Erectile dysfunction (ED), commonly known as impotence, can occur occasionally or frequently and can vary in severity from mild (a soft erection) to severe (no erection at all). It is estimated that 50 per cent of men over 50 years of age have some degree of ED, with prevalence increasing with age.

Viagra (sildenafil) was first made available on prescription in 1998 and when it came off patent in 2014 cheaper versions became available. As of this month, a brand of sildenafil called Viagra Connect is available as a pharmacy-only medicine to men over the age of 18 years.

To enable the process of safe supply, a ‘Pharmacy Checklist’ is available for pharmacists. The use of this guide is optional but the questions can help a pharmacist to determine suitability of Viagra Connect. It also provides advice to support counselling. Alongside the checklist, booklets are available giving Essential Information for Supply. These materials are available from the Electronic Medicines Compendium under Viagra Connect.

Key facts

• Sildenafil can be supplied to some men with erectile dysfunction following careful assessment
• Main concerns about safety relate to use in men with recent cardiovascular disease events, such as myocardial infarction or stroke, and the use at the same time as nitrate drugs for angina
• No more than one 50mg dose of sildenafil is to be taken per day, usually approximately one hour before
  sexual activity
• Men should be advised to consult a doctor within six months of starting sildenafil for a clinical review of potential underlying conditions and risk factors.