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.
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
In the UK have 3 categories:
Cialis Together works by dilating the blood vessels in the penis, allowing the blood vessels to widen and allowing for longer-lasting erections.
Erection problems (impotence) are very common, particularly in men over 40.
Most men occasionally fail to get or keep an erection. This is usually due to stress, tiredness, anxiety or drinking too much alcohol, and it’s nothing to worry about.
If it happens more often, it may be caused by physical or emotional problems.
Physical causes Possible cause Treatment Narrowing of penis blood vessels, high blood pressure, high cholesterol medicine to lower blood pressure, statins to lower cholesterol Hormone problems hormone replacement – for example, testosterone Side effects of prescribed medication change to medicine following discussion with GP You may also be asked to make lifestyle changes.
Do lose weight if you’re overweight stop smoking eat a healthy diet exercise daily try to reduce stress and anxiety
Don’t cycle for a while (if you cycle more than 3 hours a week) drink more than 14 units of alcohol a week
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.
If you experience any of the following side effects stop using the medicine and seek medical help immediately:
allergic reactions including rashes (frequency uncommon). chest pain – do not use nitrates but seek immediate medical assistance (frequency uncommon). priapism, a prolonged and possibly painful erection after taking CIALIS (frequency rare). If you have such an erection, which lasts continuously for more than 4 hours you should contact a doctor immediately. sudden loss of vision (frequency rare). Other side effects have been reported:
Common (seen in 1 to 10 in every 100 patients)
headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion. Uncommon (seen in 1 to 10 in every 1,000 patients)
dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired. Rare (seen in 1 to 10 in every 10,000 patients)
fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating. Heart attack and stroke have also been reported rarely in men taking CIALIS. Most of these men had known heart problems before taking this medicine.
Partial, temporary, or permanent decrease or loss of vision in one or both eyes has been rarely reported.
Oral medicines for erectile dysfunction are manufactured by Pfizer Inc., a pharmaceutical company headquartered in the UK.
Like all medicines, CIALIS can cause side effects.
Some of the most common side effects are:
headache, back pain, muscle aches, indigestion, diarrhea, nausea, vomiting, constipation, dizziness, blurred vision, eye pain, pounding heartbeat sensation, a fast heartbeat, a low blood pressure, a blurred vision, pounding heart beat at will, a low blood pressure, a heart attack and swelling of the eyelids.
1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).
2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.
3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.
Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:
Cialis (tadalafil) can interact with certain foods and beverages, possibly altering its effectiveness or increasing the if taking Cialis.
Cialis (tadalafil) can interact with certain foods and beverages, possibly altering its effectiveness or increasing if taken with certain medications.
It’s a new program that can help couples who’ve been struggling with ED or other sexual health issues get a second chance in life. The ‘Cialis free trial’ is an online program designed to help people who have been struggling with the issue for more than a year to get the first, and most likely, chance to enjoy sexual fulfillment.
With the new Cialis program, you can get a first-hand look at how the medication works to treat your condition and enhance your sexual health.
“We’re excited to introduce the new Cialis coupon program,” says, a health care provider at, who was not involved in the program.
As a new program, you may have the first chance of getting the program, which provides access to an online coupon to help you get the most out of your sex life. In this, we’ll talk about how to get the most out of your ED and any potential complications.
“This is a great program that helps millions of men who have been struggling with ED or other sexual health issues,” says, a licensed sex therapist and licensed provider of online sex therapy.
The program offers two free samples of the Cialis that can be purchased online, while an online coupon is available for men who want to use it. If you’re in the US, you can get your free coupon with a doctor’s prescription.
If you don’t already have a coupon to begin with, you can download a free trial of the Cialis coupon into your browser or use an online coupon code on the app’s website.
“Our program is designed to help men with a variety of health issues who are in the process of starting their own ED treatments,” says, a licensed sex therapist and licensed provider of online sex therapy.
While online coupon programs are a convenient way to get your sex life on the prescription market, it’s important to know that there are restrictions. The new program offers a range of coupons that can help you find the treatment you need online.
The program is free to men who qualify for a Cialis coupon or an online coupon code for ED, such as Cialis. There are a few restrictions you must have before the program to make an online purchase.
Men who qualify will need to have their Cialis coupon or a coupon code printed on their ID. For example, if a coupon code was used for ED treatments, it will need to be printed on the patient’s ID.
If you’re a man with a medical history of cardiovascular disease, liver or kidney problems or high blood pressure, you should also have the Cialis coupon or a coupon code printed on your ID.
However, you must also have your coupon and coupon code printed on your medical record. You must also have a medical history of diabetes, high blood pressure, certain eye conditions, a heart condition and a prostate condition.
If you are a woman with a medical history of heart disease or a history of high blood pressure, you should also have the Cialis coupon and coupon code printed on your ID.
“It’s important to have a medical history of heart disease,” says, a licensed sex therapist and licensed provider of online sex therapy.
Stade de France Pharmacy