Milton Keynes Formulary
Milton Keynes University Hospital NHS Foundation Trust
Milton Keynes Clinical Commissioning Group
Milton Keynes Community Health Services

7 Obstetrics, Gynaecology, and urinary-tract disorders
07-04-05 Phosphodiesterase type 5 inhibitors


Tablets 25mg, 50mg, 100mg

It is currently recommended that patients should receive eight doses of a PDE5

inhibitor with sexual stimulation at maximum dose before classifying a patient
as a non-responder. Full guidance from the British Society for Sexual Medicine.

Prescribers should ensure that generic sildenafil tablets 25, 50 and 100mg
tablets are always considered first line for the treatment of erectile dysfunction.

Only patients that meet Selected List criteria can be considered for alternative
treatments on the NHS (see below).

Doctors within secondary care are asked not to ask GPs to prescribe drugs
outside of the controls imposed by Selected List Scheme.

Alternative erectile dysfunction treatments (including branded Viagra) can
continue to be provided privately subject to patient preference.

Prescribers should review their NHS prescribing of treatments for ED to ensure
that patients who do meet Selected List criteria are prescribed generic sildenafil
25, 50 and 100mg tablets.

Quantities: guidance remains in force with a recommended dosage frequency of
one dose per week; higher quantities can be prescribed at the discretion of the

All other formulations of sildenafil or brands remain under the control of Part
XVIIIB of the Drug Tariff and can only be prescribed within that context

Selected List criteria are as follows:
any man suffering from diabetes, multiple sclerosis, Parkinson’s disease,
poliomyelitis, prostate cancer, severe pelvic injury, single gene neurological
disease, spina bifida or spinal cord injury
any man receiving treatment for renal failure by dialysis
any man who has had a prostatectomy or radical pelvic surgery or renal failure
treated by transplant
any man who has been diagnosed as suffering severe distress resulting from
erectile dysfunction where the assessment has been made by a specialist
service or GP under arrangements made with a local Health Board to provide
such assessments

Green View adult BNF  View SPC online  View childrens BNF

Tablets 10mg, 20mg


Second line after Sildenafil

NB Daily dosing is non-formulary

Once-daily Tadalafil Commissioning Statement
Prescribers should not initiate once daily tadalafil for any new patient.
Once daily tadalafil should be discontinued from primary care prescribing (deprescribed), with support from specialist services if necessary.
It should be noted that once daily tadalafil is not on the Joint Trusts formulary and as such should not have been prescribed.
Patient Information Leaflet can be found on the formulary website at:


Link  NICE: Hyperplasia (benign prostatic) - tadalafil (terminated appraisal) (TA273)

Amber 2 View adult BNF  View SPC online  View childrens BNF
Non Formulary

View adult BNF  View SPC online  View childrens BNF
Sildenafil chewable tablets Nipatra®
Non Formulary

View adult BNF  View SPC online  View childrens BNF
Tadalafil once daily
Non Formulary

View adult BNF  View SPC online  View childrens BNF
Non Formulary

View adult BNF  View SPC online  View childrens BNF