Erectile dysfunction

Erectile dysfunction is when men are unable to get or keep an erection suitable for sex. You can buy medication from Dr Fox Pharmacy by completing a short health assessment online.

Read medical information and answer medical questions to buy treatment online.

Erectile dysfunction medication


All medication supplied is UK licensed.

Viagra Connect pack

Viagra Connect (sildenafil)

50mg from £1.31 per tablet

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Viagra 50mg pack

Viagra (sildenafil)

25mg, 50mg, 100mg from £5 per tablet

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100mg pack of Sildenafil

Sildenafil (generic Viagra)

25mg, 50mg, 100mg from 71p per tablet

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10mg pack of Cialis

Cialis (tadalafil)

2.5mg, 5mg, 10mg, 20mg from £2.29 per tablet

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10mg pack of Cialis Together

Cialis Together (tadalafil)

10mg from £3.50 per tablet

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10mg pack of Tadalafil

Tadalafil (generic Cialis)

2.5mg, 5mg, 10mg, 20mg from 50p per tablet

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20mg pack of Vardenafil

Vardenafil (generic Levitra)

5mg, 10mg, 20mg from £2.97 per tablet

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100mg pack of Spedra

Spedra (avanafil)

50mg, 100mg, 200mg from £3.10 per tablet

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Prices of ED treatment from Dr Fox (in stock)
Tablet type & dosage x4 x8 x16 x32 x64
Sildenafil 25mg £4.90 £8.50 £15.20 £29.50 £45.50
Sildenafil 50mg £6.50 £11.90 £23.00 £44.00 £60.95
Sildenafil 100mg £7.20 £13.25 £26.00 £49.00
Viagra 25mg £24.20 £44.30 £82.00
Viagra Connect 50mg £17.50 £33.50
Viagra 50mg £29.40 £59.50 £112.60
Viagra 100mg £33.80 £64.45 £124.40
Tadalafil 10mg £7.95 £12.80 £21.90 £41.80
Tadalafil 20mg £8.50 £14.50 £22.50 £44.95
Cialis 10mg £35.40 £67.50 £129.60
Cialis 20mg £36.20 £68.80 £133.20
Cialis Together 10mg £16.50 £28.00
Vardenafil 10mg £11.80 £21.75 £39.90
Vardenafil 20mg £12.80 £25.75 £43.50
Spedra 50mg £16.50 £28.00 £49.50
Spedra 100mg £19.50 £37.00 £68.00
Spedra 200mg £29.50 £54.50 £98.00
Tablet type & dosage 28 tablets 56 tablets 84 tablets
Daily Tadalafil 2.5mg £17.45 £29.50 £39.95
Daily Tadalafil 5mg £20.95 £39.95 £60.95
Daily Cialis 2.5mg £66.50 £128.30
Daily Cialis 5mg £67.60 £132.20

Prescription fees

Dr Fox supplies medicine on prescription and charges a small prescription fee based on the order value of each prescription.

Prescriptions are issued by our doctors online and sent electronically to our pharmacy.

Order value Prescription fee
up to £10 £1.00
up to £20 £2.00
up to £40 £3.00
over £40 £4.00

If you have your own private or NHS paper prescription please post to our pharmacy (details).

Dr Fox prices are 25%–50% lower than other UK online clinics.

Delivery charges

UK delivery only: £2.90 per consultation via Royal Mail Tracked 24 Signed For (1-2 working days with tracking).

Parcel forwarding services are not permitted. Use only UK home or work delivery address.

Returns and refunds - unwanted items can be returned within 14 working days for a full refund.

Medical information

Written and reviewed by a team of doctors. Dr Fox is regulated by the CQC & GPhC.

About erectile dysfunction

Erectile dysfunction (ED) is common. It is not unusual for most men to have problems occasionally getting or maintaining an erection. This is usually caused by tiredness, stress, drinking too much alcohol, or anxiety. It is not usually caused by low hormone levels. Most men with erectile dysfunction are in reasonable health, although erectile dysfunction may be a symptom of poor circulation or early diabetes. Erectile dysfunction is more common in smokers and men who are overweight. Some medicines can contribute to ED as can many recreational and frequently abused drugs. Some men with ED have low testosterone levels. Cycling more than 3 hours a day can also lead to ED.

All men with persistent ED should tell their GPs about it.

ED treatments

Over the last few decades medications have revolutionised the treatment of erectile dysfunction. These medications work by enhancing the natural reaction to sexual stimulation, improving the blood flow needed for erections. Other treatments for ED include topical applications, injections into the penis, surgical devices, and counselling.

Types of medicine

Eight different erectile dysfunction tablets are available to buy online from Dr Fox pharmacy:

Each tablet has a different duration of action and side effects – see tablet differences below.

No combination of Viagra/sildenafil, Cialis/tadalafil, Levitra/vardenafil, Spedra/avanafil or other ED treatment should be used at the same time - a break of at least 24 hours should be left.


  • There is a very rare theoretical risk of abnormal heart rhythm (Prolonged QT interval) if Viagra (sildenafil) or Levitra (vardenafil) are taken at the same time as some other medications. If you are taking other medication please check this list. This risk is not applicable if taking Cialis (tadalafil) or Spedra (avanafil).
  • Serious reaction possible if any ED medication is taken at the same time as Nitrates for angina or heart failure, including glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate, GTN spray, tablet, patch or gel, nicorandil, sodium nitroprusside.
  • Serious reaction possible if any ED medication is taken at the same time as recreational drugs, particularly amyl nitrate ('Poppers').
  • Caution taking any ED medication if taking alpha-blockers (for high blood pressure or prostate enlargement) including alfuzosin, doxazosin, indoramin, prazosin, tamsulosin, terazosin.
  • Do not take any ED medication if taking riociguat (for high blood pressure in the lungs).

Also see Tablet differences: Warnings and cautions in table below.

Investigating erectile dysfunction

You should always tell your regular doctor if you are having problems with erections.

Erectile dysfunction can be a symptom of conditions such as diabetes, high blood pressure, high cholesterol, or narrowing of the arteries. Some simple tests may be required. An assessment with a doctor is particularly important if symptoms develop over a period of weeks or months, or even suddenly, without an emotional event to set them off. Erectile dysfunction can be a complication of previous operations or a side effect of some prescribed medication.

Lifestyle and risk factors

Improving lifestyle factors such as diet, exercise, stopping smoking, reducing alcohol intake, and maintaining an active lifestyle has shown improvement in ED in men of all ages. Apart from the general benefits of a healthy lifestyle, studies show improvement in erectile dysfunction symptoms and a reduced need for tablets. ED also shares risk factors with a range of other medical conditions including diabetes, heart disease, and circulatory problems, all of which are also likely to benefit from lifestyle modification.

Starting treatment

It is best to start with a lower strength tablet and build up as needed (see how to start treatment). One type of tablet sometimes works better than another. You may like to try out different tablets to see which ones suit you best.

Sexual stimulation is required for tablets to work. Without it tablets will have no effect.

You can request more than one type of tablet at a time. It is advised to try the same treatment several times before deciding to change tablet type or dosage strength.


Erectile dysfunction can be distressing and lead to relationship difficulties, anxiety, and depression. Your regular doctor may recommend counselling. This may help resolve the cause of erectile dysfunction. In some cases a problem of performance anxiety can be overcome by breaking the cycle of failure with tablet treatments.

Buy treatment

Dr Fox pharmacy supplies erectile dysfunction medication on prescription – you are required to answer a short medical questionnaire before your order can be completed.

Tablet differences

Compare PDE5 inhibitors for erectile dysfunction (data source)
Sildenafil Tadalafil Vardenafil Avanafil
Brand names Viagra, Viagra Connect Cialis, Cialis Together Levitra Spedra
Available generically Yes Yes Yes No
Starting dose 50mg 10mg 10mg 100mg
Time taken to start working 30-60 minutes 30-60 minutes (2.5mg and 5mg tablets can be taken daily) 25-60 minutes - faster for orodispersible tablets 15-30 mins on empty stomach, 1.5 hours on full stomach
How long effects last 4 hours 36 hours 4-5 hours 4 hours
Warnings and cautions
Warning Sildenafil Tadalafil Vardenafil Avanafil
Do not take Allergic to ingredients, low or high blood pressure, severe heart or liver problems, loss of vision due to NAION, recent stroke or heart attack
Rare inherited eye diseases Kidney dialysis, rare inherited eye diseases Liver or kidney problems, rare inherited eye diseases
Exclusions - talk to your doctor first Sickle cell anaemia, multiple myeloma, leukaemia, deformity of the penis, problems with your heart, stomach ulcer or bleeding problems
Drug interactions Any nitrate-based medication, usually to treat angina (important); 'poppers'; nitric oxide donors, medicines for HIV, AIDS, or fungal infections; riociguat; alpha-blockers; other ED medicines
Common side effects (% occurrence)
Adverse event Sildenafil Tadalafil Vardenafil Avanafil
Headache 12.8% 14.5% 16% 10%
Flushing 10.4% 4.1% 12% 4%
Dyspepsia (indigestion) 4.6% 12.3% 4% <2%
Nasal congestion 1.1% 4.3% 10% 2%
Dizziness 1.2% 2.3% 2% 1.2%
Abnormal vision 1.9% <2% <1%
Back pain 6.5% 2%
Myalgia (muscle pains) 5.7% <1%
Medical emergencies (very rare)
Urgent medical attention required Sudden decrease or loss of vision, Priapism (painful erection lasting 2 hours or more), allergic reaction, chest pains, heart attack

Notes: Sexual stimulation is required before erection will take place. See the manufacturer's patient information leaflet included in medicine packs for full details of cautions and interactions. If side effects are severe, stop the medication and see your doctor.

Dr Tony Steele

Authored 18 February 2010 by Dr Tony Steele
MB ChB Sheffield University 1983. Former hospital doctor and GP. GMC no. 2825328

Reviewed by Dr C. Pugh, Dr B. Babor, Dr A. Wood
Last reviewed 21 November 2022
Last updated 19 January 2024
Editorial policy


  1. Medical questions
  2. Choose treatment
  3. Complete order

Answer medical questions to order(erectile dysfunction)

Men only

Honest & accurate responses are necessary for safe medical assessment

Have you read the erectile dysfunction medical information?

Please read the medical information.
See also starting treatment for the first time.

Do you sometimes or always have difficulty getting and keeping an erection?

Have you had difficulties with erections for more than a year?

Are your erections sometimes fine?

E.g. when waking in the morning, during masturbation or in some erotic situations.

Is your blood pressure high (over 150/90)?

You must have had a blood pressure check within the last year and know the result. Doctors, nurses, and some pharmacists can check blood pressure. Answer 'Yes' if either figure is high, 150 or 90. A blood pressure measurement whilst taking blood pressure tablets qualifies.

Do you have low blood pressure?

This means any of the following:

  • Low blood pressure requiring investigation
  • Low blood pressure requiring treatment
  • Being prone to faint or feel light-headed for more than a few seconds when standing up quickly or standing for long periods

Are you overweight?

Use this BMI (Body Mass Index) calculator and answer 'yes' if the result is over 30.

Do you smoke, or drink more than 21 units of alcohol per week?

Have you been diagnosed with any of the following?

  • Allergy or reaction to previous impotence treatments
  • Heart disease including heart attack within 6 weeks or angina (heart pain on exertion)
  • History of stroke or mini stroke (transient ischaemic attack)
  • History of vision problems due to poor circulation
  • Family history of the degenerative eye disease, including retinitis pigmentosa (rare)
  • Serious kidney/renal or liver disease
  • Deformity or angulation of the penis (Peyronie’s disease)
  • Sickle cell disease or leukaemia or multiple myeloma
  • A bleeding disorder (such as Haemophilia)
  • Active stomach ulcers (also known as peptic ulcer or gastric ulcer)

Some medications may interact - are you taking any of the following?

  • Nitrates for angina or heart failure - includes glyceryl trinitrate; isosorbide mononitrate; isosorbide dinitrate; GTN spray, tablet, patch or gel; nicorandil; or sodium nitroprusside - serious reaction
  • Any recreational drugs, particularly amyl nitrate ('Poppers') - serious reaction
  • Existing ED treatment apart from Viagra/sildenafil, Cialis/tadalafil, Levitra/vardenafil, or Spedra/avanafil
  • Riociguat for high blood pressure in the lungs

Please check the ED medication you are ordering below, and answer YES if you are also taking any other medication listed

Manufacturers advise caution when taking ED medication at the same time as some other medications.

Viagra, sildenafil

  • Alpha-blockers (high blood pressure or prostate enlargement) usually ending '-osin' - includes alfuzosin, doxazosin, indoramin, prazosin, tamsulosin, terazosin
  • Entresto (sacubitril/valsartan)
  • Other medication - there is a very rare theoretical risk of abnormal heart rhythm if Viagra/sildenafil is taken at the same time as some other medications - please check this list.

Cialis, tadalafil

  • Alpha-blockers (high blood pressure or prostate enlargement) usually ending '-osin' - includes alfuzosin, doxazosin, indoramin, prazosin, tamsulosin, terazosin
  • Medication for high blood pressure
  • 5 alpha reductase inhibitors ending '-asteride' - including finasteride, dutasteride
  • Antifungal treatment ending '-azole' - including ketoconazole, itraconazole
  • HIV medication ending '-avir' - including ritonavir, indinavir
  • Phenobarbital, phenytoin, carbamazepine
  • Antibiotics: only rifampicin, and antibiotics ending '-thromycin' - including erythromycin, clarithromycin

Levitra, vardenafil

  • HIV medication ending '-avir' - including ritonavir, indinavir
  • Alpha-blockers (high blood pressure or prostate enlargement) usually ending '-osin' - includes alfuzosin, doxazosin, indoramin, prazosin, tamsulosin, terazosin
  • Other medication - there is a very rare theoretical risk of abnormal heart rhythm if Levitra/vardenafil is taken at the same time as some other medications - please check this list.

Spedra, avanafil

  • Alpha-blockers (high blood pressure or prostate enlargement) usually ending '-osin' - includes alfuzosin, doxazosin, indoramin, prazosin, tamsulosin, terazosin
  • Calcium channel blockers - includes diltiazem, verapamil (heart, blood pressure)
  • Heart rhythm medication - includes quinidine, procainamide, amiodarone, sotalol
  • Phenobarbital, primidone (epilepsy)
  • Carbamazepine (epilepsy, mood stabiliser)
  • Aprepitant (cancer chemotherapy anti-sickness)

Are you ordering Spedra and taking any of the following medications?

Answer 'No' if you are not ordering Spedra.
Spedra (avanafil) must NOT be taken with some other medications:

  • HIV medication ending '-avir' - e.g. ritonavir, indinavir, saquinavir, nelfinavir, atazanavir
  • Antibiotics ending '-thromycin' - e.g. erythromycin, clarithromycin, azithromycin, telithromycin
  • Antifungal treatment ending '-azole' - e.g. ketoconazole, itraconazole, voriconazole

Have you been advised to avoid vigorous exercise?

E.g. severe heart failure or unstable angina.

Are you aware if you have a continuous erection for 4 hours or more you should seek immediate medical advice?

This is unlikely to happen and is rare. If it occurs, seek medical advice straight away to prevent permanent damage.

Are you aware you should not take any combination of ED treatments at the same time?

  • A break of at least 24 hours should be left.
  • Do NOT exceed the prescribed dose.

Do you have any further medical information or questions?

Is there anything you do not understand or do you need further help?

Do all the following apply to you?

  • The medication is for my own use and I will not share with anyone else
  • I will read the patient information leaflet supplied with my tablets
  • I will tell my GP about my erectile dysfunction and my treatment
  • I am over 18 and I agree to identity verification checks
  • I have completed this questionnaire myself and fully understand all the information
  • My responses are honest and accurate, and I understand that this is necessary for a safe medical assessment
  • I agree to the terms & conditions, privacy policy, data sharing policy & consent to cookies

The order process

Choose medication, register, and pay

Dr Fox issues prescription online

Pharmacy team post medication direct

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