• I have always had difficulty in achieving and/or maintaining an erection
• I have a history of trauma to the area surrounding my genitals, back or pelvis
• I have recently noticed abnormalities on my penis, such as unexplained lesions, bleeding, discharge, rash, change in the colour of the skin of the penis or foreskin, thickening of the skin of the penis or foreskin that makes it difficult to draw back the foreskin
If Yes, please provide us with more information 

This can include:

• Finding it difficult to urinate
• Straining to urinate
• Having a weak flow of urine
• “Stop-start” urination
• Needing to urinate urgently and/or frequently
• Needing to urinate frequently throughout the night
• Accidently leaking urine
• Any other changes to your urinary habits

• Decrease in muscle mass
• Decrease in beard and body hair growth
• Fatigue
• Decreased sex drive
• Hot flushes
• Pain and enlargement around your breast area
• Low semen production
• Changes in your mood such as low mood, irritability, difficulty concentrating, lack of motivation
• Unexplained weight gain
• Changes in the size of your testicles 

• You feel breathless or experience chest pain with light or moderate physical activity, such as walking briskly for 15 minutes, or climbing 2 flights of stairs
• You have been medically advised to avoid strenuous exercise or sexual intercourse
• Your symptoms of erectile dysfunction have increased significantly over the past few months
• You have a history of low blood pressure, fainting, or feeling dizzy when standing up after extended periods of lying/sitting down?
If Yes, please provide us with more information

• Low blood pressure or uncontrolled high blood pressure
• Angina (chest pain), irregular heartbeat or palpitations (arrhythmia)
• A problem with any valves in your heart (valvular heart disease)
• A problem where the heart muscle becomes inflamed and does not work as well as it should (cardiomyopathy)
• Heart problems causing blood flow issues (e.g. left ventricular outflow obstruction, aortic narrowing) or severe cardiac failure
• Any other cardiovascular disease (conditions affecting the heart or blood vessels)
• Peyronie’s disease of any other deformation of the penis?
• Any medical conditions affecting the eye (such as previous loss of vision due to damage to the optic nerve, any inherited eye diseases such as retinitis pigmentosa)
• Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption?
• Liver disease or kidney impairment
• Sickle cell anaemia, multiple myeloma or leukaemia
• Bleeding issues such as haemophilia
• Active stomach ulcers
• In the past 5 years, have you had a heart operation, stroke or heart attack
• Previous history of suffering from an erection not caused by sexual stimulation, that has lasted for many hours
If Yes, please provide us with more information so that we can ensure this medication is safe for you to take

• Nitrates (nicorandil or other nitric oxide donors e.g. glyceryl trinitrate, isosorbide mononitrate or isosorbide dinitrate) for chest pain
• Drugs called ‘poppers’ for recreational purposes (e.g. amyl nitrite)
• Riociguat or other guanylate cyclase stimulators for lung problems
• HIV medicines, including ritonavir or cobicistat-containing treatment. Please give the exact names of all HIV medicines you take.
• Alpha-blockers, such as alfuzosin, doxazosin or tamsulosin; and other blood-pressure or heart medicines, including carvedilol or labetalol.
• Medicines that may increase ED-treatment levels, such as cimetidine, diltiazem, erythromycin, clarithromycin, ketoconazole or itraconazole
• St. John’s Wort
• The following antibiotics: erythromycin, clarithromycin, rifampicin
• Netupitant or aprepitant used as anti sickness drugs
• Antifungals such as ketoconazole, itraconazole, voriconazole
• Other ED treatments, including sildenafil tablets, Silandyl films, Hezkue spray, tadalafil, vardenafil, avanafil or local/injected ED treatment; or sildenafil/PDE5 treatment for pulmonary hypertension. Give the name, dose, frequency and last use.

• If you develop chest pain, collapse, severe breathlessness, stroke symptoms or a severe allergic reaction, call 999. Stop sexual activity, do not take a nitrate/GTN or poppers, and tell responders which ED medicine you took and when. Attend A&E immediately for an erection lasting 4 hours or longer. Stop treatment and seek urgent assessment for sudden vision or hearing loss. Contact us about other troublesome side effects before taking another dose.
• You must not use treatment with any other local or oral ED treatment, or another sildenafil product. Tell us if you use a PDE5 medicine for pulmonary hypertension.
• Treatment will only help to achieve/maintain an erection if you are sexually stimulated
• Alcohol, smoking, high stress levels and a high BMI can contribute to erectile dysfunction and you should make an effort to improve your lifestyle
• Treatment may cause dizziness or affect vision. Do not drive or operate machinery if affected.
• The onset of the effect of some treatments may be delayed if taken with food
• The British Association of Urological Surgeons (BAUS) has produced an information leaflet on Erectile dysfunction
• Advice and support is also available on the Sexual Dysfunction Association (SDA) website
• If treatment fails after 8 attempts, you should contact us to make an appointment to speak to a pharmacist

• You will read the Patient Information Leaflet supplied with your medication
• You will contact us and inform your GP if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment.
• You are aged 18 or over and the treatment is solely for your own use
• You have answered all the above questions accurately and truthfully and that incorrect information can be hazardous to your health
• You are aware the decision about your treatment are for both the prescriber and yourself to jointly consider during this consultation, but the final decision will always be the prescriber's.
• By continuing, you agree to our Terms & Conditions, Cancellation Policy and Privacy Policy