Sildenafil sperm quality

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.

What does this mean for patients?

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

Categories of medicine

In the UK have 3 categories:

  • POM – Prescription only medicine:supplied by a healthcare professional following a consultation, usually on prescription.
  • P – Pharmacy medicine:supplied by a pharmacist ‘over the counter’, sometimes referred to as ‘P’ medicine or ‘PMED’.
  • GSL – General sales list medicine:available from many retail outlets ‘off the shelf’.
Currently, 3 medicines are available:
  1. Cialis Together – ‘P’ medicine:available OTC while.
  2. Viagra Connect – ‘P’ medicine:available OTC after a medicallyose prescription, sometimes referred to as ‘P’ medicine.
  3. Orlistat – OTC/BSA (over the counter)-based food and drug ingredients:orlistat (alist) available from many retailers ‘off the shelf’.

Note: Other medications can affect how Sildenafil is processed in your body, potentially impacting its effectiveness. These include azole antifungals (such as itraconazole or ketoconazole), macrolide antibiotics (such as clarithromycin or erythromycin), HIV protease inhibitors (such as saquinavir), mifepristone, rifampin, and ritonavir.

Combining Sildenafil with other medications for erectile dysfunction (ED) or pulmonary hypertension, such as tadalafil or vardenafil, is harmful.

esar disfunctions
  • Sildenafil can alter the function of nitric oxide. It works by relaxing muscles in the lining of the blood vessels.
  • Sildenafil can also interact with certain heart medications, especially tamsulosin or riociguat.
  • Use Sildenafil with another medication for the same purpose (by inhibiting the enzyme in the pulmonary artery for improving blood flow). This list does not contain all potential interactions.
dr. interact with
  • Other medications that can affect how Sildenafil is processed in your body include riociguat, tadalafil, vardenafil, mifepristone, alpha-blockers, and alpha-blockers in addition to Sildenafil.
If there are any suspicious effects, contact your doctor.
  • If you’re taking an alpha-blocker for an enlarged prostate (like doxazosin or tamsulosin), it can cause pressure to drop extremely low when Sildenafil is used with nitrates. This very low blood pressure can lead to dizziness or fainting.
  • Avoid using Sildenafil with nitrates used for treating chest pain.
  • If you’re also taking an alpha-blocker for an enlarged prostate (like tamsulosin), it can cause pressure to drop extremely low when Sildenafil is used with nitrates. This very low pressure can lead to dizziness or fainting.
  • Certain HIV protease inhibitors (such as saquinavir), itraconazole, and ketoconazole can interact with Sildenafil.
  • Use Sildenafil with caution in those with a history of blood clots (such as heart attacks or strokes), high blood pressure, or severe liver disease.
  • Never use Sildenafil with a medication that may interact with Sildenafil.
  • If you are taking an alpha-blocker for an enlarged prostate (like doxazosin or tamsulosin), it can cause pressure to drop extremely low when Sildenafil is used with nitrates.

    • Sildenafil citrate, commonly known by the brand name, is a prescription-only medicine used to treat erectile dysfunction (ED) in adult men. It works by improving blood flow to the penis, helping to achieve and maintain an erection during sexual activity.

    Dosage and Administration

    Sildenafil is available in 25mg, 50mg, and 100mg strengths.

    • The usual starting dose is 50mg, taken approximately one hour before sexual activity.
    • Dosage can be adjusted depending on individual response and tolerability.
    • Take only one tablet in 24 hours, with or without food.
    • Avoid grapefruit juice, as it can increase the risk of side effects.
    • A high-fat meal may delay onset of action.

    Effectiveness

    Sildenafil has been shown to be effective in up to 80% of men with ED, with effects typically noticeable within 30 to 60 minutes, and lasting for up to 4–5 hours.

    Side Effects

    Common side effects include:

    • Headache
    • Flushing
    • Nasal congestion
    • Indigestion

    Less common but serious effects include visual disturbances, hearing changes, or prolonged erections. Seek medical attention if severe or persistent side effects occur.

    Contraindications

    Sildenafil should not be used by those:

    • Taking nitrates for chest pain
    • With severe heart or liver conditions
    • Under 18 years of age
    • With certain medication interactions (e.g. alpha-blockers, antifungals, antibiotics)

    Interactions

    Inform your doctor of all medications and supplements before use. Interactions may occur with:

    • Nitrates
    • Alpha-blockers
    • Some antibiotics and antifungal medicines

    Alcohol and Heart Conditions

    Avoid excessive alcohol while taking sildenafil, as it can lower blood pressure and increase side effect risk. Use with caution if you have any heart-related conditions.

    Availability and Cost

    Sildenafil is available by prescription only in the UK.

    • Generic versions are more affordable than branded Viagra.
    • Supplied by licensed UK pharmacies such as Online Chemist.
    • Avoid counterfeit products from unregulated websites.

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