BNF:

2.5/7.4.5

Status:

Do Not Prescribe (DNP), Grey

Decision Date:

None

Comments

For patients with erectile dysfunction needing a second line option to generic sildenafil:  

From 1st October 2025 restrictions on the prescribing of generic tadalafil for erectile dysfunction (ED) have been lifted meaning that generically written prescriptions for tadalafil no longer require the annotation "SLS”.  (Drug Tariff October 2025)

GREY: 10mg and 20mg tablets for erectile dysfunction - PDE5 inhibitors are generally considered equivalent.  2nd line choice for patients intolerant to or who fail to respond to the maximum dose of sildenafil (1st line), drug choice should be based on cost. Cost effective to prescribe generically.

GREY: 5mg once daily preparation for erectile dysfunction is an option and cost effective when a PDE5 inhibitor requirement for a patient is greater than 8 doses per month. (Decision date - August 2023)

DO NOT PRESCRIBE (DNP): tadalafil (2.5mg) once daily preparations for erectile dysfunction - significantly more expensive compared to other available treatment.  (Decision date  - December 2017/August 2023) 

DO NOT PRESCRIBE (DNP): Not to be prescribed by brand - Cialis for erectile dysfunction (for patients meeting SLS criteria and therefore eligible for NHS prescription) (Decision date - August 2019)

DO NOT PRESCRIBE (DNP):⁶ NICE TA273: Terminated appraisal for benign prostatic hyperplasia (decision date - February 2013)

Do Not Prescribe (DNP) Drug Classifications

• 5: Less cost-effective than current standard therapy
• 6: Have NICE guidance that recommends they should not be used

Grey Drug Classifications

• 5: Less cost-effective than current standard therapy

search again