Tadalafil info

[Denzel112]

I take 5mg of cialis 4-5 days a week (when i go to the gym) for blood flow and pump benefits.

I have no problems with ED, however on occasions when seeing SPs I have taken 10mg 30-60mins before hand, and i must say my dick never goes limp in the hour sessions, I've also had to re-adjust my cock into my boxers when I leave because it is still hard

[shagmore]

Not if you are fit and health and medication free, the small drop in BP, while measurable, is unnoticeable and of no real significance.

It may potentially be more problematic for those with pre-existing medical conditions, in particular anyone on BP medication, but even then will rarely result in 'dangerously' low levels.

I was just going on what was said on the label, but always seek medical advise, I am no doctor

[Doc Holliday]

I was just going on what was said on the label, but always seek medical advise, I am no doctor

In the Patient Information Leaflet the 'dangerous drop in blood pressure' is only a concern for anyone taking nitrate medication. This is commonly used to treat angina. The same applies to Amyl Nitrate more commonly known as 'poppers' and used recreationally by some people during sexual activity. Otherwise there is no real problem 

[Thephoenix]

In the Patient Information Leaflet the 'dangerous drop in blood pressure' is only a concern for anyone taking nitrate medication. This is commonly used to treat angina. The same applies to Amyl Nitrate more commonly known as 'poppers' and used recreationally by some people during sexual activity. Otherwise there is no real problem 

Never mind  tadalafil Doc!
Keep your comments going cos those tits of yours are working wonders for my ED.   



Hidden Image/Members Only

[Doc Holliday]

Never mind  tadalafil Doc!
Keep your comments going cos those tits of yours are working wonders for my ED.   

That's positive news and suggests that our therapy sessions have had a positive outcome with your Mr floppy Erectile Dysfunction problem.

I will advise my Secretary to forward you an up to date account of my professional fees. Early settlement would be appreciated.

If you wish to arrange any further treatment, please let her know and I will update my avatar picture accordingly. 

[londonroad]

Firstly, what is a 'sex professional'?

Secondly, may I ask is the 20mg Tadalafil being prescribed on NHS prescription, as you meet the eligibility criteria? Also why is your GP advising you to bite off a quarter of a 20mg tablet rather than use a pill splitter?

So that readers of this thread can grasp the issue here I take the liberty of repeating below a separate post from Doc Holliday about getting Tadalafil from your GP.

Doc Holliday posted the following in response to this post
‘ Ye, pretty much generally the case now I think. Private prescription option only’


When I first approached my GP practice for ED tablets earlier this year, I was called into the surgery for an appointment. It was with a trainee GP. I asked for Tadalafil 10mg but he said he would need to refer this to someone more senior. Eventually a prescription was issued for Sildenafil 50mg, but no clear explanation was given as to why they couldn’t prescribe Tadalafil 10mg.
Recently I made a specific online request to my GP practice for Tadalafil 10mg explaining again that I needed something as a ‘weekend pill’. I added that I had previously used Tadalafil 10mg via private prescription. Eventually this request was approved - but only for four tablets. Communication with the GP surgery is via an online platform and I had been hoping to understand why the GP practice is reluctant is prescribe Tadalafil as I’m keen to learn if there are health or other risks I need to be aware of.
I’m going to try and get a repeat prescription for Tadalafil 10mg and if that is successful, I then intend asking directly for Cialis 5mg. I have never tried using Cialis 5mg - even via private prescription. It will be interesting to see what response I get.
Incidentally, because I’m an older chap I don’t have to pay for my prescriptions - hence my efforts to now get all my ED tablets from my GP practice.

[Munter84]

may I ask is the 20mg Tadalafil being prescribed on NHS prescription, as you meet the eligibility criteria? Also why is your GP advising you to bite off a quarter of a 20mg tablet rather than use a pill splitter?

Yes, the Tadalafil was via NHS at the time (I now buy generic OTC). I can't tell you exactly what my GP's reasoning was 

[scutty brown]

Most GP groups refuse to allow prescriptions for tadalafil on cost grounds unless there are other issues making the case more complex such as MS or Parkinson's. Even then the most you're likely to get is 4x20mg / month.
Your chances of getting a 5mg daily prescription are probably between nil and zero. It's too expensive, and most GPs see it only as a secondary treatment for prostate enlargement - and even then it's often regarded as unnecessary or invalid as a treatment. I tried discussing it with my GP and he refused to accept it as a valid treatment, and that seems to be a common view

[Doc Holliday]

Doc Holliday posted the following in response to this post
‘ Ye, pretty much generally the case now I think. Private prescription option only’


When I first approached my GP practice for ED tablets earlier this year, I was called into the surgery for an appointment. It was with a trainee GP. I asked for Tadalafil 10mg but he said he would need to refer this to someone more senior. Eventually a prescription was issued for Sildenafil 50mg, but no clear explanation was given as to why they couldn’t prescribe Tadalafil 10mg.
Recently I made a specific online request to my GP practice for Tadalafil 10mg explaining again that I needed something as a ‘weekend pill’. I added that I had previously used Tadalafil 10mg via private prescription. Eventually this request was approved - but only for four tablets. Communication with the GP surgery is via an online platform and I had been hoping to understand why the GP practice is reluctant is prescribe Tadalafil as I’m keen to learn if there are health or other risks I need to be aware of.
I’m going to try and get a repeat prescription for Tadalafil 10mg and if that is successful, I then intend asking directly for Cialis 5mg. I have never tried using Cialis 5mg - even via private prescription. It will be interesting to see what response I get.
Incidentally, because I’m an older chap I don’t have to pay for my prescriptions - hence my efforts to now get all my ED tablets from my GP practice.

Thanks for that. Interesting. The situation regarding ED meds and the NHS  has been one of constant evolution and also post code differences. This has led to confusion for everyone including health professionals. The last time I posted about this in detail was a while ago and further changes in protocol were apparently in the pipeline at that time.

I am seeing my GP later this morning and as a starting point will enquire about the current situation 

[Doc Holliday]

So leading on from above I ended up down something of an NHS rabbit hole. What a shambles 

This will likely only be of interest to those members who are prescribed ED meds by their GP.

I last reported on this in 2024.

https://www.ukpunting.com/index.php?topic=431025.msg4279075#msg4279075

Historically branded ED meds Viagra, Cialis etc were only available on NHS prescription for those who met the Selected List Scheme (SLS) criteria and which is shown below.

All options have been available on private prescription if medically/clinically justified and on the basis that there is no charge for issuing the prescription just the cost of the medication and dispensing it.

Once the Viagra patent expired and generics became available, then generic sildenafil eventually could be prescribed for everyone on NHS prescription and not just those eligible under SLS criteria, but with quantity restrictions.

Generic Tadalafil when it became available, was vastly cheaper than Cialis, but was still only available on NHS prescription under SLS. 

Somewhere along the line it was decided that daily tadalafil 5mg for ED showed no benefit over ‘on demand’ dosing and it was recommended it no longer be available at all on the NHS even under SLS (in most regions) and it was removed.

However, in 2023 this was reversed again and by 2024 most ICGs had updated their Formularies to include Tadalafil daily but only to those eligible under SLS.

Not only was it back in vogue, but some ICB recommendations are advising its use over ‘on demand’ tadalafil.

So fast forward and I have learned today that the SLS requirement for both generic Tadalfil and Vardenafil was removed nine months ago in October 2025.
 
External Link/Members Only

This means that they are available to everyone on NHS prescription and not just SLS patients, though quantity may be restricted.

There are now also way more local variations in first line treatment. Most still have Sildenafil as first choice progressing to Tadalafil (either on demand or daily) but one had Tadalfil as first choice?

The only consistency seems to be that 2.5mg Tadalafil tablets should not be prescribed on NHS prescriptions due to their cost compared to 5mg. Splitting however is not advised.

If you want to find out your local prescribing guidelines, first find your relevant ICB here
External Link/Members Only

From there you need to search for the current Formulary linked to that ICB. This is not always straight forward as it seems some ICB’s have sub division formularies.

This is my local ICB Formulary External Link/Members Only

It also links to this flow diagram protocol (others may not)

External Link/Members Only

Now this is actually bang up to date with the changes in 2024 and October 2025, but when looking at a random selection of other ICB's some were equally up to date but others were not.

When searching, do not rely on AI summaries as they are mostly incorrect and out of date. Largely because the sources they are using are also either conflicting or out of date. Good luck.





Hidden Image/Members Only

[londonroad]

So leading on from above I ended up down something of an NHS rabbit hole. What a shambles 

This will likely only be of interest to those members who are prescribed ED meds by their GP.

I last reported on this in 2024.

https://www.ukpunting.com/index.php?topic=431025.msg4279075#msg4279075

Historically branded ED meds Viagra, Cialis etc were only available on NHS prescription for those who met the Selected List Scheme (SLS) criteria and which is shown below.

All options have been available on private prescription if medically/clinically justified and on the basis that there is no charge for issuing the prescription just the cost of the medication and dispensing it.

Once the Viagra patent expired and generics became available, then generic sildenafil eventually could be prescribed for everyone on NHS prescription and not just those eligible under SLS criteria, but with quantity restrictions.

Generic Tadalafil when it became available, was vastly cheaper than Cialis, but was still only available on NHS prescription under SLS. 

Somewhere along the line it was decided that daily tadalafil 5mg for ED showed no benefit over ‘on demand’ dosing and it was recommended it no longer be available at all on the NHS even under SLS (in most regions) and it was removed.

However, in 2023 this was reversed again and by 2024 most ICGs had updated their Formularies to include Tadalafil daily but only to those eligible under SLS.

Not only was it back in vogue, but some ICB recommendations are advising its use over ‘on demand’ tadalafil.

So fast forward and I have learned today that the SLS requirement for both generic Tadalfil and Vardenafil was removed nine months ago in October 2025.
 
External Link/Members Only

This means that they are available to everyone on NHS prescription and not just SLS patients, though quantity may be restricted.

There are now also way more local variations in first line treatment. Most still have Sildenafil as first choice progressing to Tadalafil (either on demand or daily) but one had Tadalfil as first choice?

The only consistency seems to be that 2.5mg Tadalafil tablets should not be prescribed on NHS prescriptions due to their cost compared to 5mg. Splitting however is not advised.

If you want to find out your local prescribing guidelines, first find your relevant ICB here
External Link/Members Only

From there you need to search for the current Formulary linked to that ICB. This is not always straight forward as it seems some ICB’s have sub division formularies.

This is my local ICB Formulary External Link/Members Only

It also links to this flow diagram protocol (others may not)

External Link/Members Only

Now this is actually bang up to date with the changes in 2024 and October 2025, but when looking at a random selection of other ICB's some were equally up to date but others were not.

When searching, do not rely on AI summaries as they are mostly incorrect and out of date. Largely because the sources they are using are also either conflicting or out of date. Good luck.





Hidden Image/Members Only

Very many thanks for taking the time and trouble to gather this information- very useful.
When we move into a new month next week I intend trying to initially get a repeat prescription for the 10mg Tadalafil tablets - as I was only prescribed 4 tablets on the initial prescription. At my GP surgery it seems more junior staff approve repeat prescriptions, but any change requests have to go to a GP.
If I’m successful with getting some more 10mg Tadalafil, I will then wait until after 1st September and ask for the 5mg Tadalafil daily. I expect such a request will get directed to a senior GP. If I am successful in getting approval for the 5mg Tadalafil daily, it will be interesting how many tablets get prescribed.

[scutty brown]

The 5mg come in boxes of 28 - holding 2 x 14 strips.
Pharmacy won't be allowed to repack them so you should get 28 irrespective of what the doctor ordered

[Munter84]

Most GP groups refuse to allow prescriptions for tadalafil on cost grounds unless there are other issues making the case more complex such as MS or Parkinson's.

Ah, I follow you a bit better now. This was an NHS GP but a private prescription, and a pretty penny it was too as this was shortly before Tadalafil generics became available OTC.

[Thephoenix]

Very many thanks for taking the time and trouble to gather this information- very useful.
When we move into a new month next week I intend trying to initially get a repeat prescription for the 10mg Tadalafil tablets - as I was only prescribed 4 tablets on the initial prescription. At my GP surgery it seems more junior staff approve repeat prescriptions, but any change requests have to go to a GP.
If I’m successful with getting some more 10mg Tadalafil, I will then wait until after 1st September and ask for the 5mg Tadalafil daily. I expect such a request will get directed to a senior GP. If I am successful in getting approval for the 5mg Tadalafil daily, it will be interesting how many tablets get prescribed.

Thanks to Doc for all the detailed and very useful research. 

[londonroad]

Very many thanks for taking the time and trouble to gather this information- very useful.
When we move into a new month next week I intend trying to initially get a repeat prescription for the 10mg Tadalafil tablets - as I was only prescribed 4 tablets on the initial prescription. At my GP surgery it seems more junior staff approve repeat prescriptions, but any change requests have to go to a GP.
If I’m successful with getting some more 10mg Tadalafil, I will then wait until after 1st September and ask for the 5mg Tadalafil daily. I expect such a request will get directed to a senior GP. If I am successful in getting approval for the 5mg Tadalafil daily, it will be interesting how many tablets get prescribed.

Success! The surgery prescribed 10 Tadalafil 10mg tablets without any questions being asked, they also set this up as a repeat prescription. Originally I was thinking I might try my luck it getting a prescription for Tadalafil Daily, but I’m now inclined to instead stick with using the 10mg which work perfectly for weekends away with my sugar babe - I can take one tablet on Friday evening and the SB can get me hard for action on the Monday morning.

[Khanmr566]

Have you guys tried dapoxetine?

[Thephoenix]

Edit

[maybe]

I asked a doctor recently whether taking ED meds without having ED whilst being on the semi high BP would be a problem and he said no and made it sound like it was taking candy sweet.

He stated that its so widely available and over the counter should tell me how safe it is, but always follow the instructions, guidelines and recommendations and get them from reputable sources. I've only taken viagra once and i was still hard the next day ..... but would like to try again.

Been contemplating whether to try something during punts as i am prone to going soft after ~15mins and have to rely on CIM to finish. Does anyone have some additional comments about taking ED meds when i don't have severe ED? The doctor was kinda blase about the whole thing and wanted some additional opinions.

[Doc Holliday]

They are now broadly considered safe, though the side effects, while rarely serious, are very common and most people will suffer some degree of minor side effects. Did you?

May I ask what age bracket you are in? 

[maybe]

They are now broadly considered safe, though the side effects, while rarely serious, are very common and most people will suffer some degree of minor side effects. Did you?

May I ask what age bracket you are in? 

From what i remember, no side effects, onlly it lasted beyond the punt and still rock solid the next day ... and wished i could use it whilst i had it. I only know it was a blue pill, but unsure which brand. I should check if my mate remembers, i also didn't break it and took the whole thing.

Nearly 50 now.

[Doc Holliday]

From what i remember, no side effects, onlly it lasted beyond the punt and still rock solid the next day ... and wished i could use it whilst i had it. I only know it was a blue pill, but unsure which brand. I should check if my mate remembers, i also didn't break it and took the whole thing.

Nearly 50 now.

Thanks. Sorry for late reply.

As you approach 50 it is possible you may begin showing some signs of ED due to physical causes, though the degree of such is hugely variable. Psychological causes may be a factor at any age and even if they are not the primary cause, they may increasingly become so, as you may progress into performance anxiety often by overthinking the whole thing.

Having read your posts in another recent thread, my guess (and it is just that) is that you don’t have a significant degree of ED. You would therefore be using ED meds recreationally on the basis that they may boost your performance.

ED meds don’t always work with men who genuinely have a fair degree of ED caused primarily by physical causes. However, when used ‘recreationally’ by those who don’t have true ED, they will usually produce ‘steel rod erections’ which are actually ‘unnatural’. But you will become hooked and should you decide to stop and revert to ‘normal’ then at the first sign of failure, you will suffer performance anxiety and start taking them again. You will then be in the cycle of psychological dependence.

Finally, I notice you have also mentioned difficulty in reaching orgasm. There would be a possibility ED meds in particular sildenafil may make that worse.

The above comments/advice is based on my personal experience.

You may well need to resort to ED meds at some later stage in life, but IMO you should delay this until you really need to. If you do decide to take them recreationally, then start with the lowest possible dose and certainly not 100mg sildenafil that you appear to have taken once in the past. (that is also a guess)

[folma322]

I take 5mg of cialis 4-5 days a week (when i go to the gym) for blood flow and pump benefits.

I have no problems with ED, however on occasions when seeing SPs I have taken 10mg 30-60mins before hand, and i must say my dick never goes limp in the hour sessions, I've also had to re-adjust my cock into my boxers when I leave because it is still hard

Same taking dose for gym benefits but daily not just on gym days, all I notice is I'm still hard after cumming.
Gym benefits not so much I thought it would get my veins to pop out of my arms. Its more noticeable now but, probably not lean enough yet. Beats taking pre-workout though.

[folma322]

.

[maybe]

start with the lowest possible dose and certainly not 100mg sildenafil that you appear to have taken once in the past. (that is also a guess)

Good advice, cheers man.

[flagwend63]

Have you guys tried dapoxetine?

This is a miracle drug. Changed me from lasting 2-3 mins to half an hour if I want. You can get it in a combo pill, 60mg dapoxetine and 100mg sildenafil (viagra). Or get dapoxetine separate, there is a slight advantage there as you can take it 2 hours before, then the sildenafil 1 hour before, to ensure they both peak around the same time.

[scutty brown]

This is a miracle drug. Changed me from lasting 2-3 mins to half an hour if I want. You can get it in a combo pill, 60mg dapoxetine and 100mg sildenafil (viagra). Or get dapoxetine separate, there is a slight advantage there as you can take it 2 hours before, then the sildenafil 1 hour before, to ensure they both peak around the same time.

There's a good reason why dapoxetine and sildenafil are not licenced in the UK as a combo pill: it can kill you. Both drugs drop the blood pressure, together possibly terminally. Any combo pills you buy are not legal.
From External Link/Members Only

Dapoxetine is not recommended for men over 65 years of age. If you are taking medicines for erectile dysfunction (PDE5 inhibitors), combining them with dapoxetine may increase the risk of dizziness and low blood pressure; such combinations require medical supervision.

In should only ever take the two together under medical supervision

[scutty brown]

Back to tadalafil, a few weeks back there was a press release suggesting that medical tracking suggested there seemed to be a direct link between regularly taking the drug and reduced chances of vascular dementia. It wasn't a clinical study, just an apparent effect that had been noted as a part of long-term studies.
And then last week this comes out:
External Link/Members Only
Which suggests there seems to be a correlation between taking tadalafil and developing glaucoma.
Again it's not a clinical study, just an observational relationship so cause/effect not proven but it is something to be aware of

[tesla]

Warning: Just because he did it and didn't suffer adverse consequences does NOT mean you can do the same. The patient information leaflet in the packets say do NOT mix different ED drugs in the same 24 hr period, so please don't unless advise by your GP.

Just been in the USA and lots of TV ads for this combined pill containing 4 ingredients, not saying its right but the yanks seem to have a different position on combining.

External Link/Members Only

[Doc Holliday]

Just been in the USA and lots of TV ads for this combined pill containing 4 ingredients, not saying its right but the yanks seem to have a different position on combining.

External Link/Members Only

No they don't. From your link

"The featured products include compounded products that have not been approved by the FDA. Compounded products may be prescribed under federal law, but are not the same as, nor are they generic versions of, any FDA-approved medication. The FDA does not verify the safety, effectiveness, or manufacturing quality of compounded products."

[tesla]

good spot, although I was not specifically referring to any US licensing body just a general observation

[scutty brown]

Just been in the USA and lots of TV ads for this combined pill containing 4 ingredients, not saying its right but the yanks seem to have a different position on combining.

External Link/Members Only

you'd have to be fucking mad to touch that mix
sidenafil + tadalafi + apomorphine + oxytocin

[GreyDave]

  Ive had a bad experiance with mixing a high dose of Tadafil 20mg and then a few hours later 100mg of Sildenafil It frightened me and another punter saw I was looking worried and like i was going to pass out we sat in a cafe and I had a few expresso coffes and a cake and half hour later I was feeling better I returned home swearing never to do it again ( Id tried to shag 3 Soho Walk ups a few years ago I even swapped the remaining Tads with my punting uncle for some Sildenafil as he prefers them...

Fast forward to now... I am 64 out of shape I am taking 5mg Tadafil daily regardless of punting  for bengin prostatic hyperplasia.. ( In layman’s teams )I have difficulty peeing some times its a few drops then it builds to a very weak dribbble out to a weak flow it makes such a difference its comfortable when I stand there and pee not powerful up the wall stuff just a consistant flow ( Ive stood in pain hoping it will flow).

The up side is erections in morning again Shagging other half with out taking a Sildenafil and watching what I eat and drink it gives a hard on like a normal one .
Down side is the erection subsides after a few mins and if I put effort in it goes quickly so with other half I can poke her and shell ask are you done yet Ill pull out with out cumming and it ll go soft .

So if I want to cum its 50-10 mg of Sildenafil about 1-2 hrs before act it delays me which is great if Im doing a WG as I get to change postions 
but annoying now doing the Other half as she just want spoons and asks if im done after a few mins  ( she`d be a good Romainian impersonator )

As a by mention I dont produce much now No pre cum  and I take a day to be able to cum a drop again some times its all most painfull cumming hard when Ive been ploughing and I no longer smell like I did its almost non smelling  Hope thats of some interest help in describing my use of these pills if i did not use It would nt work ...

[maybe]

Just been in the USA and lots of TV ads for this combined pill containing 4 ingredients, not saying its right but the yanks seem to have a different position on combining.

External Link/Members Only

A lot of things that the US sell never seems to apply to any of their standards regardless whether its food or drugs or anything else, but they allowed to sell it anyways, its nuts!

[Denzel112]

Hey guys just for your information, I was a daily user of cialis (tadalafil) at 5mg for gym benefits, and would occasionally take 10mg when seeing an SP. I found out that it was tadalafil that was giving me bad acid reflux, so if anybody here is having indigestion or acid reflux problems, tadalafil is a culprit.

[Doc Holliday]

Hey guys just for your information, I was a daily user of cialis (tadalafil) at 5mg for gym benefits, and would occasionally take 10mg when seeing an SP. I found out that it was tadalafil that was giving me bad acid reflux, so if anybody here is having indigestion or acid reflux problems, tadalafil is a culprit.

Acid reflux is a well known side effect of Tadalafil. In my case I found it intolerable.

There are a number of posts in this thread regarding gym benefits and off label use.

There is no reliable evidence of any real benefit and consequently it is not approved for that use.

[Thephoenix]

Hey guys just for your information, I was a daily user of cialis (tadalafil) at 5mg for gym benefits, and would occasionally take 10mg when seeing an SP. I found out that it was tadalafil that was giving me bad acid reflux, so if anybody here is having indigestion or acid reflux problems, tadalafil is a culprit.

Unfortunately I'm predisposed to acid reflux and Tadalafil made it worse.

I found all varieties of ED meds had the same effect, but as tadalafil stays in your system longer, so do the side effects last longer.

[Ligan]

Unfortunately I'm predisposed to acid reflux and Tadalafil made it worse.

I found all varieties of ED meds had the same effect, but as tadalafil stays in your system longer, so do the side effects last longer.

PPIs would keep it in check but yeah you'd rather not take them if possible.

[scutty brown]

PPIs would keep it in check but yeah you'd rather not take them if possible.

PPIs have the same effect as grapefruit juice and affect the metabolic breakdown rate of drugs in the liver - including tadalafil and sildenafil.
Mix PPIs and  ED drugs and the longevity in the body becomes very unpredictable

[daviemac]

PPIs have the same effect as grapefruit juice and affect the metabolic breakdown rate of drugs in the liver - including tadalafil and sildenafil.
Mix PPIs and  ED drugs and the longevity in the body becomes very unpredictable

How come along with other medication including Ed meds I can take Lansoprazole but because of the statins I take I can't have grapefruit juice? 

Surely that only people who should advise on what can or can't be taken is a medical professional with the patient's medical history in front of them.   

[scutty brown]

How come along with other medication including Ed meds I can take Lansoprazole but because of the statins I take I can't have grapefruit juice? 

Surely that only people who should advise on what can or can't be taken is a medical professional with the patient's medical history in front of them.   

It's relatively easy to say that two drugs shouldn't be taken together. However it's a whole different thing to claim that two drugs are safe to take together. The first is unlikely to cause harm, the latter may easily do so.
My comment re PPIs was based on literature I've read in the past which specifically named esomeprazole and generalised re other drugs. However curiously they are missing from the current BNF list of incompatible drugs -see
External Link/Members Only
I'll see if I can find the original literature again.
As regards statins, they seem to have a wide range of incompatibilities. For instance Atorvastatin shows 157 interactions on that BNF list, including some common antibiotics. Doesn't mention the grapefruit problem though.....you need to read the product literature for that.
And it's not just grapefruit - lemons, limes, bitter oranges, tangerines, any acidic tasting citrus fruit shares the same problem.
Here's a list of affected drugs
External Link/Members Only

There are some  statins which are not affected by this problem - could be worth discussing with your GP if it's a problem

[daviemac]

It's relatively easy to say that two drugs shouldn't be taken together. However it's a whole different thing to claim that two drugs are safe to take together. The first is unlikely to cause harm, the latter may easily do so.

It's very easy to make claims on an internet forum based on something you have read but not on years of medical training and access to someone's full medical history.

I take the PPIs that suit me, Lansoprazole, I'm also aware I can safely take blood pressure / heart meds with the other medication I take including ED meds together. I know this not because someone on a forum has told me but because the people who prescribe them have studied for years to get to be able to do so safely.

There are some  statins which are not affected by this problem - could be worth discussing with your GP if it's a problem

That is my whole point, I HAVE discussed all aspects of the seven different daily medications plus sildenafil as required that I take.  I take Simvastatin because it's the one I don't get adverse side effects from though I can't have grapefruit juice with it.

All my medications are regularly reviewed and I have annual blood test to ensure all is as it should be.

What I wouldn't do is presume that just because the meds I take suit me they would suit everyone nor would I give anyone advice on medical issues other than see your own doctor or other medical professional who has access to you full medical history.

[GreyDave]

  Ill agree with the heart burn indigestion that stays longer when Ive mixed    To be fair though 2.5 tad daily ( half of a 5mg tablet)  and then 50mg of sildenafil last week for me gave me one of the best sessions Ive had ..Yes a normal natural erection is not as hard but my goodness as a 64 year old its great to feel like I am 20 again when seeing a 21 year old WG. The uncomfortable effects are forgotten quickly 

[Hurley]

I use medexpress and they deliver to a post office of your choosing

[Handel2020]

I had no problem with the doctor offering to prescribe them but she could not offer me anything less than 10mg. The 5mg tablets were not available when I asked but that might have been my local NHS. I ended up buying 5mg tablets and splitting them so I can take them mostly as 2.5mg. Also, as people have talked about side effects does anyone get dry eye or wake up with dry eye from taking tadalafil?

[Andy4567]

So that readers of this thread can grasp the issue here I take the liberty of repeating below a separate post from Doc Holliday about getting Tadalafil from your GP.

Doc Holliday posted the following in response to this post
‘ Ye, pretty much generally the case now I think. Private prescription option only’


When I first approached my GP practice for ED tablets earlier this year, I was called into the surgery for an appointment. It was with a trainee GP. I asked for Tadalafil 10mg but he said he would need to refer this to someone more senior. Eventually a prescription was issued for Sildenafil 50mg, but no clear explanation was given as to why they couldn’t prescribe Tadalafil 10mg.
Recently I made a specific online request to my GP practice for Tadalafil 10mg explaining again that I needed something as a ‘weekend pill’. I added that I had previously used Tadalafil 10mg via private prescription. Eventually this request was approved - but only for four tablets. Communication with the GP surgery is via an online platform and I had been hoping to understand why the GP practice is reluctant is prescribe Tadalafil as I’m keen to learn if there are health or other risks I need to be aware of.
I’m going to try and get a repeat prescription for Tadalafil 10mg and if that is successful, I then intend asking directly for Cialis 5mg. I have never tried using Cialis 5mg - even via private prescription. It will be interesting to see what response I get.
Incidentally, because I’m an older chap I don’t have to pay for my prescriptions - hence my efforts to now get all my ED tablets from my GP practice.

NHS restrictions
Cialis® is not prescribable in NHS primary care for the treatment of erectile dysfunction except in men who meet the criteria listed in part XVIIIB of the Drug Tariff (Part XIb of the Northern Ireland Drug Tariff, Part 12 of the Scottish Drug Tariff). The prescription must be endorsed 'SLS'. For more information see Prices in BNF, under How to use BNF Publications.

[scutty brown]

NHS restrictions
Cialis® is not prescribable in NHS primary care for the treatment of erectile dysfunction except in men who meet the criteria listed in part XVIIIB of the Drug Tariff (Part XIb of the Northern Ireland Drug Tariff, Part 12 of the Scottish Drug Tariff). The prescription must be endorsed 'SLS'. For more information see Prices in BNF, under How to use BNF Publications.

see  External Link/Members Only:

the key parts are

The following drugs for the treatment of erectile dysfunction -

Alprostadil

Avanafil

Tadalafil

Vardenafil

Viagra

are only allowed to be prescribed to

(1)   The following patients with erectile dysfunction

====snip===

d)   a man who is suffering from any of the following - diabetes multiple sclerosis Parkinson's disease poliomyelitis prostate cancer severe pelvic injury single gene neurological disease spina bifida spinal cord injury; or

e)   a man who is receiving treatment for renal failure by dialysis; or

f)   a man who has had the following surgery - prostatectomy radical pelvic surgery renal failure treated by transplant.

I've removed as irrelevant to this discussion clauses about users with record of historic use, and users for non-ED diseases

I suspect there's two reasons
1) cost (for instance Viagra is on this ban list but cheap generic sildenafil isn't)
2) complications with sildenafil/viagra causing blood pressure problems with some of these exempted diseases / conditions

[scutty brown]

just noticed a second similar section

Alprostadil

ApomorphineHydrochloride

MoxisylyteHydrochloride

Sildenafil

Tadalafil

ThymoxamineHydrochloride

Vardenafil

d)   a man who is suffering from any of the following - diabetes multiple sclerosis Parkinson's disease poliomyelitis prostate cancer severe pelvic injury single gene neurological disease spina bifida spinal cord injury; or   
e)   a man who is receiving treatment for renal failure by dialysis; or   
f)   a man who has had the following surgery - prostatectomy radical pelvic surgery renal failure treated by transplant.   
g)   a man who has been diagnosed as suffering severe distress resulting from erectile dysfunction where the assessment has been made by a specialist service or GP under arrangements made with a Local Health Board to provide such assessments

[Doc Holliday]

Gentlemen, please see my long post above https://www.ukpunting.com/index.php?topic=460301.msg4503204#msg4503204

"NHS prescriptions for generic versions of Tadalafil and Vardenafil will no longer require a ‘SLS’ (Selected List Scheme) endorsement from the prescriber, as of 1 October 2025.

However, the SLS endorsement requirement will remain in place for the branded versions Cialis (Tadalafil) and Levitra (Vardenafil), which may only be prescribed on the NHS for the treatment of erectile dysfunction in specific, restricted circumstances (which are set out in Part XVIIIB of the Drug Tariff).

The change is expected to benefit patients who do not tolerate Sildenafil, which is already available for erectile dysfunction without restrictions, and who are currently ineligible for Tadalafil or Vardenafil under the SLS criteria."


External Link/Members Only

[Doc Holliday]

I had no problem with the doctor offering to prescribe them but she could not offer me anything less than 10mg. The 5mg tablets were not available when I asked but that might have been my local NHS. I ended up buying 5mg tablets and splitting them so I can take them mostly as 2.5mg. Also, as people have talked about side effects does anyone get dry eye or wake up with dry eye from taking tadalafil?

As in my linked post, 2.5mg tablets of tadalafil are not approved on NHS prescription due to cost.

I am surprised she could not prescribe 5mg tabs though. The decision is, as you mention, based on your local guidelines, but when I researched some randomly for my post, I could not find any that did not allow 5mg?

EDIT eye irritation is a listed side effect but an uncommon one 

[Handel2020]

Thanks. I'll just have to stick with the eye drops as I want to keep taking the tabs for now.