There are several treatments available for erectile dysfunction, so it can be difficult to know which one is the most suitable, easy-to-use and effective.

Vitaros, a cream for ED, works in a slightly different way to oral treatments like Viagra and Cialis, and is applied in a different way to other alprostadil-based medicines like Caverject or MUSE.

Ultimately, the treatment you use depends on what your doctor deems suitable for you, and your personal preference.

In most cases, a doctor will recommend oral treatments first, and advise on the use of topical treatments such as Vitaros if oral treatments are contraindicated, or have been tried but not worked sufficiently.  

If you want to discuss ED treatment options further, we recommend you make an appointment with your GP.

On this page, we’ll compare the use of Vitaros with other impotence medicines for the following:


Vitaros is applied topically to the penis using an AccuDose system. Following application, this typically works within 5-30 minutes.

Oral treatments taken on-demand, such as those containing sildenafil, may take longer to work (up to 60 minutes). Cialis Daily is essentially effective right away, but otherwise, the quickest on-demand oral treatment for ED is Spedra (effective from 15 minutes onwards).

So certainly in some cases, Vitaros is likely to show results faster than oral medicines.

However, the effects of Vitaros last for 1-2 hours, which is less than those of most oral treatments (usually 4-5 hours).

For some men though, 1-2 hours may be a more than sufficient duration (it really depends on when you plan to have sex and how long for).

Ease of use

Vitaros is a topical treatment which is applied directly to the penis at the opening of the urethra. The AccuDose system contains the correct dosage of medicine, so doesn’t need to be measured out.

This application method might be preferable for men who are hesitant to take an oral tablet, or to administer treatment using a urethral applicator (MUSE) or an injection (Caverject).

Once more, it all comes down to what you’re comfortable with.

You can read more on our How to Use Vitaros information page


In two clinical studies Vitaros was found to provide statistically significant improvement, in both primary and secondary efficacy endpoints, using the International Index of Erectile Function (IIEF) when compared with a placebo.

This included the following measures:

  • erectile function
  • vaginal penetration
  • ejaculation
  • intercourse satisfaction
  • overall satisfaction

The results found that 83 percent of patients with severe ED reported significant improvements compared with 26 percent of the placebo group.

(The efficacy of oral treatments varies, but using sildenafil as an example, the lowest dose produced an erection sufficient for intercourse in 63 percent of men in clinical trials; the median dose in 74 percent; and the highest dose in 82 percent.)

Improvements were also noted in diabetic, prostatectomy and cardiac patients using Vitaros, as well as in men who had previously failed to note a positive response from using sildenafil.

Vitaros does not interact with food or alcohol, which sets it apart from some PDE5 inhibitors; the efficacy of which can be impacted by heavy and fatty meals.

Side effects

During its clinical studies Vitaros was found to be safe and generally well tolerated. However, as with all medicines there is a risk of side effects.

The most commonly noted tend to be localised at the point of application and include a rash, pain in the urethra or penis and swelling of the penis. Between one and ten people out of 100 experience these symptoms, according to the product literature.

In clinical trials, the majority of side effects were reported as mild to moderate in severity.

There is a slight difference between how alprostadil works and how PDE5 inhibitors work.

Men who have tried PDE5i medications and failed to notice a satisfactory response might be considered for Vitaros treatment. Vitaros cream does not interact with the same medications as PDE5 inhibitors, and men with medical conditions contraindicated by other ED treatments might also be able to use Vitaros.

If you have not used Vitaros before and want to know more about this treatment, the best place to start is with your GP.

Page last reviewed:  18/04/2018