General Notes
- Drug treatments for erectile dysfunction may only be prescribed on HSC prescription under certain circumstances. These are:
- men who have diabetes, multiple sclerosis, Parkinson’s disease, poliomyelitis, prostate cancer, severe pelvic injury, single gene neurological disease, spina bifida, or spinal cord injury
- men who are receiving dialysis for renal failure
- men who have had radical pelvic surgery, prostatectomy (including transurethral resection of the prostate) or kidney transplant
- men who were receiving Caverject®, Erecnos®, MUSE®, Viagra® or Viridal® for erectile dysfunction, at the expense of the NHS, on 14th Sept 1998
- The prescription must be endorsed “SLS”.
- GPs can issue private prescriptions for patients on their list, that don’t meet SLS criteria, but cannot charge patients for issuing a private prescription.
- Men suffering from severe distress as a result of impotence should be referred for assessment by specialist in secondary care. In Northern Ireland, treatments for impotence leading to severe distress are classified as red drugs; supply is via hospital pharmacies. For full details on the red/amber list, visit http://www.ipnsm.hscni.net/red-amber/.
Drugs for erectile dysfunction
Prescribing Notes
- Refer to NICE CKS: Erectile dysfunction for further information on management. Note NHS prescription criteria in Northern Ireland differ – refer to general notes above.
- Presentation with erectile dysfunction should prompt assessment and screening for cardiovascular disease.
- There is not enough evidence to routinely recommend tadalafil ‘once daily’ (2.5mg, 5mg) preparations for erectile dysfunction.
- It may take time to work, 6 attempts with a particular drug, at a maximal dose with optimum timing and stimulation is recommended before considering treatment failure; if continued failure try switching to an alternative PDE5i.
- Sildenafil and tadalafil are now available to purchase from pharmacies for suitable patients.