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Repeat prescription for erectile dysfunction treatment you already take

Here you can ask a doctor to continue erectile dysfunction treatment that another doctor has already assessed and prescribed for you. This route is for continuation only: if the problem is new, has changed or nobody has yet looked for its cause, the first assessment belongs with a GP who can examine you. This page explains what the doctor checks before repeating a prescription and what would stop him.

Who this route is for, and who should start with a GP

The route suits a man who already has a prescription for an erectile dysfunction medicine, from a GP in Ireland or a doctor elsewhere in the EU, has used it, tolerates it, and whose health has not changed in a way that matters. The doctor here continues a decision another prescriber made after assessing you.

A first assessment needs more than a questionnaire. Erectile difficulties are often linked to narrowed arteries, diabetes, high blood pressure, raised cholesterol, low testosterone, low mood, alcohol or other medicines, and they can be the first noticeable sign of a heart or circulation problem. Finding the cause means blood pressure, blood sugar and cholesterol checks and sometimes an examination, so a new or clearly changed problem should start with your GP. A few 50 mg sildenafil products can also be supplied by a pharmacist without a prescription; that pharmacy route is separate from this assessment.

What counts as continuing, and what is a new decision

Continuing means the same active substance at the strength your previous prescriber set. Three substances are used: sildenafil, tadalafil and vardenafil. All of them increase blood flow into the penis in response to sexual stimulation, but the effect lasts for different lengths of time, and tadalafil can also be prescribed as a lower dose taken every day. None of them is taken more than once in 24 hours.

Moving to a higher strength, switching to another substance, changing to a daily dose or restarting after a long break are new clinical decisions, not repeats. The doctor may still be able to make them from your answers, may ask for more information such as a recent blood pressure reading, or may suggest discussing the change with your own doctor. The same applies if the medicine no longer works as well as it did.

What to have ready before you start

The most useful thing to send is a photograph of your last prescription or of the pharmacy label on the box, showing the substance, strength and prescriber. Add how often you use it, how well it works and any side effects, such as headache, flushing or changes in vision.

The questionnaire then asks a short set of safety questions: whether you take nitrates, for example a glyceryl trinitrate spray or isosorbide mononitrate, or riociguat; whether you have had a heart attack or a stroke in the last six months, or have unstable angina or severe heart failure; whether your blood pressure is very low, or high and untreated; whether you take an alpha-blocker such as tamsulosin or doxazosin; whether you have ever suddenly lost the sight in one eye or have retinitis pigmentosa; and whether you have taken such a medicine before and tolerated it. List everything else you take as well, including products sold online as herbal remedies for sexual performance.

Changes since your last prescription that matter

A continuation check exists to catch what has changed since another doctor last looked at you. The product information lists the following as contraindications, which means the medicine is not used, not that it needs extra care: nitrates in any form, including the recreational drugs known as poppers, or riociguat; a recent heart attack or stroke, which the questionnaire takes as the last six months; severe liver impairment; blood pressure below 90/50 mmHg; an inherited disorder of the retina such as retinitis pigmentosa; and loss of vision in one eye caused by non-arteritic anterior ischaemic optic neuropathy (NAION). If any of these now applies, the prescription will not be repeated.

Unstable angina, severe heart failure, or new chest pain or breathlessness on exertion mean that your heart should be assessed in person first. A newly started alpha-blocker can make blood pressure fall further, so the timing and dose need a prescriber's advice, and some antifungal, antibiotic and HIV medicines raise the level of these medicines in the blood.

When to get urgent medical help

An erection that is painful or lasts more than four hours needs emergency care, because it can damage the penis permanently: go to an Emergency Department or call 112 or 999. Sudden loss or dimming of vision in one or both eyes, or sudden loss of hearing, means stopping the medicine and seeking urgent medical advice. Chest pain during or after sex is an emergency; tell the treating team that you have taken an erectile dysfunction medicine, because it changes which heart medicines they can safely give you.

Continuing treatment does not replace regular heart and blood sugar checks with your GP.

How the prescription reaches you and what the pharmacy does

Everything happens in writing, with no video call, no phone appointment and no live chat. The doctor may ask for your previous prescription or a recent blood pressure reading, may advise you to see your GP, or may decline. Prescriptions are issued by lek. Damian Wojno, a doctor registered in Poland, PWZ no. 3211301.

Where continuing the treatment is appropriate, you receive a cross-border prescription as a PDF by email, in the format set out in the Annex to Directive 2012/52/EU, naming the active substance with its strength, form, quantity and dosage. Print it and take it, with photo identification, to a pharmacy of your choice; there is no PIN code in this route. The pharmacist keeps professional judgement and may decline. The medicine itself is priced and paid for at the pharmacy, separately from the assessment.

Can I use this if I have never been prescribed a medicine for erectile dysfunction?

This route is meant for continuing treatment that a doctor has already assessed. A first episode of erectile difficulties deserves a look at the cause, including blood pressure, blood sugar and cholesterol, and that belongs with a GP who can see you. A pharmacist can also supply some 50 mg sildenafil products without a prescription after asking about your health.

My last prescription was written by a doctor in another country. Does that count?

It can. What matters is that a doctor assessed you and prescribed the medicine, and that you can show which substance and strength it was, ideally with a photograph of the prescription or the pharmacy label. The doctor here decides from your answers whether continuing it is appropriate.

Can I move to a higher strength or try a different medicine?

That is a new clinical decision rather than a repeat, which the doctor may make from your answers, ask more about, or leave to your own doctor. Never take more than one dose in 24 hours or combine two medicines from this group.

I have started a tablet for my prostate. Can I still continue?

Say so in the questionnaire. Alpha-blockers such as tamsulosin or doxazosin lower blood pressure further when combined with these medicines, so the doctor needs the dose and start date. He decides whether and how treatment can continue.