This page answers common forum questions related to various treatments for erectile dysfunction. These generally come in two forms: PDE5 inhibitors, such as the likes of Viagra, Cialis, Spedra and Levitra; and PGE-1 prostaglandins, which include Caverject, MUSE, Vitaros and Viridal Duo. These two types of treatments work differently and come with specific pros and cons depending on the person taking it.

How effective are erectile dysfunction treatments?

This will likely depend on your needs, circumstances and genetics. Each medication comes with some advantages. Cialis and other PDE5 inhibitors, for example, are tablets and more convenient to take, while Caverject is thought to have fewer interactions with other medications.

Whichever treatment is suitable for you, there are many options available and your prescribing clinician should be able to offer a treatment that is both safe and effective. Studies have shown that PDE5 inhibitors are helpful for the vast majority of those using them. For those who find these treatments are ineffective, or unsuitable, PGE1 prostaglandins may be able to provide the desired results.

Which ED medicines have the best reviews?

First of all, there’s no definitive resource for medication reviews. Lots of sites that carry them are open-source, so there’s not likely to be as much balance in terms of experience. People who took it and found it didn’t work at all may be more likely to post a bad review; whereas someone who took it and found it worked fine may not be inclined to share their experience.

While reviews of products can be helpful, they are not necessarily an accurate description of the product or, more importantly, a guarantee that you will get the same results from the treatment. For some, Levitra might be the most effective and appropriate treatment, for others it might be Cialis. As with many treatments for all conditions, there is an element of trial and error with the choice of drug as well as the dosage used.

Can I consume alcohol with ED treatments?

For the most part, alcohol consumption is not dangerous when taking ED treatments, but it can result in low blood pressure and should therefore be kept to a minimum. Alcohol is also a common cause of erectile dysfunction and it can lead to the treatment being ineffective. It is therefore recommended that you avoid alcohol while using any erectile dysfunction medication. If alcohol is the root cause of the condition, your doctor will likely want to address this issue before prescribing any medication.

Can Viagra cure ED?

This will depend on the cause of the problem, but Viagra, as well as many other treatments, has been shown to be highly effective in treating the condition. The causes of erectile dysfunction include both physical conditions (high blood pressure for example) and psychological (anxiety is one of its most common causes). While these treatments can relieve (not “cure”) the symptoms, they will not necessarily deal with the underlying causes.

How long until ED treatment kicks in?

Each treatment has its own timeframe for when it will become effective and this can be altered by other factors. These might include alcohol consumption and taking after food (large meals will likely slow down the rate of absorption of PDE5 inhibitors, for example). Timing when to take the treatment is important, but as these treatments can last for several hours, this shouldn’t be too difficult to do.

  1. PDE5 inhibitors range in how long they take to kick in.
  2. Viagra (sildenafil): Between 30 and 60 minutes to take effect and lasts for 4 to 5 hours.
  3. Cialis (tadalafil): Between 30-45 minutes and lasts for 24-36 hours.
  4. Spedra (avanafil): Between 15 and 30 minutes and lasts for 6 to 12 hours.
  5. Levitra (vardenafil): Between 30 and 60 minutes and lasts for 4 to 5 hours.
  6. Cialis Daily is taken every 24 hours and its effects should be continuous.
  7. PGE1 prostaglandins contain the active ingredient alprostadil. These are applied in different ways and their effects are therefore not uniform. These include:
  8. Caverject: Between 5 and 20 minutes to take effect and lasts for up to 1 hour.
  9. MUSE: Between 5 and 20 minutes and lasts for 30 to 60 minutes.
  10. Viridal Duo: Between 5 and 15 minutes and lasts for up to 1 hour.
  11. Vitaros: Between 5 and 30 minutes and lasts for 1 to 2 hours.

Will they affect my ability to drive?

These medications should not affect your ability to operate any form of heavy machinery. There is a small chance, however, that you will experience side effects, such as dizziness from low blood pressure. If you do experience symptoms, avoid driving and consult with your doctor, who might suggest a lower dosage or another treatment.

Are they available over the counter?

These erectile dysfunction treatments are not available to buy over the counter without a prescription, with the exception of Viagra Connect. In 2017, due to the risks of buying Viagra online from fake pharmacists, the government decided that this product could be sold without the need for a prescription. The decision of whether this treatment is safe for you, however, remains in the hands of your pharmacist.

Are there generic versions of these medications?

Yes, some of these medications have both branded and generic versions of the drug, which are named after its active ingredient. For Viagra this is Sildenafil. For Cialis it is Tadalafil and for Levitra it is Vardenafil.

There are branded versions of some PGE1 prostaglandins (alprostadil), such as Viridal Duo and Caverject, but no non-branded generics at the moment.

What do I do if ED treatment is not working?

As there are so many options available, it is likely that your doctor and you can find a medical solution to erectile dysfunction. This might include increasing the dosage of the treatment you are currently taking or trying a different drug. It is important to remain patient while you try these different options because, for the vast majority of men, these medications are highly effective.

Can I buy these erectile dysfunction treatments online?

Yes. You can buy prescription erectile dysfunction medications online through GPhC registered pharmacies, but you will need to go through a health assessment first. This can often take the form of a questionnaire which is then reviewed by a prescriber, or a video consultation.

You should be wary of pharmacies that don’t have a procedure to check your suitability for a medication first. ED treatments are either prescription only or pharmacy medicines, and aren’t available over the counter. This means that you’ll always need to have a health screening before they can be issued.

Look for the GPhC logo. This should give you details of the pharmacy registration with the independent UK pharmacy regulator. In the UK, pharmacies need to be registered with this body to be able to operate.

Never buy medications online without being sure that the pharmacy is properly registered in the UK. Some illicit pharmacies may offer counterfeit medications which present a number of risks, because they may not be made in a clinical setting and contain ingredients which shouldn’t be ingested.

How should ED medication be stored?

In general, tablets should be stored at below 25C, sometimes 30C. For other types of medication, such as vials for injections, check the recommended storage instructions on the patient information leaflet. In some cases (Caverject is an example) you might need to keep them in the fridge. All medications should be kept out of reach and sight of children.

Might I be allergic to any ingredients in ED treatment?

If you have any allergies you should inform your doctor, so they are able to prescribe a medication that is safe for you. All should come with a patient information leaflet that lists all the ingredients. 

Some tablets might contain lactose, which some might be intolerant to. If you have an allergy or intolerance to anything, speak to your prescriber about this during consultation.

Why might it be unsuitable for me to use these medications?

All medications come with some risk and these will need to be understood and weighed up before you start treatment.

For some, these might be interactions with other medications, such as PDE5 inhibitors with nitrates (for angina). For others, contraindications might be an issue, such as sickle cell anaemia and alprostadil. There might be other reasons as to why your doctor may think these treatments are unsuitable. For example, emotional issues, alcoholism and being in a difficult relationship. For these reasons, your doctor will likely ask you several personal questions, to which it is best to be as open and honest as possible to ensure that the condition is effectively and safely treated.

Page last reviewed:  25/09/2020