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Erectile Dysfunction (ED) Tablets & Cream

Cialis 10mg 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 Medical 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 332 69 90. 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.   

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.   

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 Medical 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 332 69 90. 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.   

Cialis 5mg Tablets
Pack Size: 28 tablets
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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 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.

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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.

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 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.

 

Levitra 20mg 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 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.

Levitra 5mg Tablets
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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.

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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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Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The recommended starting dose is 50 mg.
You should not take Nipatra more than once a day.

You should take Nipatra about one hour before you plan to have sex. The tablet should be chewed whole.
If you have the impression that the effect of Nipatra is too strong or too weak, talk to your doctor or pharmacist.

Nipatra will only help you to get an erection if you are sexually stimulated. The amount of time Nipatra takes to work varies from person to person, but it normally takes between half an hour and one hour. You may find that Nipatra takes longer to work if you take it with a heavy meal.
If Nipatra does not help you to get an erection, or if your erection does not last long enough for you to complete sexual intercourse you should tell your doctor.

If you take more Nipatra than you should

You may experience an increase in side effects and their severity. Doses above 100 mg do not increase the efficacy.

You should not take more tablets than your doctor tells you to.

Contact your doctor if you take more tablets than you should.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist. 

Sildenafil belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. It works by helping to relax the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited. Sildenafil will only help you to get an erection if you are sexually stimulated. You should not take sildenafil if you do not have erectile dysfunction. You should not take sildenafil if you are a woman.

Nipatra is a treatment for men with erectile dysfunction, sometimes known as impotence. This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity.
You must talk to a doctor if you do not feel better or if you feel worse. 

Like all medicines, this medicine can cause side effects although not everybody gets them. The side effects reported in association with the use of Nipatra are usually mild to moderate and of a short duration.

If you have chest pains during or after intercourse: - Get in a semi -sittingpositionandtrytorelax.
- Do not use nitrates to treat your chest pain.
- Contact your doctor immediately.

All medicines including Nipatra can cause allergic reactions. You should contact your doctor immediately if you experience any of the following symptoms after taking Nipatra: sudden wheeziness, difficulty in breathing or dizziness, swelling of the eyelids, face, lips or throat.
Prolonged and sometimes painful erections have been reported after taking Nipatra. If you have an erection which lasts for more than 4 hours, you should contact a doctor immediately.

If you experience a sudden decrease or loss of vision, stop taking Nipatra and contact your doctor immediately. Very common (may affect more than 1 in 10 people):
Headache.
Common (may affect up to 1 in 10 people) include:

Facial flushing, indigestion, effects on vision (including colour tinge to vision, light sensitivity, blurred vision or reduced sharpness of vision) stuffy nose and dizziness.
Uncommon (may affect up to 1 in 100 people) include:
Vomiting, skin rash, bleeding at the back of the eye, eye irritation, bloodshot eyes /red eyes, eye pain, double vision, abnormal sensation in the eye, irregular or rapid heartbeat, muscle pain, feeling sleepy, reduced sense of touch, vertigo, ringing in the ears, nausea, dry mouth, chest pain and feeling tired.

Rare (may affect up to 1 in 1,000 people) include:
High blood pressure, low blood pressure, fainting, stroke, nosebleed and sudden decrease or loss of hearing. Additional side effects reported from post-marketing experience include: pounding heartbeat, chest pain, sudden death, heart attack or temporary decreased blood flow to parts of the brain. Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to Nipatra. Cases of convulsions or seizures and serious skin reactions characterised by rash, blisters, peeling skin and pain which require immediate medical attention have also been reported.
If you get any side effects, talk to your doctor or pharmacist. This includes any side effects not listed in this leaflet. 

Do not take Nipatra:

  • If you are taking medicines called nitrates, as the combination may cause a potentially dangerous decrease in your blood pressure. Tell your doctor if you are taking any of these medicines which are often given for relief of angina pectoris (or “chest pain”). If you are not certain, ask your doctor or pharmacist.

  • If you are using any of the drugs known as nitric oxide donors such as amyl nitrite (“poppers”), as the combination may also lead to a potentially dangerous decrease in your blood pressure.

  • If you are allergic to sildenafil or any of the other ingredients of this medicine (listed in section 6).

  • If you have a severe heart or liver problem.

  • If you have recently had a stroke or a heart attack, or if you have low blood pressure.

  • If you have certain rare inherited eye diseases (such as retinitis pigmentosa).

  • If you have ever had loss of vision due to non-arteritic anterior ischaemic optic neuropathy (NAION). Warnings and precautions Talk to your doctor or pharmacist before taking Nipatra

  • If you have sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells), multiple

    myeloma (cancer of bone marrow).

  • If you have a deformity of your penis or Peyronie’s Disease.

  • If you have problems with your heart. Your doctor should in that case carefully check whether your heart can take

    the additional strain of having sex.

  • If you currently have a stomach ulcer, or a bleeding problems (such as haemophilia).

  • If you experience sudden decrease or loss of vision, stop taking Nipatra and contact your doctor immediately. You should not use Nipatra with any other oral or local treatments for erectile dysfunction.

    Children and adolescents

    Special considerations for children and adolescents.
    Nipatra should not be given to individuals under the age of 18.
    Special considerations for patients with kidney or liver problems.
    You should tell your doctor if you have kidney or liver problems. Your doctor may decide on a lower dose for you.

    Other medicines and Nipatra

    Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
    Nipatra chewable tablets may interfere with some medicines, especially those used to treat chest pain. In the event of a medical emergency, you should tell any health care professional treating your condition that you have taken Nipatra and when you did. Do not take Nipatra with other medicines unless your doctor tells you that you can.
    You should not take Nipatra if you are taking medicines called nitrates, as the combination of these products may cause a potentially dangerous decrease in your blood pressure. Always tell your doctor or pharmacist if you are taking any of these medicines that are often used for the relief of angina pectoris (or “chest pain”).
    You should not take Nipatra if you are using any of the drugs known as nitric oxide donors such as amyl nitrite (“poppers”) as the combination may also lead to a potentially dangerous decrease in your blood pressure.
    If you are taking medicines known as protease inhibitors, such as for the treatment of HIV, your doctor may start you on the lowest dose (25 mg) of Nipatra.
    Some patients who take alpha-blocker therapy for the treatment of high blood pressure or prostate enlargement may experience dizziness or light-headedness, which may be caused by low blood pressure upon sitting or standing up quickly. Certain patients have experienced these symptoms when taking Nipatra with alpha-blockers. This is most likely to occur within 4 hours after taking Nipatra. In order to reduce the likelihood that these symptoms occur, you should be on a regular daily dose of your alpha-blocker before you start Nipatra. Your doctor may start you on a lower dose (25 mg) of Nipatra.

Nipatra with food, drink and alcohol

Nipatra can be taken with or without food. However, you may find that Nipatra takes longer to start working if you take it with a heavy meal.
Drinking alcohol can temporarily impair your ability to get an erection. To get the maximum benefit from your medicine, you are advised not to drink excessive amounts of alcohol before taking Nipatra.

Pregnancy, breast-feeding and fertility

Nipatra is not indicated for use by women.

Driving and using machines

Nipatra can cause dizziness and can affect vision. You should be aware of how you react to Nipatra before you drive or use machinery.
Nipatra chewable tablets contain aspartame, a source of phenylalanine. If you suffer from phenylketonuria (a rare, hereditary disorder of the metabolism) you should take this into account.

Nipatra chewable tablets contain lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. 

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lways take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The recommended starting dose is 50 mg.
You should not take Nipatra more than once a day.

You should take Nipatra about one hour before you plan to have sex. The tablet should be chewed whole.
If you have the impression that the effect of Nipatra is too strong or too weak, talk to your doctor or pharmacist.

Nipatra will only help you to get an erection if you are sexually stimulated. The amount of time Nipatra takes to work varies from person to person, but it normally takes between half an hour and one hour. You may find that Nipatra takes longer to work if you take it with a heavy meal.
If Nipatra does not help you to get an erection, or if your erection does not last long enough for you to complete sexual intercourse you should tell your doctor.

If you take more Nipatra than you should

You may experience an increase in side effects and their severity. Doses above 100 mg do not increase the efficacy.

You should not take more tablets than your doctor tells you to.

Contact your doctor if you take more tablets than you should.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist. 

Sildenafil belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. It works by helping to relax the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited. Sildenafil will only help you to get an erection if you are sexually stimulated. You should not take sildenafil if you do not have erectile dysfunction. You should not take sildenafil if you are a woman.

Nipatra is a treatment for men with erectile dysfunction, sometimes known as impotence. This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity.
You must talk to a doctor if you do not feel better or if you feel worse. 

Like all medicines, this medicine can cause side effects although not everybody gets them. The side effects reported in association with the use of Nipatra are usually mild to moderate and of a short duration.

If you have chest pains during or after intercourse: - Get in a semi-sitting position and try to relax.
- Do not use nitrates to treat your chest pain.
- Contact your doctor immediately.

All medicines including Nipatra can cause allergic reactions. You should contact your doctor immediately if you experience any of the following symptoms after taking Nipatra: sudden wheeziness, difficulty in breathing or dizziness, swelling of the eyelids, face, lips or throat.
Prolonged and sometimes painful erections have been reported after taking Nipatra. If you have an erection which lasts for more than 4 hours, you should contact a doctor immediately.

If you experience a sudden decrease or loss of vision, stop taking Nipatra and contact your doctor immediately. Very common (may affect more than 1 in 10 people):
Headache.
Common (may affect up to 1 in 10 people) include:

Facial flushing, indigestion, effects on vision (including colour tinge to vision, light sensitivity, blurred vision or reduced sharpness of vision) stuffy nose and dizziness.
Uncommon (may affect up to 1 in 100 people) include:
Vomiting, skin rash, bleeding at the back of the eye, eye irritation, bloodshot eyes /red eyes, eye pain, double vision, abnormal sensation in the eye, irregular or rapid heartbeat, muscle pain, feeling sleepy, reduced sense of touch, vertigo, ringing in the ears, nausea, dry mouth, chest pain and feeling tired.

Rare (may affect up to 1 in 1,000 people) include:
High blood pressure, low blood pressure, fainting, stroke, nosebleed and sudden decrease or loss of hearing. Additional side effects reported from post-marketing experience include: pounding heartbeat, chest pain, sudden death, heart attack or temporary decreased blood flow to parts of the brain. Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to Nipatra. Cases of convulsions or seizures and serious skin reactions characterised by rash, blisters, peeling skin and pain which require immediate medical attention have also been reported.
If you get any side effects, talk to your doctor or pharmacist. This includes any side effects not listed in this leaflet. 

Do not take Nipatra:

  • If you are taking medicines called nitrates, as the combination may cause a potentially dangerous decrease in your blood pressure. Tell your doctor if you are taking any of these medicines which are often given for relief of angina pectoris (or “chest pain”). If you are not certain, ask your doctor or pharmacist.

  • If you are using any of the drugs known as nitric oxide donors such as amyl nitrite (“poppers”), as the combination may also lead to a potentially dangerous decrease in your blood pressure.

  • If you are allergic to sildenafil or any of the other ingredients of this medicine (listed in section 6).

  • If you have a severe heart or liver problem.

  • If you have recently had a stroke or a heart attack, or if you have low blood pressure.

  • If you have certain rare inherited eye diseases (such as retinitis pigmentosa).

  • If you have ever had loss of vision due to non-arteritic anterior ischaemic optic neuropathy (NAION). Warnings and precautions Talk to your doctor or pharmacist before taking Nipatra

  • If you have sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells), multiple

    myeloma (cancer of bone marrow).

  • If you have a deformity of your penis or Peyronie’s Disease.

  • If you have problems with your heart. Your doctor should in that case carefully check whether your heart can take

    the additional strain of having sex.

  • If you currently have a stomach ulcer, or a bleeding problems (such as haemophilia).

  • If you experience sudden decrease or loss of vision, stop taking Nipatra and contact your doctor immediately. You should not use Nipatra with any other oral or local treatments for erectile dysfunction.

    Children and adolescents

    Special considerations for children and adolescents.
    Nipatra should not be given to individuals under the age of 18.
    Special considerations for patients with kidney or liver problems.
    You should tell your doctor if you have kidney or liver problems. Your doctor may decide on a lower dose for you.

    Other medicines and Nipatra

    Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
    Nipatra chewable tablets may interfere with some medicines, especially those used to treat chest pain. In the event of a medical emergency, you should tell any health care professional treating your condition that you have taken Nipatra and when you did. Do not take Nipatra with other medicines unless your doctor tells you that you can.
    You should not take Nipatra if you are taking medicines called nitrates, as the combination of these products may cause a potentially dangerous decrease in your blood pressure. Always tell your doctor or pharmacist if you are taking any of these medicines that are often used for the relief of angina pectoris (or “chest pain”).
    You should not take Nipatra if you are using any of the drugs known as nitric oxide donors such as amyl nitrite (“poppers”) as the combination may also lead to a potentially dangerous decrease in your blood pressure.
    If you are taking medicines known as protease inhibitors, such as for the treatment of HIV, your doctor may start you on the lowest dose (25 mg) of Nipatra.
    Some patients who take alpha-blocker therapy for the treatment of high blood pressure or prostate enlargement may experience dizziness or light-headedness, which may be caused by low blood pressure upon sitting or standing up quickly. Certain patients have experienced these symptoms when taking Nipatra with alpha-blockers. This is most likely to occur within 4 hours after taking Nipatra. In order to reduce the likelihood that these symptoms occur, you should be on a regular daily dose of your alpha-blocker before you start Nipatra. Your doctor may start you on a lower dose (25 mg) of Nipatra.

Nipatra with food, drink and alcohol

Nipatra can be taken with or without food. However, you may find that Nipatra takes longer to start working if you take it with a heavy meal.
Drinking alcohol can temporarily impair your ability to get an erection. To get the maximum benefit from your medicine, you are advised not to drink excessive amounts of alcohol before taking Nipatra.

Pregnancy, breast-feeding and fertility

Nipatra is not indicated for use by women.

Driving and using machines

Nipatra can cause dizziness and can affect vision. You should be aware of how you react to Nipatra before you drive or use machinery.
Nipatra chewable tablets contain aspartame, a source of phenylalanine. If you suffer from phenylketonuria (a rare, hereditary disorder of the metabolism) you should take this into account.

Nipatra chewable tablets contain lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. 

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Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The recommended starting dose is 50 mg.
You should not take Nipatra more than once a day.

You should take Nipatra about one hour before you plan to have sex. The tablet should be chewed whole.
If you have the impression that the effect of Nipatra is too strong or too weak, talk to your doctor or pharmacist.

Nipatra will only help you to get an erection if you are sexually stimulated. The amount of time Nipatra takes to work varies from person to person, but it normally takes between half an hour and one hour. You may find that Nipatra takes longer to work if you take it with a heavy meal.
If Nipatra does not help you to get an erection, or if your erection does not last long enough for you to complete sexual intercourse you should tell your doctor.

If you take more Nipatra than you should

You may experience an increase in side effects and their severity. Doses above 100 mg do not increase the efficacy.

You should not take more tablets than your doctor tells you to.

Contact your doctor if you take more tablets than you should.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist. 

Sildenafil belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. It works by helping to relax the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited. Sildenafil will only help you to get an erection if you are sexually stimulated. You should not take sildenafil if you do not have erectile dysfunction. You should not take sildenafil if you are a woman.

Nipatra is a treatment for men with erectile dysfunction, sometimes known as impotence. This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity.
You must talk to a doctor if you do not feel better or if you feel worse. 

Like all medicines, this medicine can cause side effects although not everybody gets them. The side effects reported in association with the use of Nipatra are usually mild to moderate and of a short duration.

If you have chest pains during or after intercourse: - Get in a semi-sitting position and try to relax.
- Do not use nitrates to treat your chest pain.
- Contact your doctor immediately.

All medicines including Nipatra can cause allergic reactions. You should contact your doctor immediately if you experience any of the following symptoms after taking Nipatra: sudden wheeziness, difficulty in breathing or dizziness, swelling of the eyelids, face, lips or throat.
Prolonged and sometimes painful erections have been reported after taking Nipatra. If you have an erection which lasts for more than 4 hours, you should contact a doctor immediately.

If you experience a sudden decrease or loss of vision, stop taking Nipatra and contact your doctor immediately. Very common (may affect more than 1 in 10 people):
Headache.
Common (may affect up to 1 in 10 people) include:

Facial flushing, indigestion, effects on vision (including colour tinge to vision, light sensitivity, blurred vision or reduced sharpness of vision) stuffy nose and dizziness.
Uncommon (may affect up to 1 in 100 people) include:
Vomiting, skin rash, bleeding at the back of the eye, eye irritation, bloodshot eyes /red eyes, eye pain, double vision, abnormal sensation in the eye, irregular or rapid heartbeat, muscle pain, feeling sleepy, reduced sense of touch, vertigo, ringing in the ears, nausea, dry mouth, chest pain and feeling tired.

Rare (may affect up to 1 in 1,000 people) include:
High blood pressure, low blood pressure, fainting, stroke, nosebleed and sudden decrease or loss of hearing. Additional side effects reported from post-marketing experience include: pounding heartbeat, chest pain, sudden death, heart attack or temporary decreased blood flow to parts of the brain. Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to Nipatra. Cases of convulsions or seizures and serious skin reactions characterised by rash, blisters, peeling skin and pain which require immediate medical attention have also been reported.
If you get any side effects, talk to your doctor or pharmacist. This includes any side effects not listed in this leaflet. 

Do not take Nipatra:

  • If you are taking medicines called nitrates, as the combination may cause a potentially dangerous decrease in your blood pressure. Tell your doctor if you are taking any of these medicines which are often given for relief of angina pectoris (or “chest pain”). If you are not certain, ask your doctor or pharmacist.

  • If you are using any of the drugs known as nitric oxide donors such as amyl nitrite (“poppers”), as the combination may also lead to a potentially dangerous decrease in your blood pressure.

  • If you are allergic to sildenafil or any of the other ingredients of this medicine (listed in section 6).

  • If you have a severe heart or liver problem.

  • If you have recently had a stroke or a heart attack, or if you have low blood pressure.

  • If you have certain rare inherited eye diseases (such as retinitis pigmentosa).

  • If you have ever had loss of vision due to non-arteritic anterior ischaemic optic neuropathy (NAION). Warnings and precautions Talk to your doctor or pharmacist before taking Nipatra

  • If you have sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells), multiple

    myeloma (cancer of bone marrow).

  • If you have a deformity of your penis or Peyronie’s Disease.

  • If you have problems with your heart. Your doctor should in that case carefully check whether your heart can take

    the additional strain of having sex.

  • If you currently have a stomach ulcer, or a bleeding problems (such as haemophilia).

  • If you experience sudden decrease or loss of vision, stop taking Nipatra and contact your doctor immediately. You should not use Nipatra with any other oral or local treatments for erectile dysfunction.

    Children and adolescents

    Special considerations for children and adolescents.
    Nipatra should not be given to individuals under the age of 18.
    Special considerations for patients with kidney or liver problems.
    You should tell your doctor if you have kidney or liver problems. Your doctor may decide on a lower dose for you.

    Other medicines and Nipatra

    Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
    Nipatra chewable tablets may interfere with some medicines, especially those used to treat chest pain. In the event of a medical emergency, you should tell any health care professional treating your condition that you have taken Nipatra and when you did. Do not take Nipatra with other medicines unless your doctor tells you that you can.
    You should not take Nipatra if you are taking medicines called nitrates, as the combination of these products may cause a potentially dangerous decrease in your blood pressure. Always tell your doctor or pharmacist if you are taking any of these medicines that are often used for the relief of angina pectoris (or “chest pain”).
    You should not take Nipatra if you are using any of the drugs known as nitric oxide donors such as amyl nitrite (“poppers”) as the combination may also lead to a potentially dangerous decrease in your blood pressure.
    If you are taking medicines known as protease inhibitors, such as for the treatment of HIV, your doctor may start you on the lowest dose (25 mg) of Nipatra.
    Some patients who take alpha-blocker therapy for the treatment of high blood pressure or prostate enlargement may experience dizziness or light-headedness, which may be caused by low blood pressure upon sitting or standing up quickly. Certain patients have experienced these symptoms when taking Nipatra with alpha-blockers. This is most likely to occur within 4 hours after taking Nipatra. In order to reduce the likelihood that these symptoms occur, you should be on a regular daily dose of your alpha-blocker before you start Nipatra. Your doctor may start you on a lower dose (25 mg) of Nipatra.

Nipatra with food, drink and alcohol

Nipatra can be taken with or without food. However, you may find that Nipatra takes longer to start working if you take it with a heavy meal.
Drinking alcohol can temporarily impair your ability to get an erection. To get the maximum benefit from your medicine, you are advised not to drink excessive amounts of alcohol before taking Nipatra.

Pregnancy, breast-feeding and fertility

Nipatra is not indicated for use by women.

Driving and using machines

Nipatra can cause dizziness and can affect vision. You should be aware of how you react to Nipatra before you drive or use machinery.
Nipatra chewable tablets contain aspartame, a source of phenylalanine. If you suffer from phenylketonuria (a rare, hereditary disorder of the metabolism) you should take this into account.

Nipatra chewable tablets contain lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. 

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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 Medical 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 332 69 90. 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 Medical 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 Medical 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 332 69 90. 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.   

Spedra Tablets 100mg
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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 Medical 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 332 69 90. 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.

 

Spedra Tablets 200mg
Pack Size: 4 tablets
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Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose is a 100 mg tablet, as needed. You should not take Spedra more than once a day. Tell your doctor if you think Spedra is too strong or too weak. He/she may suggest you switch to a different dose of this medicine. Dose adjustments can also be required if Spedra is used together with certain other medicines. If you are taking a medicine such as erythromycin, amprenavir, aprepitant, diltiazem, fluconazole, fosamprenavir or verapamil (‘moderate CYP3A4 inhibitors’) the recommended dose of Spedra is a 100 mg tablet, with an interval of at least 2 days between doses.

You should take Spedra about 30 minutes before you have sexual intercourse. Remember that Spedra will only help you to get an erection if you are sexually stimulated.

Spedra can be taken with or without food; if taken with food, it may take longer to work.

If you take more Spedra than you should

If you take too much Spedra, you should tell your doctor straight away. You may get more side effects than usual and they may be worse.

If you have any further questions on the use of Spedra, ask your doctor or pharmacist.

Spedra contains the active substance avanafil. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. Spedra is a treatment for adult men suffering from erectile dysfunction (also known as impotence). This is when you cannot get, or keep a hard, erect penis suitable for sexual activity.

Spedra works by helping the blood vessels in your penis to relax. This increases the blood flow into your penis, helping it stay hard and erect when you get sexually excited. Spedra does not cure your condition.

It is important to note that Spedra only works if you are sexually stimulated. You and your partner will still need to use foreplay to get ready for sex – just as you would if you were not taking a medicine to help you.

Spedra will not help you if you do not have erectile dysfunction. Spedra is not for women.

Serious 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.

Other side effects include:

Common (may affect up to 1 in 10 people)

  • headache
  • flushing
  • nasal congestion

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 drink 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.

Spedra Tablets 50mg
Pack Size: 4 tablets
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Takes less than 3 minutes to complete

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Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose is a 100 mg tablet, as needed. You should not take Spedra more than once a day. Tell your doctor if you think Spedra is too strong or too weak. He/she may suggest you switch to a different dose of this medicine. Dose adjustments can also be required if Spedra is used together with certain other medicines. If you are taking a medicine such as erythromycin, amprenavir, aprepitant, diltiazem, fluconazole, fosamprenavir or verapamil (‘moderate CYP3A4 inhibitors’) the recommended dose of Spedra is a 100 mg tablet, with an interval of at least 2 days between doses.

You should take Spedra about 30 minutes before you have sexual intercourse. Remember that Spedra will only help you to get an erection if you are sexually stimulated.

Spedra can be taken with or without food; if taken with food, it may take longer to work.

If you take more Spedra than you should

If you take too much Spedra, you should tell your doctor straight away. You may get more side effects than usual and they may be worse.

If you have any further questions on the use of Spedra, ask your doctor or pharmacist.

Spedra contains the active substance avanafil. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. Spedra is a treatment for adult men suffering from erectile dysfunction (also known as impotence). This is when you cannot get, or keep a hard, erect penis suitable for sexual activity.

Spedra works by helping the blood vessels in your penis to relax. This increases the blood flow into your penis, helping it stay hard and erect when you get sexually excited. Spedra does not cure your condition.

It is important to note that Spedra only works if you are sexually stimulated. You and your partner will still need to use foreplay to get ready for sex – just as you would if you were not taking a medicine to help you.

Spedra will not help you if you do not have erectile dysfunction. Spedra is not for women.

Serious 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.

Other side effects include:

Common (may affect up to 1 in 10 people)

  • headache
  • flushing
  • nasal congestion

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 drink 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.

Viagra 100mg Tablets
Pack Size: 4 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 Medical 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 50g 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 332 69 90. 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 Medical 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 Medical 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 332 69 90. 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.

Vitaros Cream
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Always use this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

Vitaros is available in two dosage strengths of 200 and 300 mcg alprostadil in
100 mg of cream. Vitaros should be used as needed to achieve an erection. Each Vitaros AccuDoseTM container is for single use only and should be properly discarded after use.
For an erection: the starting dose should be recommended by a physician.
Do not adjust your dose yourself. Talk to your doctor who will instruct you on proper technique for administration and accomodation of your dose.
Do not apply Vitaros more than 2-3 times a week and only once per 24 hour period.
The onset of effect is within 5 to 30 minutes after administration. The duration of effect is approximately 1 to 2 hours. But, the actual duration can vary from patient to patient.
Apply Vitaros to the tip of the penis within 5 to 30 minutes prior to attempting intercourse by following the instructions below:

1. Wash your hands before applying Vitaros. Remove the AccuDoseTM container from the foil pouch by tearing fully across from the notched edge. Remove the AccuDoseTM container from the sachet. Save the sachet for discarding the used AccuDoseTM container later. Remove the cap from the tip of the container.

  • Grasp the tip of the penis with one hand and gently manipulate to widen the opening of the penis. Note: if you are not circumcised, first retract and hold the foreskin back prior to widening the opening of the penis. (Figure 2) 

  • Hold the barrel of the AccuDoseTM container between your fingers and place the tip of the container over the opening of the penis and slowly (over 5-10 seconds) push down the plunger with your finger until all the cream is expelled from the AccuDoseTM container barrel. Note: do not insert the tip of the AccuDoseTM container into the opening of the penis. (Figure 3) 


  • Hold the penis in an upright position for approximately 30 seconds to allow the cream to penetrate. There might be an excess cream. The amount of excess cream will vary depending on the patient and it is not unusual that half of the dose will remain at the edge of the opening. Do not use a second AccuDoseTM to compensate for cream not expelled into the opening of the penis. Any excess cream covering the opening may be rubbed gently into the skin surrounding the application site with the tip of a finger.

  • Remember each Vitaros dose is good for a single administration only. Replace the cap on the AccuDoseTM container and place in the opened foil sachet, fold and discard in accordance with local requirements.

  • Vitaros may be irritating to the eyes. Wash your hands after applying Vitaros. 

. What Vitaros is and what it is used for

Vitaros is available in two dosage strengths of 200 and 300 mcg alprostadil in
100 mg of cream.Vitaros is used to treat erectile dysfunction (ED) in men 18 years of age or older. ED is the inability to attain or maintain an erection suf
ficient for sexual intercourse. There are several causes of ED including medications that you may be taking for other conditions, poor blood circulation in the penis, nerve damage, emotional problems, too much smoking or alcohol use, and hormonal problems. Often ED is due to more than one cause. Treatments for ED include switching medications, if you are taking a medication that causes ED, prescription medications, medical devices that produce an erection, surgical procedures to correct blood flow to the penis, penile implants and psychological counseling. After application of Vitaros the onset of erection is within 5 to 30 minutes. You should not stop taking any prescription medications, unless told to do so by your doctor. 

 you get a long-lasting erection of more than 4 hours, contact your doctor immediately.

Your doctor may reduce your dose of Vitaros or disontinue your treatment.

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

You:

  • -  mild to moderate local aching, burning or pain and redness of the penis,

  • -  rash,

  • -  genitalpruritus,

  • -  penileoedema

  • -  inflammation of the glans penis (balantitis)

  • -  penile tingling, throbbing numbness, burning Your partner:

- 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 but potentially serious side effects (may affect up to 1 in 100 patients):

You:

- 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
- urethralstenosis
- increase in sensitivity
- penileitching
- genitalrash
- scrotalpain
- fullness in genital
- lack of sensation to penis
- urinary tract in
flammation
Your partner:
- vulvovaginalpruritus
*Increased sexual/physical activity in combination with Vitaros may increase the risk of heart attack or stroke in patients with underlying disease/risk factors
(see Section 2).
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Duration of side effects:

Most effects are short acting and resolve within 1-2 hours 

2. What you need to know before you use Vitaros Do not use Vitaros

  • -  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)

  • -  if you are allergic to alprostadil or any of the other ingredients of this medicine

    (listed in section 6).

  • -  if 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

  • -  if you have an abnormally formed penis

  • -  if you have an inflammation or infection of the penis

  • -  if you are prone to a venous thrombosis

  • -  if you have a hyperviscosity syndrome which could result in a long-lasting

    erection

  • -  if you have been told not to have sex for health reasons such as heart problems

    or a recent stroke.

  • -  if your partner is pregnant, breast feeding or of childbearing potential unless

    you use a condom barrier.

    Warnings and precautions

    Talk to your doctor or pharmacist before using Vitaros 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 (dizziness)

  • -  hepatic and/or renal insufficiency, a lowered dose due to impaired metabolism may be required

  • -  fainting
    A condom should be used in the following situations:

    • -  your partner is pregnant or breastfeeding

    • -  your partner is of childbearing potential

    • -  to prevent sexually transmitted diseases

    • -  during oral sex and anal sex
      Only latex condoms have been studied. It is not known if condoms made of other materials may be damaged. 

      If you are taking drugs to prevent blood clots, do not take Vitaros as there may be an increased risk for bleeding or blood found in the urine.

      In combination with high blood pressure medication, Vitaros use may increase symptoms of dizziness and fainting, especially in the elderly.

      Pregnancy and breast-feeding and fertility

      There are no data on the use of Vitaros in pregnant women. 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.

      Driving and using machines

      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 Medical 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 Medical 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.

THE Medical Online Doctor service is owned and operated by Total Health Ethos Limited (Company Reg. 6170784). All orders are fulfilled by our pharmacy partners, BSM 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. © 2017 Total Health Ethos Limited. All rights reserved.
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