Erectile dysfunction treatment is used to help you get or keep an erection that’s hard enough to have sex with. Erectile dysfunction treatments only work if you’re sexually aroused, they can’t help if you have low sex drive, or if you’re ejaculating faster than you want to (premature ejaculation).

Most erectile dysfunction treatments work in a similar way, making it easier for blood to flow into the penis when you’re aroused, making it easier to get and keep an erection.

There are many kinds of pills for erectile dysfunction, but they are all part of the same group of drugs called PDE5 inhibitors. PDE-5 inhibitors work by relaxing your blood vessels, which increases blood flow to the penis and helps you to get an erection.

Each pill has a different active ingredient so, while they’re all PDE5 inhibitors, each pill may work a little differently from another. This means that you may need to try a few different pills to get the best result for you.

There are 4 main types of erectile dysfunction tablets:

• Sildenafil (used in Viagra, Viagra Connect, and generic Sildenafil) – these are the NHS’s first choice and they’re the most popular. They start working about 30 mins after you take them and last for 4-6 hours.
• Tadalafil (used in Cialis, Cialis Daily, and generic Tadalafil) – often known as the ‘weekend pill’, tadalafil medications get to work in about 30 mins and can last for up to 36 hours.
• Vardenafil (used in Levitra and generic Vardenafil) – similar to Viagra, vardenafil medications start after about 30 mins and last 4-6 hours, but they can be slightly better to take for men with eye problems.
• Avanafil (used in Spedra) – this medication is the fastest-acting one, getting to work in as little as 15 mins.

All of these treatments are:

• Effective for most men who try them
• Safe as long as a doctor has approved treatment (or pharmacist as well for Viagra Connect)
• Can be prescribed and bought online without a previous diagnosis or prescription

What’s the strongest/most effective tablet?

Even though some of the dosages for certain treatments appear higher than other treatments, that doesn’t mean some treatments are stronger than others. All of these medications are as effective as each other.

For these types of medication, the chance of it working is slightly higher as the dosage goes up, but so is the risk of side effects. We recommend starting on the standard dose and only changing to a higher one if the standard dose didn’t work and you didn’t get any serious side effects.

You may need to try different tablets to find one which dose and which medication works best for you. Never take more than one erectile dysfunction tablet of any kind within 24 hours, as they can interact and cause serious side effects. Also, it’s important not to switch medications or change the dose of your treatment without the help of a doctor.

What’s the most cost effective tablet?

If you have sex on up to 3 different days a week, then the most cost effective treatment for you could be Sildenafil. We offer Sildenafil from just £14.99 for 4x 50mg tablets, or £2.79 per pill if you buy 28x 25mg or 50mg tablets.

If you have sex on more than 3 different days a week, then the most cost effective treatment might be Cialis Daily. At £72.00 for 28 pills it works out as £2.68 per pill, but you have to take one every day, so they might not last you as long if you’re not having sex that often.

Which tablet has the least side effects?

Apart from Spedra, all erectile dysfunction pills cause side effects in less than 2% of men who try them.

Lower dosages of medications are less likely to give you side effects. We normally recommend you try the standard dose first to see if you get any side effects before thinking about switching to lower dosages. Never change dosages without the help of a doctor.

Which tablet works fastest?

Spedra is the fastest working tablet you take before sex. It can start working as fast as 15 mins after you take it, compared to the other tablets which all take at least 30 mins.

Cialis Daily is always working so the effects are instant. Since you take it every day, there’s no need to plan ahead for sex – it’s ready when you are.

Which tablet lasts longest?

Cialis is the longest lasting tablet you take before sex. Cialis can last up to 36 hours, which is why it’s sometimes known as the ‘weekend’ pill.

Cialis Daily doesn’t stop working. As long as you keep taking your daily tablet, Cialis Daily is always in effect and can work non-stop.

Viagra, Cialis, Levitra, Spedra

How effective is it?

• Viagra: 74%
• Cialis: 60-70%
• Levitra: 58-74%
• Spedra: 52-71%

User rating

• Viagra: 8.5
• Cialis: 8.7
• Levitra: 8.0
• Spedra: 5.7

Is there a generic?

• Viagra: Sildenafil
• Cialis: Tadalafil
• Levitra: Vardenafil
• Spedra: No

Over the counter version?

• Viagra: Viagra Connect
• Cialis: No
• Levitra: No
• Spedra: No

Available in a daily dosage?

• Viagra: No
• Cialis: Cialis Daily
• Levitra: No
• Spedra: No

Available dosages

• Viagra: 25mg, 50mg, 100mg
• Cialis: 2.5mg, 5mg, 10mg, 20mg
• Levitra: 5mg, 10mg, 20mg
• Spedra: 100mg, 200mg

Standard starter dose

• Viagra: 50mg
• Cialis: 10mg
• Levitra: 10mg
• Spedra: 100mg

How fast does it work?

• Viagra: 30-60 mins
• Cialis: 30 mins
• Levitra: 30-60 mins
• Spedra: 15-30 mins

How long does it last?

• Viagra: 4-6 hours
• Cialis: Up to 36 hours
• Levitra: 4-6 hours
• Spedra: 6 hours

Chance of side effects?

• Viagra: Less than 2%
• Cialis: Less than 2% on 10mg
• Levitra: Less than 2%
• Spedra: 2% or over

Our erectile dysfunction medication prices:

4 tablets, 8 tablets, 12 tablets, 16 tablets, 28 tablets

• Viagra 25mg: £19.99, £29.99, £45, £54.99, £90
• Viagra 50mg*: £29.99, £49.99, £70, £84.99, £125
• Viagra 100mg: £33.99, £59.99, £80, £94, £155
• Viagra Connect 50mg*: £19.95, £34.95, £52, £64.95, £113
• Sildenafil 25mg: £15.99, £23, £40.50, £44, £78
• Sildenafil 50mg*: £14.99, £27.99, £41, £44.99, £78
• Sildenafil 100mg: £24.99, £34.99, £52, £59, £100
• Cialis 2.5mg: -, -, -, -, £72
• Cialis 5mg: -, -, -, -, £72.00
• Cialis 10mg*: £40.99, £79.99, £120, £146, £265
• Cialis 20mg: £39.99, £74.99, £119, £148, £265
• Tadalafil 2.5mg: -, -, -, -, £54.99
• Tadalafil 5mg: -, -, -, -, £54.99
• Tadalafil 10mg*: £27, £46, £62, £80, £140
• Tadalafil 20mg: £29, £51, £68, £88, £150
• Vardenafil 5mg: £25, £45, £65, £85, –
• Vardenafil 10mg: £30, £50, £70, £90, –
• Vardenafil 20mg: £35, £55, £80, £105, –
• Spedra 100mg*: £32, £53, -, -, –
• Spedra 200mg: £41, £72, -, -, –

Standard starting dose for this erectile dysfunction medication

Vitaros cream is the only erectile dysfunction cream available.

• Usually only recommended if you can’t use erectile dysfunction tablets, or they aren’t safe for you to use
• Gets to work in 5-15 mins
• Works for up to 75% of men who try it
• Can be more difficult to use than tablets
• Is more likely to cause penis pain as a side effect

The active ingredient in Vitaros is alprostadil. You can also get alprostadil for erectile dysfunction as:

• An injection you use on the base of the penis
• A pellet that you put down the urethra (the hole at the tip of the penis)

As well as erectile dysfunction tablets and creams, other treatment options include:

• Lifestyle changes
• Erectile dysfunction exercises
• Counselling
• Penis pumps
• Penile implants

Counselling can help if you are getting erectile dysfunction because you’re anxious about sex. It can also help you manage how your erectile dysfunction symptoms make you feel.

You can combine lifestyle changes and erectile dysfunction exercises with medications for even better results.

Penile implants are usually only used as a last resort when all other treatment options don’t work or aren’t safe. This is because it involves having invasive surgery.

Yes. When you go to the NHS about your erectile dysfunction (ED), a doctor or nurse will start by asking you about your lifestyle, relationships, and any specific problems you’re having. They will carry out some basic health checks, which include taking your blood pressure and doing a physical exam. Depending on your symptoms, you might need to do some extra tests too.

Once your doctor has examined you and carried out some investigations, they’ll go through some NHS recommendations for treatment, like lifestyle changes, medications like the ones we offer, and counselling.

Yes there are. While medical treatments are usually the best options, it’s understandable if you want to try a more natural approach first. There are a few ED treatments that don’t involve medication:

• Erectile dysfunction exercises – there are exercises, like kegels, you can do to make the muscles around your penis stronger, which can improve blood flow and erections.
• Lifestyle changes – by making some changes to the way you live your life, you could naturally improve your erections, for example:
• Quitting smoking
• Cutting down on alcohol
• Eating a balanced diet
• Exercising regularly
• Losing weight if you’re overweight
• Reducing your stress levels

Herbal products, food, or over-the-counter supplements are not good options.

A lot of sites will suggest or try to sell you these treatments options, but the truth is they aren’t proven to work. We don’t recommend trying them because you will likely end up wasting your time and money, without improving your erectile dysfunction symptoms, instead of getting treatment that works. If you do decide to try one of these options, we recommend you choose ones that are properly checked for safety.

You can’t cure erectile dysfunction so it never comes back, but you can get effective, long-term treatment.

There’s a few different ways to improve your erectile dysfunction long-term:

• Lifestyle changes – these can help improve your ability to get and keep erections
• Treating underlying health problems – if your erectile dysfunction is a side effect of another health problem, treating it could improve your symptoms long-term
• Switching medications – if your erectile dysfunction is a side effect of another medication you’re taking, you may be able to switch treatments and your symptoms may go away
• Counselling – if your erectile dysfunction is related to your mental health, counselling could improve your symptoms long-term

It’s also safe to take erectile dysfunction medications long-term, as long as your health situation doesn’t change.

• Avanafil for Erectile Dysfunction (2013) Annals of Pharmacotherapy [accessed 5th November 2020]
• British Society for Sexual Medicine Guidelines on the Management of Erectile Dysfunction in Men (2017) The Journal of Sexual Medicine [accessed 5th November 2020]
• Erectile dysfunction (impotence) (2017) NHS [accessed 5th November 2020]
• Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction (2005) BMC Urology [accessed 5th November 2020]
• Ocular side effects of Levitra® (vardenafil) – results of a double-blind crossover study in healthy male subjects (2019) Drug Des Devel Ther [accessed 5th November 2020]
• Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review (2007) The Journal of Sexual Medicine [accessed 5th November 2020]