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ED

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Treatment options, compared honestly

Erectile dysfunction (ED) is common and treatable, and the UK has several licensed options with real evidence behind them.

  • Sildenafil. Prescription-only at most doses; licensed in the UK “for treatment of men with erectile dysfunction.” Standard dose 50mg, taken around an hour before sexual activity, adjustable between 25 and 100mg. Since 2017, a 50mg version (Viagra Connect) is available directly from a pharmacy after a consultation with the pharmacist, without needing a separate prescription.
  • Tadalafil. Licensed for ED, with two prescription dosing options: an on-demand dose (10-20mg, taken at least 30 minutes before sexual activity, with effects that can last over 24 hours) or a low daily dose (2.5-5mg). Cialis Together 10mg has separate Pharmacy medicine status, which means a pharmacist may supply that specific product without a prescription after checking it is suitable.
  • Devices and other options. Vacuum erection devices and other non-drug options exist and can be appropriate depending on the cause. Not covered in detail here; ask a prescriber or GP about the full range.
  • Talking to a GP. A legitimate first step. ED can be an early marker of cardiovascular issues, so a GP conversation is never a wasted one, whichever route you choose afterward.

How UK online ED clinics work, and what regulation requires of them

Since February 2025, the GPhC’s guidance for online pharmacy services is explicit that prescribers must not base a decision on a questionnaire alone; they’re expected to independently verify what a patient has told them, for example through two-way communication, and to record their reasoning if they choose not to speak with the patient directly. ED specifically is flagged in that guidance as a condition where a simple tick-box questionnaire may not be enough on its own. Mandatory identity verification also applies to every prescription-only or pharmacy medicine sale. A clinic that skips these steps isn’t following current GPhC guidance.

Costs at a glance

Per-tablet prices for generic sildenafil and tadalafil at the UK clinics we’ve checked commonly start under £2 per tablet, with branded Viagra and Cialis costing substantially more for the same active ingredient at an equivalent dose. See our branded vs generic cost breakdown for exactly why, and our full clinic comparison for current consultation fees and pricing.

Frequently asked questions

What's the difference between sildenafil and tadalafil?

Sildenafil is taken about an hour before sexual activity and lasts a few hours. Tadalafil can be taken as a single on-demand dose that may remain effective for over 24 hours, or as a low daily dose for men who expect to be sexually active twice a week or more.

Can I buy ED treatment without a prescription?

Some specific Pharmacy medicine products can be supplied after a pharmacist consultation without a prescription: Viagra Connect contains sildenafil 50mg, and Cialis Together contains tadalafil 10mg. Other strengths and products remain prescription-only. Neither pharmacy product is suitable for everyone.

Are generic ED tablets as effective as branded ones?

UK generics must meet a strict bioequivalence standard against the branded product, confirmed for both sildenafil and tadalafil in published studies. See our branded vs generic comparison for the detail.

Who shouldn't take sildenafil or tadalafil?

Anyone taking nitrate medication (an absolute contraindication), anyone with very low blood pressure, a recent heart attack or stroke, or certain other cardiac conditions. A proper consultation should screen for these before prescribing.