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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’.
As with the list of what is shown on the form,, and so on, the application for an application for the product ‘over the counter’ will be in the following 3 categories:
  • GSL – Health products:
  • BSL – BSL – BiosensitisLowerLower’ (BSL – Losing your BSL status). The list of 3 categories is not always available.
  • Viagra has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

    Common side effects reported from Viagra use include:

    • Headache
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    • Nasal bleeding (bloody nose)
    • Nausea
    • Diarrhea
    • Muscle aches or pains
    • Flushing
    • Facial pain or tenderness
    • Vision changes
    • Light sensitivity

    More severe side effects include:

    • Painful erections or erections that last longer than 4 hours
    • Sudden loss of vision
    • Sudden loss of hearing
    • Ringing in the ears
    • Chest pain
    • Shortness of breath
    • Painful urination
    • Increased urination frequency
    • Fainting
    • Dizziness
    • Skin rash
    • Hives
    • Facial swelling

    If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

    As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Viagra. Viagra can interact with bodily substances, causing potentially serious adverse reactions.

    Specifically, you should inform your health care provider of any nitrate medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

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    Viagra has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

    Common side effects reported from Viagra use include:

    • Headache
    • Heartburn
    • Congestion
    • Nasal bleeding (bloody nose)
    • Nausea
    • Diarrhea
    • Muscle aches or pains
    • Flushing
    • Facial pain or tenderness
    • Vision changes
    • Light sensitivity

    More severe side effects include:

    • Painful erections or erections that last longer than 4 hours
    • Sudden loss of vision
    • Sudden loss of hearing
    • Ringing in the ears
    • Chest pain
    • Shortness of breath
    • Painful urination
    • Increased urination frequency
    • Fainting
    • Dizziness
    • Skin rash
    • Hives
    • Facial swelling

    If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

    As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Viagra. Viagra can interact with bodily substances, causing potentially serious adverse reactions.

    Specifically, you should inform your health care provider of any nitrate medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

    In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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    This medication can cause a sudden loss of vision in one or more eyes. If you have a known drug interaction, try to avoid using Viagra with other medications that can cause a sudden drop in blood pressure.

    Tell your doctor if you are history of folic acid deficiency, prostate cancer, or liver disease.

    In addition, let your doctor know if you are pregnant or plan to become pregnant.

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    If you are a woman, you must be aware of the potential risks and Button do not take more than the recommended dose of Viagra.

    As with all prescription medications, inform your doctor of any medical conditions you may have, including those that you have been diagnosed with when you first started taking Viagra, or Viagra may cause your symptoms.

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    Cialis has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

    Common side effects reported from Cialis use include:

    • Headache
    • Indigestion
    • Heartburn
    • Upset stomach
    • Gas
    • Nausea
    • Flushing

    More severe side effects include:

    • Painful erections or erections that last longer than 4 hours
    • Sudden loss of vision
    • Sudden loss of hearing
    • Ringing in the ears
    • Chest pain
    • Shortness of breath
    • Painful urination
    • Increased urination frequency
    • Fainting
    • Dizziness
    • Skin rash
    • Hives
    • Facial swelling

    If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

    As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Cialis. Cialis can interact with bodily substances, causing potentially serious adverse reactions.

    Specifically, you should inform your health care provider of any alpha-blocker, antifungal, HIV protease inhibitor, or high blood pressure medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

    In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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    Disclaimer: This is not medical advice. Inform your doctor of any medical condition you currently have, possible after using Cialis.

    Keep all medical professional contact information out of the reach of personal go buy. This includes seeking advice from a health care professional, discussing potential side effects with a healthcare provider, and providing instructions on how to to take the medicine safely.

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    Cialis is not a cure for ED. It works only in the body. It does not improve sexual performance or satisfy the desire of any partner. It is a medication that helps you get back to an erection the next time you have sex.

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    What is Cialis?

    Cialis is a type of medication called a tadalafil. It works by relaxing the blood vessels in your penis, allowing blood to flow into the penis when you get sexually excited, and making it easier to get an erection when you are sexually excited.

    Cialis typically starts to work within 30 minutes to 1 hour after ingestion. However, it is important to be aware of the effects of Cialis before you have sex.

    Cialis can cause side effects such as headache, flushing, nasal congestion, indigestion, and heartburn. These side effects are not listed in this article.

    If you experience any side effects you cannotby, that are listed within the article, notify your doctor, or have any other health conditions or medications you may be taking. If you have any other concerns about taking Cialis, be sure to consult your health care provider or get medical advice.

    Uses of Cialis

    Cialis is used to treat erectile dysfunction (ED) in men.

    Cialis is also used to treat pulmonary arterial hypertension (PAH).

    Pulmonary arterial hypertension is a disease in which the arteries in the lungs become enlarged and narrow. This makes it harder for a blood pressure to be kept up.