OTC vs POM Erectile Dysfunction Treatments: Understanding Your Options

When it comes to treating Erectile Dysfunction (ED) in the UK, men now have more choices than ever before. With the availability of over-the-counter (OTC) options like Viagra Connect and Cialis Together, alongside prescription-only medicines (POM) like daily Tadalafil, it's important to understand the differences to make an informed decision. This comprehensive guide from Happy Pharmacy will help you navigate these options safely and effectively.

Understanding Erectile Dysfunction

Erectile dysfunction is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It affects millions of men in the UK, particularly those over 40, and can result from various factors including:

• Cardiovascular disease

• Diabetes

• High blood pressure

• Stress and anxiety

• Certain medications

• Lifestyle factors (smoking, alcohol use)

The Options Available

1. Viagra Connect (OTC)

Viagra Connect is the pharmacy-only version of sildenafil 50mg, available without prescription following a consultation with a pharmacist.

Key Features:

• Active ingredient: Sildenafil citrate 50mg

• Time to effect: 30–60 minutes

• Duration: 4–6 hours

• Dosing: As needed, maximum once daily

• Food interaction: Best taken on empty stomach

2. Cialis Together (OTC)

Cialis Together is the pharmacy-only version of tadalafil 10mg, offering longer-lasting effects than Viagra Connect.

Key Features:

• Active ingredient: Tadalafil 10mg

• Time to effect: 30 minutes

• Duration: Up to 36 hours

• Dosing: As needed, maximum once daily

• Food interaction: Can be taken with or without food

3. Daily Tadalafil (POM)

Daily tadalafil is a prescription-only medicine taken every day at a lower dose, providing continuous readiness for sexual activity. It is available through Happy Pharmacy's online service following a questionnaire and review with a healthcare professional.

Key Features:

• Active ingredient: Tadalafil 2.5mg or 5mg

• Time to effect: Continuous coverage after 5 days

• Duration: Ongoing daily coverage

• Dosing: Once daily at the same time

• Food interaction: Can be taken with or without food

• Access: Available online from Happy Pharmacy following our ED Consultation

Key Differences: OTC vs POM Options

Convenience vs Medical Oversight

OTC Options (Viagra Connect & Cialis Together):

• ✓ No GP appointment needed

• ✓ Quick access via online pharmacy consultation

• ✓ Suitable for occasional use

• ✗ Limited to one strength

• ✗ Requires pharmacy assessment each time

POM Daily Tadalafil:

• ✓ Comprehensive online medical assessment

• ✓ Available online from Happy Pharmacy

• ✓ Quick questionnaire and healthcare review

• ✓ Different strengths available, doses can be adjusted

• ✓ Discreet home delivery

• ✗ Requires prescription renewal

Usage Patterns

OTC "As-Needed" Approach:

• Best for men who have sex less than twice weekly

• Requires planning around sexual activity

• More suitable for sporadic sexual activity

• Lower overall medication exposure

POM Daily Approach:

• Ideal for men who have sex twice or more weekly

• No planning required – always ready

• Better for regular sexual activity

• Helps restore spontaneity to relationships

Side-by-Side Comparison Table

Effectiveness: Which One Works Best?

All three medications – Viagra Connect, Cialis Together, and Tadalafil – are clinically proven to be highly effective for ED. However, the best choice often depends on your lifestyle and preferences. Some men may respond better to one medication over another, so it can be helpful to try different options under the supervision of a regulated pharmacy like Happy Pharmacy.

Safety Considerations

All ED medications should be taken under medical guidance to ensure safety, especially if you have underlying health conditions or take other prescriptions (e.g., nitrates for chest pain).

Do not take these medications if you:

• Use nitrates or nitric oxide donors

• Have severe heart or liver disease

• Have low blood pressure or uncontrolled hypertension

• Recently experienced a stroke or heart attack

Happy Pharmacy only provides these treatments following a thorough online consultation with a licensed UK prescriber. This ensures that any medication you receive is safe, appropriate, and part of a regulated supply chain.

Side Effects: What to Expect

While generally well tolerated, Viagra Connect, Cialis Together, and Tadalafil may cause mild side effects in some men. These typically include:

• Headache

• Flushing

• Nasal congestion

• Indigestion

• Dizziness

• Back pain (more common with Cialis and Tadalafil)

Most side effects are short-lived and resolve on their own. If you experience any unusual or severe symptoms, contact your GP or Happy Pharmacy support team immediately.

Can You Switch Between Them?

Yes – under professional guidance, many men safely switch between Viagra Connect, Cialis Together, and Tadalafil based on their response, side effects, or convenience.

For example:

• If you find Viagra Connect effective but too short-acting, Cialis Together or Tadalafil may suit you better.

• If cost is a concern, switching from branded Cialis to generic Tadalafil is a great option.

Always speak to a regulated healthcare provider before changing medications to ensure proper dosage and safety.

Lifestyle and ED Treatment

Medication is just one part of the solution. For long-term results and better sexual health, consider addressing underlying causes of ED with:

• Regular exercise

• A balanced diet

• Limiting alcohol

• Quitting smoking

• Managing stress or anxiety

At Happy Pharmacy, we offer more than just prescriptions – we provide a discreet, judgment-free service that supports your overall wellbeing.

Why Choose Happy Pharmacy?

When treating sensitive issues like erectile dysfunction, it’s crucial to use a safe, regulated, and reputable pharmacy. Happy Pharmacy offers:

• MHRA-approved medications

• Private online consultations reviewed by UK prescribers

• Discreet packaging and delivery

• Competitive pricing on branded and generic treatments

• Ongoing support from licensed pharmacists

Avoid counterfeit drugs from unregulated websites. With Happy Pharmacy, you can trust that your treatment is genuine and tailored to your needs.

Final Thoughts: Which ED Treatment Is Right for You?

Choosing between Viagra, Cialis, and Tadalafil doesn’t have to be confusing. All three are effective, but your lifestyle, budget, and medical history will help determine the best fit.

Here’s a quick recap:

• Viagra Connect: Great for spontaneous occasions; short-acting

• Cialis Together: Long-lasting and versatile; more expensive

• Tadalafil: Cost-effective Cialis alternative; equally effective

If you’re still unsure, speak to the team at Happy Pharmacy. We’re here to help you find a safe, effective solution to erectile dysfunction – with confidentiality, compassion, and clinical expertise.

Blog medically reviewed by : Palvinder Deol, GPhC Registered Pharmacist, 27 May 2025

References

1. NHS – Erectile Dysfunction: Causes, Diagnosis, and Treatment

2. British Association of Urological Surgeons – ED Treatments Overview

3. Pfizer – Viagra (Sildenafil) Patient Information Leaflet

4. Eli Lilly – Cialis (Tadalafil) Prescribing Information

5. European Medicines Agency (EMA) – Tadalafil Approval