Use of Cialis in the UK

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Fed up with the well known side effects of Tamsulosin, so asked my GP if I could switch to Cialis. He said no as it was ' red listed '. Should have asked if this is based on safety or cost. Since found out that this has been approved by NICE. Anybody else in the UK had a similar experience?

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    I recently switched from Flomax to alfuzosin (generic for Uroxatral). I take the alpha blocker with dutasteride (generic for Avodart). For me alfuzosin works better that Flomax for lessening lower urinary tract symptoms.  The sexual side effects are much less as well.  I mentioned this switch to my GP and he's going to switch as well.  He's been suffering from BPH for quite a while as well.  I was amazed that he wasn't more aware of the different types of alpha blockers that are available.

    I did take low-dose Cialis for a short period while on Flomax/Avodart.  If you're taking Cialis and an alpha blocker you have to take them at least 4 hours apart otherwise blood pressure might be lowered too much causing even more dizziness.  However, I stopped taking Cialis because the nasal congestion from the combination of Flomax and Cialis was simply too much for me to take (especially at night). With the switch to alfuzosin, I don't feel that I need to take low-dose Cialis.

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    • Posted

      Cialis in 10mg or 20mg is recommended for ED. My GP rescrib es it. I get a private prescription. I also buy over the counter in a number of countries. If you have BPH problems, you might think of a physical treatment which does not affect sexual performance. TURP has a poor reputation on this site and probably best avoided if you are still sexual active
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    • Posted

      I still have congestion.  The last couple of nights it was less (I find nasal strips helpful). I have been noticing some dizziness, but I don't think it is any worse than when I was on Flomax (my blood pressure is typically "low" normal without the alpha blockers).  I've noticed a slight eye blurriness lately, but I spend a lot of time looking at monitors.  It actually feels more like a stickiness of my lid to my eye, so I'm not sure this is due to the medications (my mother had a similar problem when she was my age).   Tinnitus is much better now on alfuzosin (which is one of the reasons I switched).

      I keep a daily urination journal.  Here are the differences in the averages while using flomax/avodart and alfuzosin/avodart (1st number is flomax/avodart and second is alfuzosin/avodart)

      24 hour amount urinated is 2120 mL versus 1943 mL

      Number of daytime trips to urinate (does not include defecation trips): 10.7 versus 8.1

      Average amount urinated per trip during the daytime: 126 mL versus 146 mL

      Number of times I get up at night to urinate: 3.0 versus 2.6

      With regards to the nighttime trips, the journal has shown me that I am producing too much urine at night. Typically, if the amount urinated during sleeping time is greater than 30 percent of the 24 hour total, then a person is considered to have nocturnal polyuria.  I exceed 30% about 1/3rd of the time and have gotten close to 50% a number of times.  So, I am now looking at "lifestyle" changes to get my kidneys to shift urine production from the nighttime to daytime.  Since I prefer not to take prescription drugs, I'm trying natural diuretics (cranberry and I might even try dandelion).  My goal is to get down to 20% on a consistent basis.  When that has happened in the past, I never get up more than twice (which I can live with).

      Don't underestimate lifestyle changes when dealing with LUTS. In addition to BPH, often times men have overactive bladder, or simply drink too much at night or have nocturnal polyuria or sleep apnea.  These are discussed in many posts on this forum. Good luck.

       

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    • Posted

      I should mention that with diuretics (natural or prescription), you have to be careful when you take the diuretic.  If taken too late in the day, they might actually increase urine production at night.  I've seen recommendation for taking prescription diuretics late in the afternoon.  I'm going to start taking the natural diuretics in the late morning/early afternoon and then adjust as needed.

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    • Posted

      One last thing, Andy.  I assume you are aware that many decongestants tighten the bladder neck and sphincters and should not be taken if you have BPH.  I wish I had known this 5 years ago when I had almost complete/acute urinary retention and the pain and agony that goes with it (a subsequent MRI indicated that none of my organs were damaged). That episode occurred during the holidays, when I was sitting more than usual, drinking alcohol and took Sudafed.
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  • Posted

    I had this problem. It isn't red listed it's just not approved for BPH any more. Doctor said he could issue a private prescription but that is expensive. Asked about buying it on-line as that is much cheaper and he said that would be a good idea. KTC is the on line pharmacy I got mine from. Hope this helps.

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  • Posted

    Did you tell him it is the low dose one a day that you need? Several friends of mine get it on NHS prescriptions.

    Also many cardiologists take and advise it as it is good for the heart.

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    • Posted

      Hi Derek, the low dose on-a-day Cialis is still under patent and is subject to the SLS (Selected List Scheme) restrictions.  5mg/day was recommended for the treatment of BPH, not the one-off dose of 10mg or 20mg.  As you say, the generic tadalafil version of the one-off dose should be available eventually.  If you have had prostate surgery then you can ask for the low dose one-a-day as treatment for erectile dysfunction (as you can if you have other conditions such as Parkinsons or diabetes).

      The 'Selected List' can be found in Schedule 2 of the NHS (General Medical Services Contracts) (Prescription of Drugs etc.) Regulations 2004 which is reproduced in Part XVIIIB of the Drug Tariff. The items included on the list may only be prescribed for the patient groups and for the purpose listed in the Tariff.

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    • Posted

      My GP happily prescribes the 20mg version for what you describe as one-off dose to deal with ED.  In some other countries it can be bought OTC eg Dubai and Argentina without that formality.  Now that viagra patent has expired I presume it won't be long before the same happens to cialis

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