Viagra and other treatments for Erectile Dysfunction

Dr Andrews

At Dr Andrews, we understand that Erectile Dysfunction can be an embarrassing topic to discuss, but with the variety of safe and effective treatments that have been developed over the years we can help resolve ED problems in many cases.

The treatments offered by Dr Andrews are from the same family of drugs and work in the same way: by helping get more blood flow to the penis and allowing sexual stimulation to cause an erection. Importantly, the treatments will not work without sexual stimulation.

All the Erectile Dysfunction treatments are Phosphodiesterase Type 5 Inhibitors (PDE5s for short) and act by preventing a chemical already present in the body from narrowing the blood vessels in the penis. This then allows better blood flow to the penis after sexual stimulation, causing an erection.

Although all from the same drug family, each drug can have a different effect on individual patients, and there are some differences in the duration of action (how long the drug is active in your bloodstream for) and also how long before sexual activity the dose needs to be taken.



Sildenafil and Viagra are the same drug. Viagra is the original branded version first launched in 1998 and Sildenafil it’s cheaper generic version available in The UK since 2013. Viagra is manufactured by Pfizer, whilst many different companies now produce generic sildenafil.

Both drugs are taken around one hour before sexual activity and the treatment remains in the blood stream for 4 hours. The onset of action can be delayed if consumed with a meal.


The side effects of Sildenafil and Viagra are usually mild (headaches, nausea and a warmth felt in the face) with the treatment being well tolerated and effective. They both come in 25mg, 50mg and 100mg strengths.

The recommended starting dose is 50mg to be taken one hour before sexual activity. Most men will find that the 50mg starting dose has the desired effect, but if it does not work on four separate occasions, the dose should be increased to 100mg (provided there are no side effects). If side effects are felt on 50mg, then a 25mg dose should be used the next time.

Sildenafil or Viagra should be used on multiple and separate attempts before considering it is not effective for you.

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In November 2017, the drug company which produces Cialis lost its’ patent allowing different companies to produce generic equivalents of Cialis at a much lower cost. This is great news for patients who can benefit from generic Tadalafil and pay less than 1/3 of the price of branded Cialis. If you still want to use branded Cialis, it is available to order.

Cialis or the generic version Tadalafil are slightly different to the other treatments available as they last in the blood stream for 36 hours after consumption, leading them to be nicknamed “The Weekend Pill”. A dose taken on Friday night should last through to Sunday morning.

It only needs to be taken 30 minutes before sex.

It is available in four strengths: 2.5mg, 5mg, 10mg, and 20mg.

A further difference with Cialis and Tadalafil are the 2.5mg and 5mg strengths which are taken every day and are designed for patients who anticipate sexual activity at least twice weekly.

The starting dose of Cialis or Tadalafil is 10mg at least 30 minutes before sexual activity. No more than two doses of 10mg or 20mg treatments should be consumed in a week.

As with the other treatments, multiple attempts should be undertaken before deciding the drug is not working for you.

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Levitra contains the drug Vardenafil and there are three strengths available: 5mg, 10mg and 20mg.

Although the strengths for Levitra may look smaller than that for Viagra or Sildenafil they are reasonably equivalent.

Levitra needs to be consumed 25-60 minutes before sex and its onset may be delayed if consumed with a fatty meal.

The starting dose of Levitra is 10mg 25-60 minutes before sex Most men will find that the starting dose has the desired effect, but the dose can be increased to 20mg if required after multiple failed attempts. Moreover, the 5mg treatment can be used if side effects are felt.

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Spedra contains the drug Avanafil and is the newest treatment available.

It is the fastest acting treatment available and can work in just 15 minutes if taken on an empty stomach. The effects are delayed by up to 90 minutes if the dose is consumed with food. 

Spedra remains active in the bloodstream for around 4 hours.

There are three strengths: 50mg, 100mg and 200mg. The starting dose of Spedra is 100mg taken 15-30 minutes before sexual activity As with the other treatments, the dose can be increased if tolerated or reduced as required and should be used on a few occasions before concluding it is not effective.

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Further information for each treatment can be found in the Patient Information Leaflet which is provided with every treatment that Dr Andrews supplies or in the Dr Andrews Fact Sheet.


It is important that no combination of the different treatments should be used at the same time. Further, a break of 24 hours should be left between doses of Viagra, Sildenafil, Levitra and Spedra with a 36 hour gap between Cialis or Tadalafil doses.


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