Last updated 14 September 2023
On 14 March 2023, the UK Medicines regulator approved an application to reclassify the erectile dysfunction medication Cialis. When marketed asCialis Together(tadalafil 10mg), it will be a ‘P’ (pharmacy) medication, and so available ‘over the counter’ in pharmacies – see. This follows the 2018, ‘P’ classification of (sildenafil 50mg) which has been available OTC, without a prescription, since then.
This decision is good news for men’s health …. Erectile dysfunction can be a debilitating condition, so it’s important men feel they have fast access to quality and legitimate care
Dr Laura Squire, MHRA’s Chief Officer for Healthcare, Quality and Access
Unfortunately, there is a strong black market in the UK for ED medicines, which are often unlicensed or counterfeit. UK Border Force and the MHRA seize millions of pounds of these fake products from criminals annually. This new classification of tadalafil 10mg will enable men who suffer from ED to obtain it safely from a local pharmacy.
Sanofi, the drug manufacturer, is expected to launch Cialis Together later in 2023. Cialis Together will be available to purchase in pharmacies without a prescription by men over 18 with erectile dysfunction. Cialis Together tablets will contain 10mg tadalafil and the maximum pack size will be 8 tablets. Other doses and pack sizes of Cialis and tadalafil will still be available on prescription through doctors and specially trained pharmacists. Before purchase in a pharmacy there must be an assessment with a pharmacist, who will check that Cialis Together is appropriate and safe, or whether consultation with a GP is necessary.
Men suffering with ED will have another treatment option with the convenience of purchasing it in their local pharmacy, including pharmacies found inside supermarkets (eg. Tesco, Asda, Sainsbury’s). The pharmacist will ask some health questions, may check blood pressure, and will advise on treatment with Cialis Together or Viagra Connect, or the need to consult a GP. Pharmacies usually have a private room for such discussions.
Cialis Together is a 10mg tadalafil product for use at least 30 minutes prior to anticipated sexual activity. Its effects can last. It is not recommended for daily use. The maximum recommended dose of Cialis Together will be one tablet in 24 hours. Prescription Cialis and tadalafil will still be available at different doses.
Dr Fox welcomes the wider access to ED medication for men that Cialis Together classified as a ‘P’ OTC medication will provide. We at Dr Fox are aware of the difficulties men have in discussing ED with their GPs and in accessing ED medication. We know that Cialis is effective and safe for most men and this change provides another option for obtaining ED treatment. Pharmacists are health professionals who are able to give ED advice but they will also know when to refer men who would benefit from a doctor’s assessment. ‘P’ medicines can also be supplied on prescription, and we will offer Cialis Together, when available, alongside our other competitively priced ED products.
Dr Claire Pugh, Dr Fox Medical Director
In the UK have 3 categories:
Cialis Together will be available in OTC pharmacies without a prescription Dapoxetine + Sildenafil is a longer term treatment termed POMO (sildenafil multiple omissions) or ‘poema’.
1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).
2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.
3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.
Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:
Cialis (tadalafil) is a phosphodiesterase (PDE-5) inhibitor. It works by relaxing the blood vessels in the penis, allowing blood to flow when sexually aroused. Cialis is rapidly absorbed into the bloodstream, with peak plasma levels typically occurring within 30 minutes to 1 hour. Cialis is considered the first-line therapy for erectile dysfunction, although sexual stimulation is required to achieve optimal results.
Cialis works by inhibiting the enzyme PDE5, which regulates blood flow in the penis. This action allows blood to flow into the penis, facilitating the achievement and maintenance of an erection.
Cialis is effective for many men with erectile dysfunction, but it also has some side effects. Common side effects include headache, flushing, indigestion, and nasal congestion. These side effects are usually mild and temporary, but if they persist or worsen, it is important to consult a healthcare professional for further evaluation and management.
Cialis can cause side effects in some individuals. Common side effects include headache, indigestion, and nasal congestion. These side effects are usually mild and temporary. If they persist or worsen, it is important to consult a healthcare professional for further evaluation and management.
Cialis is metabolized in the liver, and this metabolism may influence its effects. Some medications may affect Cialis’s efficacy, while others may interact differently. It is important to note that Cialis should be used only under the guidance of a healthcare professional. It should not be used in women, as it may cause birth defects in the unborn child.
Additionally, tadalafil, the active ingredient in Cialis, may interact with other medications. It is important to inform your healthcare provider about any medications you are currently taking before starting Cialis. Inform your healthcare provider if you are currently using any of the following medications:
Cialis may cause side effects in some individuals.
The common side effects of Cialis may include headaches, flushing, and indigestion.
It is important to note that not all common side effects are listed here. It is recommended to consult with a healthcare professional for more details on these side effects to ensure your safety.
To determine the most suitable treatment option for your specific needs, it is crucial to:
You can also report any unusual symptoms or side effects to the FDA at www.fda.gov or call 1-800-FDA-1088.
Certain medications can interact with Cialis. It is important to inform your healthcare provider about all medications you are currently taking. This includes over-the-counter drugs, vitamins, and herbal supplements.
Additionally, some prescription drugs and over-the-counter medicines may interact with Cialis.
It is important to note that Cialis should only be used as prescribed by a healthcare professional.
Generic name:tadalafilBrand names:cialisDrug class:nitratesFormulation:oral tabletRoute:oralTo:norepinephrineAdministration:daily low doseTherapeutic use:as necessaryNote:the drug is not indicated for the treatment of pulmonary arterial hypertension (PAH) or the treatment of benign prostatic hyperplasia (BPH).Drug-related uses:tadalafil is used to treat the symptoms of benign prostatic hyperplasia (BPH) and to improve the symptoms of erectile dysfunction. Tadalafil may be used in combination with other medications to treat these conditions. For more information, ask your doctor or pharmacist.
PharmacologyCialis belongs to the class of phosphodiesterase-5 inhibitors. It works by increasing the flow of blood to the penis. The active ingredient in Cialis, tadalafil, is a phosphodiesterase (PDE) inhibitor. Tadalafil inhibits the enzyme phosphodiesterase (PDE) that breaks down cGMP, a substance that relaxes and widens blood vessels. This results in increased blood flow to the penis and improved sexual function in men with PAH and BPH.
Use in MenCialis is prescribed as andrug for the treatment of erectile dysfunction in men with PAH or benign prostatic hyperplasia. It may also be used for the treatment of erectile dysfunction in men with PAH who have not responded to treatments in the past.
Tadalafil, also known as Cialis Professional, is a medication used to treat erectile dysfunction (ED) and benign prostatic hyperplasia (BPH). This medication works by increasing blood flow to the penis to help men get and keep an erection.
Tadalafil belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. It works by relaxing the blood vessels in the penis, allowing blood to flow into the penis when an erection occurs.
Tadalafil is taken orally and works by increasing blood flow to the penis. This helps men achieve and maintain an erection.
Yes, tadalafil is approved for the treatment of erectile dysfunction.
Do not take tadalafil if you are taking any nitrate medications. This can cause serious health problems.
Tadalafil is not intended for use in women and children. It should not be taken by children and adolescents. It can cause serious side effects, including heart problems, low blood pressure, and vision problems.
You should watch out for side effects, especially if you have a medical condition, take other medications, or are taking other drugs.
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult your doctor before starting any new medication.
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