First-time use of ED tablets

Attempt of therapy counselling

Start with a low dose and try the medication repeatedly at the beginning with a low dose.

Find a tablet that works well and take the lowest dose that is effective.

Men who are prone to low blood pressure may feel dizzy or lightheaded after taking this medicine. This is rare. As a precaution, avoid situations where it is not possible to sit or lie down for several hours after taking the first tablet.

Viagra (sildenafil)

Viagra lost its exclusive patent in the UK in June 2103 and is now legally available in the UK under the name Sildenafil. Sildenafil is sometimes also known as ‘generic Viagra’ or ‘generic Sildenafil’.

There are three strengths of Viagra/Sildenafil tablets: 25mg, 50mg and 100mg. Most men should start with 50mg tablets.

Sildenafil

If 50 mg tablets do not work after four attempts and do not cause any side effects, the dose should be increased to 100 mg. The maximum should be tried on eight different occasions before deciding that it is not effective.

Viagra/Sildenafil must be taken at least 45 minutes and preferably one hour before sex. Sexual stimulation is necessary for an erection. Tablets work for up to 4 hours and should not be taken more than once a day.

Since June 2013, inexpensive generic Sildenafil is available.

Cialis (Tadalafil)

Cialis is available in four strengths: 2.5 mg, 5 mg, 10 mg and 20 mg.

The usual starting dose of Cialis is a 10mg tablet taken about 30 minutes before sexual activity. This can be increased to a maximum of 20 mg as a single dose or reduced to 5 mg in response to treatment.

The effect of Cialis lasts up to 36 hours. It should not be taken more than once a day or more than twice a week (see below Cialis in low dosage).

Cialis should be tried on many different occasions before deciding that it is ineffective. Sexual stimulation is required for an erection. Cialis will not cause erections without it. The effectiveness of Cialis is not altered by food.

Cialis lost its patent protection in the UK in November 2017 and is now legally available in generic form as Tadalafil.

Low-dose Cialis

Men who need Cialis more than twice a week should take one 2.5 mg or 5 mg tablet daily. This daily dose is likely to be effective and will not cause an accumulation of Cialis.

Levitra (Vardenafil)

There are three strengths of Levitra: 5mg, 10mg and 20mg. Most men should start with a single 10mg tablet.

If 10mg is not effective, the dose can be increased to a maximum of 20mg. If 10mg causes side effects, the dose should be reduced to 5mg.

Levitra should be taken about 25 minutes to one hour before attempting intercourse. It can be taken with or without food. Its effects may be delayed if taken with high-fat meals. Levitra works for 4-5 hours and should not be taken more than once a day.

It should be tried on several separate occasions before deciding that it is ineffective. Levitra works only when arousal is present.

Levitra lost its patent protection in the UK in October 2018 and is now legally available in generic form as vardenafil.

Spedra (Avanafil)

The recommended dose is 100 mg, taken as needed about 15-30 minutes before sexual activity. Depending on individual effectiveness and tolerance for impotence, the dose can be increased to a maximum dose of 200 mg or decreased to 50 mg. The recommended maximum dosage frequency is once a day. Sexual stimulation is required for a response to the treatment. Spedra continues to work for about 4 hours and should not be taken more than once a day.

The onset of action may be delayed by up to 1.5 hours if taken on a full stomach.