Lasts up to 36 hours, or taken daily so that treatment and the occasion are no longer linked.
Explained by a GMC-registered GP, not a leaflet
Honest about what we can and cannot prescribe remotely
Side effects given the same weight as benefits
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Tadalafil is a PDE5 inhibitor. It blocks an enzyme that breaks down the signal causing blood vessels in the penis to relax, so blood flow increases in response to arousal.
It does not cause an erection by itself — sexual stimulation is still required. This is the most common misunderstanding, and it accounts for a good number of apparent treatment failures.
Its distinguishing feature is duration. Sildenafil works for around four to six hours; tadalafil for up to 36. That removes the need to plan around a tablet, which many people find matters more than any difference in effectiveness.
As needed: 10mg or 20mg, at least 30 minutes before sex. Effective for up to 36 hours, so timing is far less critical than with sildenafil.
Daily: 2.5mg or 5mg every day, at the same time. This separates treatment from the occasion entirely, which many couples strongly prefer, and it also treats prostate symptoms.
The nitrate interaction is the one that kills people, and it includes GTN spray used occasionally. Always declare every medicine, including ones you use rarely.
No routine monitoring of the drug itself. But cardiovascular risk should be assessed — blood pressure, cholesterol, HbA1c and morning testosterone.
Yes, after a proper assessment. Erectile dysfunction is well suited to remote consultation, because the history does most of the diagnostic work.
What we will not do is treat it as purely a supply problem. Erectile dysfunction is frequently the first sign of cardiovascular disease — appearing on average three to five years before a heart attack or stroke, because the arteries involved are smaller and narrow sooner.
So the consultation covers blood pressure, cholesterol, HbA1c, testosterone, smoking, alcohol, medicines and mood, not just the prescription. We have found significant undiagnosed disease in people who came in only for tablets, and that is the point.
Tadalafil is available as an inexpensive generic and costs have fallen substantially since patent expiry.
Tadalafil is also sold from pharmacies without a prescription in some circumstances, after a pharmacist consultation.
Branded Cialis costs many times more than generic tadalafil containing the identical drug.
Unlicensed "herbal" erection products bought online frequently contain undeclared PDE5 inhibitors at unknown doses. The MHRA has seized them repeatedly. They are genuinely dangerous with nitrates and in heart disease.
Taken as needed, it can simply be stopped. The daily dose can also be stopped without tapering, though prostate symptoms will return.
Vacuum devices, alprostadil as cream, pellet or injection, and surgical implants for a small number of men.
Some blood pressure tablets, antidepressants and finasteride can all contribute, and alternatives sometimes exist. Smoking, alcohol and weight matter directly. Sudden onset with preserved morning erections points towards anxiety or relationship factors, where psychosexual therapy helps more than any tablet.
Tadalafil lasts up to 36 hours and is unaffected by food; sildenafil lasts four to six hours and is delayed by a heavy meal. Tadalafil causes back and muscle ache more often. Both are cheap generics, and trying the other is reasonable.
Usually yes — except nitrates and nicorandil, which are absolutely contraindicated. Tell us everything you take, including sprays used only occasionally.
For some men, considerably. It removes the planning entirely and also treats prostate symptoms. It costs more over a month than occasional use.
A recognised tadalafil effect, usually mild and settling within a day or two. If it persists, a different PDE5 inhibitor may suit better.
They are worth doing. Erectile dysfunction can be the first sign of cardiovascular disease or diabetes, and finding that early is more valuable than the prescription.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
On this page
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Time to be seen
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Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
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Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
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Usually
Free
Same day
Often 10 to 15 minutes
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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