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BNSSG Adult Joint Formulary

7.4 Erectile and ejaculatory conditions

Last edited: 01-02-2024

7.4.1 Erectile dysfunction

First line drugs Second line drugs Specialist drugs Secondary care drugs


  • Please see BNSSG Erectile Dysfunction Primary Care Prescribing Guidelines
  • Prescriptions for generic sildenafil no longer need to be endorsed SLS
  • Other drug treatments (including branded sildenafil – Viagra®) for erectile dysfunction may only be prescribed by a GP at NHS expense under certain criteria set by the Department of Health. These drugs are therefore only GREEN when used in accordance with these criteria (and endorsed 'SLS'). Note that the DH require that prescribing in cases of severe distress should only take place in specialist centres, and in these circumstances the drugs are RED.
  • Sildenafil and tadalafil are RED when used for pulmonary arterial hypertension


Sildenafil (TLS Green)

Tadalafil tablets (weekly) (TLS Blue)

Tadalafil 5mg tablets (once daily) (TLS Amber Specialist Initiated)

Treatment of erectile dysfunction in adult males post robotic laparoscopic prostatectomy (penile rehabilitation) only - for up to a 12 month duration


Vardenafil (TLS Amber Specialist Recommended)

Alprostadil intracavernosal injection (Caverject®, Viridal® Duo) (TLS Amber Specialist Recommended)

  • The lowest acquisition cost should be prescribed and brands should not be changed without appropriate patient counselling

Alprostadil urethral application (Muse®) (TLS Amber Specialist Recommended)

Alprostadil urethral cream (Vitaros®) (TLS Amber Specialist Recommended)

Aviptadil / Phentolamine (Invicorp®) (TLS Amber Specialist Recommended)


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