inhibitor). Simply put, Viagra 25mg tablets work by relaxing blood vessels and allowing a greater flow of blood to the penis. This increased flow will enable the penis to successfully become erect when sexually stimulated. In the majority of cases Viagra 25mg will take effect within thirty minutes. If the tablet is taken after eating a heavy meal that is high in fat, it can take a little longer to take effect. Viagra 25mg tablets will usually remain effective between four to six hours.    

Viagra 25mg tablets are the lowest strength of Viagra available. Viagra 25mg tablets are normally used in patients who have experienced side effects when taking the starting dose of Viagra 50mg tablets. Although they are the lowest strength treatment, Viagra 25mg tablets can still successfully treat ED in many patients with the lowest chance of side effects.

Viagra 25mg tablets will, for most, resolve the symptoms of erectile dysfunction. Even if the cause is psychological, its effect can help to break the cycle of anxiety associated with being unable achieve and maintain a satisfactory erection. 

Viagra 25mg, as with all drugs has the potential to produce side-effects. Fortunately, these side effects are usually brief and mild, if experienced at all. The most common side-effects relating to Viagra 25mg tablets are; facial flushing and headache. Uncommon side effects can include; indigestion, a stuffy nose and a blue tint to the vision. As Viagra 25mg tablets are the lowest strength available, you are much less likely to experience side effects.

Viagra 25mg tablets may not be suitable if any of the following apply:

  • You suffer from heart disease or heart rhythm problems
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a haemophiliac
  • You suffer from sickle cell anaemia or leukaemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Viagra 25mg tablets will be safe for you to use.

Viagra 25mg tablets can slightly lower the blood pressure. For most men this isn’t a concern. However, this effect on blood pressure can be exaggerated if Viagra is taken with a nitrate drug, such as Isosorbide or Glyceryl Trinitrate (GTN). If taking nitrate drugs then Viagra 25mg tablets should not be used. Viagra 25 mg tablets should be used in caution if combined with alpha blockers due to the potenial hypotensive effects.   

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  • You should take one Viagra 50mg tablet 30 minutes to 1 hour before sex.
  • Viagra can take up to an hour to take effect in some men, although it can take effect in as little as 20 minutes.
  • Viagra can produce an effect for up to 4 – 5 hours.
  • You should never take more than tablet for erectile dysfunction (Viagra, Cialis, or Levitra) in a 24-hour period.
  • You should take Viagra on an empty stomach, or after a low fat meal, and try to limit your alcohol intake to ensure it remains effective.
Viagra does not always work for everyone the first time they use it. If this is the case you should not give up, guidance states that you should try Viagra at least 8 times before trying an alternative dose or treatment. If you find Viagra effective and do not experience any serious side effects you can request a repeat order via your online account. If you followed the above guidance and still find Viagra ineffective you may wish to increase the strength to Viagra 100mg tablets, or alternatively try a different medicine such as Cialis, Levitra or Spedra.

Viagra 50mg tablets are available from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat erectile dysfunction in men. To find out more about erectile dysfunction and see all the available treatments, see our Online Doctor Erectile Dysfunction page.

Viagra 50mg are the original branded erectile dysfunction (ED) tablets, released in 1998 by Pfizer. Known as ‘the blue pill’ due to their distinctive shape and colour, Viagra is one of the best-known branded medicines around the world. Viagra 50mg tablets contain the active ingredient sildenafil, which expands the blood vessels that flow to the penis. This leads to increased blood flow to the penis and results in the ability to achieve a satisfactory erection when sexually stimulated. Viagra 50mg tablets can be taken as little as 30 minutes to 1 hour before sex and can produce an effect for 4 – 5 hours, meaning you should be able to get an erection at any point in this window. This allows you to take it discreetly before it is required.

Viagra 50mg tablets are the starting dose for patients new to Viagra and are often the first erectile dysfunction treatment that many men try. This dose is suitable for many men who will continue taking Viagra 50mg tablets or switch to the equivalent generic Sildenafil 50mg tablets. Men should try taking Viagra 50mg tablets on 8 separate occasions before deciding whether to change dose or treatment. If side effects are experienced then the lower dose Viagra 25mg tablets can be taken whereas if 50mg does not produce a satisfactory erection then the stronger Viagra 100mg tablets can be tried.

Viagra 50mg tablets will, for most, resolve the symptoms of erectile dysfunction. As they open the blood vessels that supply blood to the penis, they are effective at treating the physical causes of erectile dysfunction. However, if the cause of ED is psychological, its effect can help to break the cycle of anxiety associated with being unable achieve and maintain a satisfactory erection. If you suffer with ED due to psychological causes it is recommended that you discuss your condition with your GP or a sexual health therapist.

If you do experience side effects from Viagra 50 mg tablets they may include headache, flushing, light headedness and rarely a stuffy nose or indigestion. Viagra has a small risk of nausea, vomiting, diarrhoea, and skin rash as with all medicines. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.

If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.

Viagra 50mg tablets may not be suitable if any of the following apply:

  • You suffer from heart disease or heart rhythm problems
  • You have had a heart attack or stroke within the last six months
  • You have high or low blood pressure
  • You suffer from liver or kidney disease
  • You are a haemophiliac
  • You suffer from sickle cell anaemia or leukaemia
  • There is a physical deformity of the penis
  • You suffer from retinitis pigmentosa
  • You have a stomach ulcer

If any of the above apply, it is important to let your prescriber know so they can judge whether Viagra 50mg tablets will be safe for you to use.

Viagra 50mg tablets can slightly lower the blood pressure. For most men this isn’t a concern. However, this effect on blood pressure can be exaggerated if Viagra is taken with a nitrate drug, such as Isosorbide or Glyceryl Trinitrate (GTN). If taking nitrate drugs then Viagra 50mg tablets should not be used. Viagra 50mg tablets should be used in caution if combined with alpha blockers due to the potenial hypotensive effects. Viagra may be taken with alpha-blockers, provided there is at least a six-hour gap between the medicines, however it must never be taken with nitrates.

You should avoid using the recreational drug ‘Poppers’, also called ‘Aromas’ or ‘Room Odourisers’ when you are taking Viagra as these also contain nitrates and can have dangerous effects on blood pressure.

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Vitaros cream comes in single dose containers that should be discarded after use.

Vitaros should only be used once in a 24 hour period and should not normally be used more than two to three times a week.

After application of Vitaros, you should see an effect in 5 - 30 minutes. The effects normally last for one to two hours, however the speed of onset and duration of effects can vary between individuals.

As with all erectile dysfunction treatments, if you get an erection that lasts longer than four hours you should seek medical treatment immediately.

How to apply Vitaros cream

Wash your hands. Remove the dosing device from the foil sachet and keep the sachet for disposing of the dosing device later. Remove the cap from the tip of the dosing device.

Hold the tip of the penis with one hand and gently widen the opening of the penis. You may need to hold back your foreskin to do this.

Holding the barrel of the dosing device between your fingers, gently place the tip of the device at the opening of the penis. Slowly (over 5 - 10 seconds) push down the plunger until all the cream has been dispensed. You should not put the tip of the device into the opening of your penis.

Hold the penis in an upright position for around 30 seconds to allow the cream to penetrate. Not all cream will will enter the opening of the penis, this is normal. Gently rub an excess cream into the area surrounding the opening of the penis using your finger. You should never use a second dose of Vitaros cream to make up for any cream that doesn't enter the penis opening.

Place the empty dosing device into the foil sachet and discard. Wash your hands to remove any excess cream.

For instructions on applying Vitaros that include diagrams, please read the information leaflet enclosed with your medicine.

Vitaros cream contains the active ingredient alprostadil and is used from the treatment of ED in men. It is applied when required before sex to help achieve an erection in 5 - 30 minutes. Vitaros is fast and easy to apply and may be more convenient for some men than taking a tablet. Due to the local effects it produces, Vitaros cream normally only produces an effect for around one to two hours, rather than the standard four to six hours of most tablet ED treatments. This may be beneficial in some men that only want a short period of action due to side effects or for other reasons.

Vitaros cream requires storage in the fridge. It can be kept out of the fridge for a period of 72 hours and still retain its effectiveness. Stoarge outside a fridge for longer than 72 hours may make the product less effective at producing an erection and use is not recommended. When Vitaros is delivered to you it should be immediately stored in the fridge to ensure the product remains viable. You can then take it out of the fridge on the day of use to ensure it is applied at room temperature or to take with you if travelling.

Like all ED medicines, Vitaros may not be fully effective the first time you use it. You should use at least four applications on separate occasions before trying a different treatment. You should never apply more than one dose of Vitaros, even if the first is ineffective.

Vitaros cream is a novel and convenient treatment for erectile dysfunction, however the cream does not act as a contracpetive and does not protect against sexually transmitted diseases. A condom should still be used with Vitaros.

Vitaros cream is generally well-tolerated with few side effects. Most side effects that are experienced are local and only last for one to two hours. This may make Vitaros a good option for men who cannot use ED tablets, such as Viagra, Cialis or Levitra, due to intolerable side effects.

Please read the Patient Information Leaflet before you use Vitaros.

Vitaros cream, like all medicines, can produce side effects. If you do experience side effects from Vitaros, it may mean your dose is too high and needs to be lowered. Most side effects are not serious and only last for one to two hours. Side effects can include:

Common side effects (may affect more than 1 in 10 patients):

  • Mild to moderate local aching, burning or pain and redness of the penis
  • Rash or itching
  • Swelling of the penis (penile oedema)
  • Inflammation of the glans penis (balantitis)
  • Tingling, throbbing numbness or burning of the penis
  • Mild vaginal burning or itching, vaginitis (this effect may be due to the drug or to the act of vaginal penetration. Using a water-based lubricant can help to make vaginal penetration easier).

Uncommon side effects (up to 1 in 100 patients):

Men who apply the cream:

  • Light-headedness/dizziness
  • Prolonged erection for more than 4 hours
  • Fainting
  • Low blood pressure or rapid pulse
  • Pain at the application site or in extremity
  • Urethral stenosis
  • Increase in sensitivity
  • Penile itching
  • Genital rash
  • Scrotal pain
  • Fullness in genital
  • Lack of sensation in the penis
  • Urinary tract inflammation

Women who are exposed to the cream during sex:

  • vulvovaginal pruritus (itching

Increased sexual/physical activity in combination with Vitaros may increase the risk of heart attack or stroke in patients with underlying disease/risk factors

If any of the side effects listed become serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Vitaros cream is not suitable for use if:

  • You have underlying disorders such as drop in blood pressure when going from a lying/sitting to a standing position, history of a heart attack, and syncope (dizziness).
  • You are allergic to alprostadil or any of the other ingredients of this medicine.
  • You have a condition that might result in a long-lasting erection or a condition such as sickle cell anaemia or trait, thrombocythemia, polycythemia, multiple myeloma, or leukaemia.
  • You are taking medicines to prevent blood clots (increased risk of blood int he urine).
  • You have an abnormally formed penis.
  • You have an inflammation or infection of the penis.
  • You are prone to a venous thrombosis.
  • You have a hyperviscosity syndrome which could result in a long-lasting erection.
  • You have been told not to have sex for health reasons such as heart problems or a recent stroke.
  • Your partner is pregnant, breast feeding or of childbearing potential unless you use a condom barrier.

Vitaros is not suitable for online purchase if you have a history of the following local effects that have been observed with the use of Vitaros:

  • Prolonged erections lasting >4 hours (priapism)
  • Symptomatic hypotension (low blood pressure with dizziness)
  • Hepatic and/or renal insufficiency (liver or kidney problems)
  • Fainting
  • You are taking medicines for high blood pressure (may cause dizziness and fainting)

A condom should always be used in the following situations when using Vitaros cream:

  • Your partner is pregnant or breastfeeding
  • Your partner is of childbearing potential
  • To prevent sexually transmitted diseases
  • During oral sex and anal sex

Pregnant women should not be exposed to Vitaros. It is not recommended to use Vitaros while breastfeeding.

It is not known whether Vitaros has an effect on human male fertility.

Vitaros may make you feel dizzy or faint. Do not drive or operate machinery within 1 to 2 hours after administration. 

About Erectile Dysfunction (ED)

Erectile Dysfunction (ED) Background

The Independent Pharmacy Online Doctor service allows men suffering with the distress of erectile dysfunction (impotence) to have a private consultation with a doctor and receive the treatment they require in a safe and discreet manner.

Many men do not seek treatment for erectile dysfunction, as they do not want to reveal their condition and often find it embarrassing. Using The Independent Pharmacy Online Doctor service allows you to get the treatment you require without seeing a doctor in person.

Erectile dysfunction (ED) can also be referred to as impotence. ED is a condition that affects men and is the inability to achieve and maintain a satisfactory erection for sexual intercourse, or in response to sexual stimulation. Erectile Dysfunction is a very common condition that can affect any man at any age, although it becomes increasingly common with advancing years. It is estimated that around 50% of men between the ages of 40 and 70 will experience ED at some point.

Erections are caused when a man becomes sexually excited. This arousal causes the brain to send signals to the nerves in the penis. Upon receiving these signals the nerves increase the blood flow to the penis, causing it to enlarge and harden. If anything interrupts this process then erectile dysfunction can occur. This interruption may be physical, psychological or medicinal.


Physical causes of ED include:

  • Vascular conditions - such as diabetes, high blood pressure and cardiovascular disease, all of which can affect the flow of blood to the penis.
  • Hormonal conditions - such as over or underactive thyroid, hypogonadism and Cushing’s syndrome, all affect the hormonal levels of the body and can lead to impotence
  • Neurogenic conditions - such as multiple sclerosis and Parkinson’s disease will affect the body’s nervous system and can interfere with the process of achieving an erection
  • Anatomical conditions - like Peyronie’s disease that affect the tissue in the penis and can result in erectile dysfunction


Psychological causes of ED include:

  • Mental conditions - such as stress, anxiety and depression can lead to erectile dysfunction
  • Emotional problems can affect your physical ability to achieve or maintain an erection too. Examples of which include; lack of sexual knowledge or past sexual abuse, being in a new relationship.


Medicinal causes of ED include:

  • Certain medicines can lead to erectile dysfunction in some men. Examples of these include; beta blockers, diuretics, corticosteroids, antidepressants, antihistamines, and cytotoxics.

Erectile Dysfunction (ED) Symptoms

Erectile dysfunction will present itself as an inability to achieve or maintain a satisfactory erection during sexual intercourse. When dealing with ED it is very important to understand and identify the underlying cause. For example if you’re able to achieve and maintain an erection while you masturbate but find you are unable to get an erection with your sexual partner, this would suggest the cause is psychological. However, if achieving and/or maintaining an erection isn’t possible under any circumstance, it would be safe to assume the problem is primarily physical or potentially medicinal.

Erectile dysfunction is most commonly caused by reduced blood flow to the penis. In a large proportion of cases this can be due to narrowing of the blood vessels flowing into the penis, meaning that there is insufficient blood flow to produce an erection. Some causes of reduced blood flow are; weight gain, high blood pressure, high cholesterol, smoking and diabetes. For this reason erectile dysfunction can be an early indicator of heart disease and it is important to have a full health check with your GP.

In general, symptoms of erectile dysfunction that come on slowly are more likely to indicate a physical cause (e.g. narrowing of the blood vessels to the penis) whereas symptoms that are sudden in onset may suggest psychological causes.

Other causes of erectile dysfunction can include: injury to, or diseases that affect, the nerves going to the penis, hormonal causes (e.g. low testosterone), side effects of medicines, excess alcohol, drug abuse, and psychological causes such as anxiety, depression, stress or relationship issues.

Erectile Dysfunction (ED) Diagnosis

How Will My GP Diagnose Erectile Dysfunction?

When consulting your doctor about erectile dysfunction it will be necessary to answer some questions about your sexual history. It’s important to answer these questions honestly as it may affect the diagnosis. This may include questions about:

  • Your sexual orientation
  • Your previous and current sexual relationship
  • Your levels of sexual desire or libido
  • How long you have been suffering from ED and to what degree you are able to achieve an erection
  • Whether you have been able to ejaculate or orgasm

Other more general lines of enquiry will likely include:

  • Questions about your overall physical health
  • Questions about your overall mental health
  • Whether you drink alcohol or take recreational drugs
  • What medication you are currently taking
  • Questions about your diet, exercise levels and lifestyle

The doctor may wish to perform a series of simple tests, as ED can be caused by a more serious underlying condition such as cardiovascular disease or diabetes. These tests may include:

  • A blood pressure test
  • Height, weight and waist measurements
  • A heart rate check
  • A blood glucose and lipids test

There may be the need to perform a physical examination of the penis. This way the doctor can rule out any physical abnormality or anatomical reason for why ED is occurring. If over the age of 50 then the GP may wish to perform a rectal exam where they will insert a gloved finger into the anus. This exam will help the doctor rule out underlying conditions, such as prostate cancer.

In some cases a blood sample may be taken for analysis. This sample will show the hormone levels in the blood. This analyses will help identify or rule-out any hormonal conditions like hypogonadism, which is low levels of testosterone in the blood.

Erectile dysfunction is somewhat rare in men under the age of 40, so for a small number of cases further testing may be required. If this is the case then your GP may wish to refer you to a specialist, though this is rarely necessary.

Erectile Dysfunction (ED) Treatment

Treatment for erectile dysfunction has improved significantly in recent years with most sufferers being able to resume normal sexual activity as a result. There are four main drugs used to treat erectile dysfunction, these are Sildenafil (Viagra & generic), Tadalafil (Cialis), Avanafil (Spedra) and Vardenafil (Levitra). Ultimately, these tablets all do the same job, however there are important differences between them that we will summarize. Choosing the one that is right for you will depend on a variety of factors, like your health and whether you are taking any other medicines. It also comes down to personal preference.

Just to note, Viagra and Sildenafil are the same drug. Look closely on a packet of Viagra and you will see it states ‘contains Sildenafil’. Viagra is simply a branded name given by one manufacturer to this particular drug. So for all intents and purposes they are exactly the same in all but name.

Strengths:

Viagra / Sildenafil / Nipatra tablets:

  • 25mg
  • 50mg
  • 100mg


Cialis / Tadalafil tablets:

  • 10mg
  • 20mg


Levitra / Vardenafil tablets:

  • 5mg
  • 10mg
  • 20mg

Spedra / Avanafil tablets:

  • 50mg
  • 100mg
  • 200mg

As with all four sets of tablets, Viagra (Sildenafil), Cialis, Spedra and Levitra, the right strength for you won’t relate to the size of an individual or their blood pressure. It is recommended that new patients start on the middle strength, so in the case of Sildenafil and Viagra, 50mg. For Levitra, the starting dose is 10mg, Spedra is 100mg and Cialis, the lower strength, 10mg, will be the entry level dose. This initial trial should be attempted at least four times before it is judged whether that dose is effective or whether it needs to be altered to a higher or lower strength. In some cases if one drug is proving completely ineffective then trying one of the other drugs may be a more prudent option rather than attempting a higher strength.

Viagra, Sildenafil, Cialis, Spedra and Levitra all need to be taken before sex. Their effect should remain viable for several hours after taking. There is slight variation between the three with regards to how long before and for how long these effects last.


Viagra / Sildenafil tablets:

Should be taken an hour before sex and the effects should last between 4-5 hours.

Cialis / Tadalafil tablets:

Should be taken 30 minutes before sex and the effects last for around 36 hours.

Levitra / Vardenafil tablets:

Should be taken 25 minutes – 1 hour before sex and the effects last for 4-5 hours.

Spedra / Avanafil tablets: 

Can take effect in as little as 15 minutes and the effects last for 4-6 hours.

Just to clarify, when it states ‘effects last for 4-5 hours’, this doesn’t mean the erection will remain constant for this time. The penis should still require stimulation or sexual arousal to maintain an erection.


Does food affect any of these tablets and should I expect side effects?

Viagra / Sildenafil tablets:

Any food can potentially slow down the action of Sildenafil. As a precaution it is best to leave a couple of hours in between eating and taking the dose.

Cialis / Tadalafil tablets:

Is not affected by food so no restrictions apply.

Levitra / Vardenafil tablets:

Heavy meals or food high in fat can affect its action so it is advised to avoid such foods prior to use.

Headaches and flushing are the most common side effects for Sildenafil, Cialis and Levitra.

As with all prescription medicines it is very important to remember that you only take these medicines after having the proper medical consultation such as with our Online Doctor. Buying them without a consultation with a medical practitioner can be dangerous and leave you susceptible to ineffective, fake or even dangerous medicines.

Erectile Dysfunction (ED) Prevention

ED can be caused, or contritubed to, by lifestyle factors, such as smoking, being overweight and feelings of stress and anxiety. It’s easy to reduce the risk of developing erectile dysfunction by making simple changes, for example:

  • Quitting smoking
  • Losing any extra weight and maintaining a healthy diet
  • Moderating the amount of alcohol you drink
  • Taking regular exercise
  • Reducing your stress levels

These simple lifestyle changes will vastly improve your physical and general health, which will decrease your chances of developing conditions such as diabetes or cardiovascular disease, both of which can cause ED. Having a good level of general health will also reduce the risk of needing any prescription medicine. The less medicine you are taking the lower the risk of suffering an erectile dysfunction inducing side-effect.

 

*RRP is based on the highest price found for a comparable online service found on 04/09/14.

Erectile Dysfunction Treatment FAQ's

 

 

With all the different ED treatments available on the market, where do I start?

The treatments for erectile dysfunction are available in the following strengths:

 ‘As required’ ED treatments

Viagra 25mg, 50mg & 100mg tablets - the normal starting dose for people who have not taken Viagra before is 50mg. If it is highly effective then the strength should be reduced to the 25mg. If the 50mg strength has been tried on 4 separate occasions and if it doesn't produce the required effects then it can be increased to 100mg (as long as there are no side effects). The 100mg should be tried 8 different attempts before the tablets are deemed to be ineffective. For Viagra to be effective, it needs to be taken 45 minutes to 1 hour before sex. You should never take more than one Viagra tablet in a 24-hour period.

Viagra is now available legally in the UK under the name sildenafil or generic Viagra; the exclusive patent expired in July 2013. It is medically equivalent and now available at a fraction of the cost.

Sildenafil 25mg, 50mg & 100mg tablets – follow the same instructions as given above for Viagra tablets, the starting dose is sildenafil 50mg. Remember, these are medically equivalent to Viagra however because they are generic they are available at a significantly reduced price.

Cialis 10mg & 20mg tablets - the normal Cialis starting dose is 10mg. If it is highly effective then it should be reduced to the 5mg. It should be tried on 4 separate occasions and if it doesn't produce the required effects then it can be increased to the 20mg strength (as long as there are no side effects). The 20mg should be tried 8 different attempts before the tablets are deemed to be ineffective. If more than 2 tablets are needed a week then the 2.5mg or 5mg daily tablets should be considered. It can be taken as little as 30 minutes or up 12 hours before it is needed. The effectiveness of Cialis is not altered with food.

Levitra 10mg & 20mg tablets - the normal Levitra starting dose is 10mg. It should be tried on 4 separate occasions and if it doesn't produce the required effects then it can be increased to the 20mg strength (as long as there are no side effects). The 20mg should be tried 8 different attempts before the tablets are deemed to be ineffective.


Spedra 50mg, 100mg & 200mg tablets - the normal Spedra starting dose is 100mg. If it more than effective then the strength should be reduced to the 50mg.If the 100mg strength has been tried on 4 separate occasions and if it doesn't produce the required effects then it can be increased to the 200mg strength (as long as there are no side effects). The 200mg should be tried 8 different attempts before the tablets are deemed to be ineffective. For Spedra to be effective, it needs to be taken 45 minutes to 1 hour before sex.

Daily ED treatments 

Cialis 2.5mg & 5mg daily tablets – the normal starting dose is 2.5mg daily. This can be increased to 5mg daily if after a number of months the 2.5mg strength is not producing the desired effects. It is important to try to take Cialis Daily at the same time each day and not to supplement your treatment with any ‘as required’ ED tablets or treatments.

With all of the erectile dysfunction tablet treatments, sexual stimulation is necessary for arousal.

As we are all individuals, one tablet or brand may work better than another and trying them to find one that suits you is acceptable. Remember to take the lowest possible dose that gives you the effects you are looking for.


As a precaution, avoid situations where it is not possible to sit or lie down a few hours after taking a tablet for the first time.

If you would like to try more than one type of ED tablet, we have a erectile dysfunction starter pack which contains Viagra 50mg, Cialis 10mg and Levitra 10mg tablets or you may order more than one box through the consultation process.


How long do I have to leave between doses?

You should not take Viagra, Spedra or Levitra more than once a day. You should not take more than 2 ‘as required’ Cialis in a week. Do not take more than 1 Cialis Daily in a 24-hour period.


Is one brand of ED treatment more effective than another?

Cialis, Levitra, Spedra, and Viagra (sildenafil) work in a similar way to produce an erection but there are subtle differences in length of duration and speed of onset.

Cialis generally has the fastest onset, sometimes within as little as 15 minutes. It also produces the longest effect, up to 36 hours. Is not affected by food and can be taken as little as 30 minutes or up to 12 hours before it is needed.

Spedra works as quickly as 15 minutes and last up to 6 hours.

Levitra takes around 30 minutes to produce an erection and lasts a little longer than Viagra - up to 5 hours.

Viagra takes on average 30 minutes to kick in and continues for around 4 hours. This also applies to Sildenafil tablets.

We are all different and one type of tablet may work better for you than another. In addition, factors like the amount of alcohol consumed and when and what you ate can alter the effects of the individual treatments. You may wish to try different tablets and see which suits you best.

 

If one of these ED treatments isn't effective, can I try another?

We are all different and one type of tablets may work better for you than another. You may want to try different tablets and see which suits you the best.

You should never take different treatments at the same time; leave at least 24 hours between taking any erectile dysfunction treatments (leave 36 hours for Cialis).


What are the side effects of erectile dysfunction treatment?

Viagra and the other erectile dysfunction treatments in the same family are very well tolerated. Any adverse effects that do occur are mostly mild: headaches, flushing, heartburn, and nasal congestion.


When do I take my erectile dysfunction treatment?

Sexual stimulation is necessary for an erection when taking any of these tablets. Viagra/sildenafil needs to be taken at least 45 minutes and preferably one hour before sex.

Cialis can be taken between 30 minutes and 12 hours before sex. Do not take more than 1 tablet in 36 hours or 2 tablets in a week. If you need to take more than 2 Cialis tablets a week then the daily dose strengths of 2.5mg or 5mg may be more appropriate for you.

Levitra should be taken about 25 minutes to 1 hour before attempting intercourse. It can be taken with or without food. Its effect may be delayed if taken with meals high in fat.

Spedra is taken as needed approximately 30 minutes before sexual activity. Onset of action may be delayed up to 1.5 hours, if taken on a full stomach.


If I need more than 2 Cialis tablets a week, what other options are there?

Taking more than 2 tablets of Cialis will lead to a build up in your system. If you need more than 2 tablets a week then we recommend the 2.5mg or 5mg daily doses of Cialis.


Should I avoid grapefruit and grapefruit juice when taking ED tablets?

Grapefruit and grapefruit juice can reduce the elimination of certain medicines from the body. This may lead to a build up drug in your system. For this reason we advise you avoid grapefruit and grapefruit juice whilst taking erectile dysfunction medication.


What do I do if the ED tablet I took didn't work?

The usual starting dose for erectile dysfunction tablets is
 Viagra 50mg, Sildenafil 50mg, Cialis 10mg, Spedra 100mg or Levitra 10mg. If it has not had the desired effect or didn't last 4 hours then it is important to try again for another 3 separate occasions before moving up to the higher strength. It can take a few attempts at first before you get the desired effect for your treatment.

If the starting dose was more effective than anticipated then reduce the dose to the lower strength treatment.

With all the ED treatments arousal is necessary, the tablets will not work without it and the medication will then simply wear off after 4 hours.

Avoid taking ED medication with a heavy meal/high fat meal. This may delay the onset/ take longer to start working.

Drinking excessive amounts of alcohol is not recommended as it will impair your ability to achieve an erection and you will not receive the maximum benefits form the medication.



Can I cut any of the erectile dysfunction treatments in half?

Both The Independent Pharmacy and the manufacturers do not recommend cutting or breaking any of the ED treatments.


If my erection does not subside after 4 hours, what should I do?

An erection that last for more than 4 hours (known as priapism) needs urgent medical attention. If left untreated, it can cause long-term damage to the penis. It is important to understand that this condition is rare, if you use erectile dysfunction treatments sensibly and as directed there is only a very small risk of this occurring.


If I take an ED tablet every time I have sex, will I become addicted to it?

Viagra and the other erectile dysfunction treatments are not addictive but it is important to bear in mind that by taking this medication you are treating the symptoms and not the underlying cause of the condition. Therefore in the future you may need a higher strength tablet if the underlying condition was to get worse. If the erection difficulties are due to performance anxiety then men may feel unable to perform without them and become psychologically reliant on them as a back up.


Will I have to take ED treatments forever?

The amount of time you need to take erectile dysfunction medications for will depend on the cause of your condition. If it is due to another medical condition such as diabetes, high blood pressure or obesity by changing your lifestyle and getting effective treatment for this condition, you may see a slow improvement in your symptoms of erectile dysfunction.

Alternatively, if your ED is caused by psychological reasons like anxiety, you may need counseling to overcome the issues at the heart of your condition. Remember that erectile dysfunction treatments treat the symptoms of ED but not the underlying causes.


Is Erectile Dysfunction same as impotence?

Erectile Dysfunction (ED) is the condition when sufficient erection cannot be attained or maintained long enough for normal sexual function. It is commonly referred to as male impotence.


Do all men have erectile dysfunction?


Not necessarily. However, one in five men experiences it at some stage in their lives, even though only 10% of those who have it ever seek treatment. It is commonly perceived as lack of virility and loss of manliness, therefore men tend to keep the incidence to themselves and suffer in silence unnecessarily.


Is erectile dysfunction related to aging?


It can occur at any age, but it is more prevalent in men over 40. This is mainly because older men are at greater risk of developing many of the physical causes of erectile dysfunction such as heart disease and hypertension (high blood pressure). Erectile dysfunction is not an inevitable part of aging though.


How does ED occur?


Erectile dysfunction occurs when the blood supply to the penis is reduced. Typically, during an erection, the arteries that bring in the blood are relaxed, allowing more blood to flow in, while the veins that carry the blood away are constricted, reducing the outflow. Sexual stimulation, and associated nerve impulses and hormones, kick start this reaction. Any disruption in this process can result in ED.


What are the usual causes of erectile dysfunction?


Lifestyle diseases like hypertension, diabetes, atherosclerosis (narrowing of the blood vessels – commonly due to cholesterol) and heart disease that affect blood circulation in general often precipitate erectile dysfunction. Neurological reasons include multiple sclerosis and Parkinson’s’ disease, while hormonal imbalances such as high levels of prolactin and low levels of testosterone also may result in ED. It can be an adverse side effect of certain medications used to for treat allergies, depression, high blood pressure or Parkinson’s disease. Injury to the pelvic area or to nerves that control erection may also be the cause in some cases.


So it’s not all in the head?


This is one of the most damaging misconceptions about erectile dysfunction. According to a University of Maryland Medical Centre report, only 15% of the cases are purely psychological in nature. The causes of the remaining 85% can be traced to some physical problem. Anxiety, unresolved anger and other emotional issues between partners are the usual psychological causes. Depression also may cause impotence.


Can erectile dysfunction be prevented?


Whilst all causes of erectile dysfunction may not be preventable, maintaining a healthy lifestyle goes a long way in preventing the physical causes such as hypertension, diabetes, atherosclerosis and heart disease. Smoking, as well as alcohol and drug abuse, are some examples of the other preventable causes. Effective communication between partners also helps.


Can erectile dysfunction be treated successfully?


Most cases of erectile dysfunction respond to medication. Viagra, or other treatments such as Sildenafil, Cialis and Levitra, help those with ED to achieve erection and maintain it. They are normally taken around and hour before sex and will only work when you become aroused. For most people they are not available from the NHS and must be paid for privately from your local GP or an Online Doctor service.


Is sex counselling and surgery necessary?


Not in most cases of ED. To identify and resolve psychological causes of ED, sex counselling can help. Surgical correction of physical defects, if any, can resolve ED in some cases. When non-surgical treatment measures are exhausted, surgery to implant a penile prosthesis can be considered to manage the condition.


What are the other treatment options for erectile dysfunction?

  • Lifestyle changes - Quitting smoking, reducing alcohol intake, getting regular physical exercise, and reducing weight are all that may be necessary to resolve the issue in many cases.
  • Vacuum devices - 
They are applied externally to create a vacuum that helps draw in blood to the penis. A ring is used at the base of the penis to reduce outflow and maintain the erection longer.
  • Referral to other healthcare professionals - 
The case may be referred to an urologist or to neurologist, if necessary. If the condition persists even after the probable physical reasons are ruled out, a psychologist may help resolve the issue.

Can I buy ED treatment online?

Yes, you can buy all available erectile dysfunction treatments online from The Independent Pharmacy Online Doctor service. By filling in a consultation for one of our UK prescribers to check and, if appropriate, they can issue with a prescription for the ED treatment of your choice. This prescription is then dispensed by our NHS pharmacy and dispatched to a location of your choice.

Is it safe & legal to buy erectile dysfunction treatment online?

You should always check that if you are buying medicines online, including erectile dysfunction tablets, the website you are buying from is legitimate. To provide prescription medicines online, the website must be registered with the Care Quality Commission (CQC) in the UK as well as the medicines coming from a GPhC-registered pharmacy.

At The Independent Pharmacy, we display all of our regulating bodies clearly on the website including the CQC & GPhC. We are an NHS pharmacy and have a clickable link to Trustpilot, the independent review site, on every page to allow customers to check out what real people are saying about us.

We will always ensure any consultation through The Independent Pharmacy Online Doctor service is safe, completely confidential and follows all the best practice & legal requirements from all UK regulatory bodies.

How do I know the erectile dysfunction treatment I receive is not fake?

All the ED treatments we supply are sourced from the same UK wholesalers used by your local high street pharmacy. We always ensure that the products we supply are of the highest quality and have a UK product licence. Being a registered NHS pharmacy we use the same medicines for our Online Doctor service as we supply to our NHS patients.  

 

 

Erectile Dysfunction: Fact Vs. Fiction

When it comes to erectile dysfunction there are a few common misconceptions and associated stigmas that surround this condition. Hopefully this blog can address these issues and clear a few things up.

Taking Viagra Will Mean You Will Get An Erection

The biggest myth that stalks erectile dysfunction, especially in pop-culture, is that treatments such as Viagra cause an erection. In truth, this is not the case. Without the necessary arousal or sexual stimulation an erection cannot be achieved or maintained. The active ingredients in the three main treatments (Sildenafil, Tadalafil and Vardenafil) don’t automatically provide you with an erection. What they actually do is open the veins allowing blood to flow to the penis more freely and effectively when properly stimulated. Essentially, you could take Sildenafil or Tadalafil and still not achieve an erection if lacking the necessary sexual arousal.


Erectile Dysfunction is linked to sexual attraction

A variant of the above myth is the notion that if a man needs to take a treatment such as Viagra that means he isn’t sexually attracted his partner. This is simply not the case. Just to reiterate, even with erectile dysfunction medication a man can only achieve an erection if he is properly stimulated.

If there is difficulty achieving and maintaining an erection with your partner because you find her physically unattractive, or if the reason is an unresolved psychological issue then taking erectile dysfunction tablets isn’t likely to resolve this.


Erectile dysfunction is when you can NEVER get an erection

Another common misconception stems from the belief, ‘I don’t have erection problems all the time and therefore it cannot be erectile dysfunction.’ This belief is false. Men with erectile dysfunction can suffer many different kinds of symptoms, including any of the following:

  • You cannot achieve an erection at all.
  • You can achieve a mild erection but it’s not hard enough to enter your partner.
  • You can achieve an erection but you cannot maintain it throughout sexual intercourse.


Erectile Dysfunction only occurs in old men

Erectile dysfunction can be seen as something that only happens to older men and it’s just a normal part of aging that you simply have to live with. Erectile dysfunction can happen at any age. It simply becomes increasingly more common the older we get. It’s estimated that half of men between the ages of 40 and 70 suffer with erectile dysfunction. This statistic increases as we look beyond the age of 70, with 7 in every 10 men believed to be sufferers.


Where do these myths come from?

It’s unsurprising these myths and stigmas regarding erectile dysfunction exist when you look at how pop-culture continually perpetuates these notions through film, television and comedy acts. It may provide us a quick laugh but as a consequence it’s reinforcing stigmas such as:

  • You should feel embarrassed or ashamed about requiring treatment.
  • Using erectile dysfunction tablets is a cheat to bypass a lack of attraction.
  • Taking a tablet will automatically provide an erection.
  • Only old men require them.

As we age the likelihood of our bodies malfunctioning increases and so with it does the chances of developing erectile dysfunction. Our eyesight can suffer similarly with age. The difference being there is no stigma attached to wearing glasses, contact lenses or receiving laser eye surgery to treat the latter. So why does a stigma still exist in our culture that shames a man into thinking he can’t enjoy a fuller, more pleasurable sex life should erectile dysfunction strike?

ED Treatment Options

Although it is true that erectile dysfunction (impotence) is not a life-threatening condition, it can have a considerable impact on your quality of life and psychological well-being. Therefore, if you feel that you suffer from ED, you may wonder if it is actually treatable.

You may be surprised to learn that there are several different ways that erectile dysfunction can be treated. It may be appropriate to combine different forms of treatment to ensure you are treating not only the symptoms of ED, but also the causes.

Lifestyle Changes

There are many lifestyle changes that you can make that could help reduce the effects or risk of erectile dysfunction. These include:

  • Maintaining a healthy body weight
  • Reducing your intake of fatty and salty foods
  • Giving up smoking and recreational drugs
  • Reducing your intake of alcohol
  • Reducing your stress levels
  • Participating in a healthy amount of physical exercise

 

Medication

One of the more common forms of treatment that you may come across if you suffer from erectile dysfunction is what is known as Phosphodiesterase type-5 inhibitors (PDE-5 inhibitors). Oral drugs in this class include the likes of vardenafil (Levitra), tadalafil (Cialis) and sildenafil (Viagra) are known to be effective in impotence treatment and can be used when required to experience relief from the symptoms of erectile dysfunction.

These particular drugs improve the blood flow to the penis, allowing enough blood to enter to form a satisfactory erection. Erectile dysfunction treatments like this, such as Viagra, Cialis, Levitra, Nipatra & Spedra, are effective in up to 90% of men and have been used safely for a number of years. You can find out more about the ED tablets available from The Independent Pharmacy Online Doctor above.

Treating Psychosexual Causes

Often there are underlying psychological problems that cause erectile dysfunction, and it may be that group psychotherapy, cognitive behaviour therapy, counselling or sex therapy will be helpful for treating the causes. These are thought to be most successful when combined with physical therapy.

Other treatments available for erectile dysfunction that does not respond to drug treatment or counselling include prosthesis, hormone therapy, vacuum devices and even surgery. These should only be considered for severe cases of erectile dysfunction that are unresponsive to first-line treatments.

As you can see, there are a wide variety of treatments for erectile dysfunction, and even if it means trying a few different types, it’s still reassuring to know that there are solutions to a condition that cause much disruption in your life.

The Independent Pharmacy is an online pharmacy and online doctor service is owned and operated by ABSM Healthcare Ltd (Company Reg. 08515600) and Red Label Medical Ltd (Company Reg. 08676338). All information that appears on this website is intended for information purposes only and should be used to supplement, not replace, your relationship with your local healthcare professionals. You should consult your doctor if you think you may have a health problem or before you start taking a new medicine. Please ensure you always read the information leaflets supplied with any medicinal products.For more information see our policies and terms and conditions at the bottom of every page. © 2014 ABSM Healthcare Ltd. All rights reserved.
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