Cialis Together reviews: a complete guide for UK patients

DoktorABC editorial team

Accurate, up-to-date health information written by our editorial team and reviewed by UK-registered prescribers.

Individual responses vary. This article is for general information only and does not constitute medical advice.

What is Cialis Together?

Cialis Together is a pharmacy medicine (P medicine) containing 10 mg of tadalafil, the same active ingredient as prescription Cialis. It was reclassified from prescription-only to pharmacy medicine status by the MHRA in March 2023, making it the first tadalafil product available without a prescription in the UK. 

It is available to men aged 18 and over following a consultation with a pharmacist. The maximum dose is one tablet per day, and the maximum pack size available as a pharmacy medicine is eight tablets. It is not intended for continuous daily use: men who find themselves using it at least twice a week are advised by the SmPC to speak to a GP about whether a once-daily prescription dose would be more appropriate. 

Like all PDE5 inhibitors, Cialis Together only works in conjunction with sexual stimulation. It does not produce an erection independently of arousal.

Sources and methodology

Combining user-reported themes with clinical data produces a more complete picture than either source alone. The following sets out what this article draws on and the limitations to bear in mind when reading it.

What this article draws on:

What users commonly report

The themes below are drawn from independently reported reviews on regulated pharmacy platforms and reflect the most consistently raised points, both positive and negative. Individual responses vary and these themes are not a substitute for clinical evidence.

What users report positively

The 36-hour window:
The extended duration of effect is the most consistently cited advantage of Cialis Together over Viagra Connect. Clinical studies confirmed that tadalafil produces statistically significant improvements in erectile function for up to 36 hours following dosing. [2] Users consistently describe this as the defining practical benefit: being able to take the tablet well in advance, without needing to time it precisely around sexual activity.

Less planning required:
Unlike sildenafil (Viagra Connect), which works best on an empty stomach with a one-hour lead time, Cialis Together can be taken with or without food. Users who previously found Viagra Connect’s timing requirements inconvenient, particularly around meals or social occasions, frequently cite this as a reason for preferring Cialis Together.

Reliability from early use:
The SmPC notes that most men will achieve an erection the first or second time they use Cialis Together. This is reflected in user reviews, where the majority report the medicine working as expected within the first one or two attempts, which builds confidence in continuing treatment.

Discretion:
The tablets are small, standard in appearance, and do not require refrigeration or any unusual storage. Users frequently mention the convenience of being able to carry them without any particular planning.

What users report as limitations or adjustment issues

Back pain and muscle aches:
This is the most commonly mentioned side effect in user reviews, and it aligns directly with the SmPC, which lists back pain, myalgia, and pain in extremity as common adverse reactions. It typically occurs 12 to 24 hours after taking the tablet and resolves on its own. It is more specific to tadalafil than to other PDE5 inhibitors and reflects the medicine’s inhibition of PDE11, which is present in muscle tissue.

Headache:
Headache is listed as a common side effect in the SmPC. It is the most frequently reported adverse effect across the PDE5 inhibitor class and is usually mild to moderate. Users who experience it typically report that it improves with subsequent use.

Cost per tablet:
Cialis Together is priced higher per tablet than generic prescription sildenafil, which is available considerably more cheaply through a GP prescription. Some users who find the medicine effective switch to prescription tadalafil once they have established it suits them, primarily for cost reasons.

The eight-tablet pack limit:
The maximum pharmacy pack size is eight tablets, which the MHRA set at reclassification. Users who use the medicine more frequently than this allows, or who want the daily low-dose option, need a prescription.

How Cialis Together performs in clinical trials

The efficacy data in the Cialis Together SmPC (section 5.1) draws on 16 clinical studies involving 3,250 patients, covering a range of ED severities, ages, and underlying causes. 

The headline figures from the primary efficacy studies:

• 81% of patients reported that tadalafil improved their erections, compared with 35% on placebo. 
• 75% of intercourse attempts were successful in tadalafil-treated patients, compared with 32% on placebo. 
• Improvement was reported across all severity categories: 86% of men with mild ED, 83% with moderate ED, and 72% with severe ED reported improvement, compared with 45%, 42%, and 19% respectively on placebo. 

The SmPC also confirms that tadalafil demonstrated statistically significant improvement in erectile function and the ability to have successful sexual intercourse up to 36 hours following dosing, as well as the ability to achieve erections as early as 30 minutes following a 10 mg dose. 

These figures are from clinical trials using tadalafil at doses of 10 mg and 20 mg in controlled conditions. They describe averages across large populations and cannot predict what any individual will experience.

Cialis Together vs Viagra Connect: a user-focused comparison

Both are pharmacy medicines available without a prescription following a pharmacist consultation. The differences between them are practical rather than efficacy-based.

The practical choice between the two comes down primarily to timing flexibility and side effect tolerability. Men who want a longer window, less concern about meal timing, or fewer visual effects may find Cialis Together more suitable. Men who experience back pain or muscle aches with tadalafil may prefer sildenafil. Neither is universally better.

Cialis Together vs prescription tadalafil

Cialis Together and prescription tadalafil contain the same active ingredient, but prescription tadalafil opens up options that the pharmacy version cannot provide. The main advantages of the prescription route are dose flexibility, the option of once-daily dosing, and a lower cost per tablet.

Dose flexibility: Prescription tadalafil is available at 2.5 mg, 5 mg, 10 mg, and 20 mg. The 10 mg pharmacy dose is the middle of that range. Men who need a lower dose, for example those on alpha-blockers or certain other medicines, or a higher dose because 10 mg is insufficiently effective, can only access those options via prescription.

Daily low-dose dosing: The 2.5 mg and 5 mg doses are specifically licensed for once-daily use, which maintains a continuous background level of tadalafil and removes the need for any dose timing. This option is not available without a prescription. The SmPC for Cialis Together specifically notes that men using it at least twice a week should consider discussing the once-daily prescription option with a GP. 

Cost: Generic prescription tadalafil is considerably less expensive per tablet than Cialis Together. Once a man has established that tadalafil suits him, a prescription route is typically more cost-effective for ongoing use.

Who needs a GP assessment before using Cialis Together

The pharmacist consultation before purchasing Cialis Together exists to identify men for whom it is not appropriate. The following groups should speak to a GP rather than accessing it via pharmacy.

Must not use Cialis Together:

• Men taking nitrates in any form, including GTN spray, nicorandil, or amyl nitrite (poppers). The combination can cause a serious, potentially life-threatening drop in blood pressure. 
• Men with severe cardiovascular conditions: heart attack or stroke within the last six months, unstable angina, NYHA Class 2 or greater heart failure, uncontrolled arrhythmias, or uncontrolled hypertension or hypotension. 
• Men taking riociguat. 
• Men who have previously experienced vision loss in one eye due to NAION. 

Should see a GP before using Cialis Together:

• Men taking alpha-blockers, where a lower prescription dose may be more appropriate. 
• Men with severe kidney or liver impairment. 
• Men who experience breathlessness or chest pain with light physical activity, such as brisk walking or climbing two flights of stairs. 
• Men whose ED has not improved after several attempts on different occasions. 
• Men who have not had a GP review of their ED within the last six months. The SmPC advises that all men with ED should consult a doctor within six months, as ED can be a sign of an underlying condition such as cardiovascular disease, diabetes, hypertension, or depression. 

How to access Cialis Together through DoktorABC

DoktorABC is a regulated UK digital health platform that connects patients with UK-registered healthcare professionals. Following an online medical questionnaire, a UK-registered pharmacist or prescriber assesses suitability. If Cialis Together is appropriate, medication is dispensed by a GPhC-registered partner pharmacy and delivered in discreet packaging.

DoktorABC does not itself provide medical care, issue prescriptions, or dispense medicines. All clinical decisions are made by the UK-registered healthcare professional following an individual assessment.

Conclusion

Cialis Together gives men in the UK a direct, regulated route to tadalafil without a GP appointment. The 36-hour window and freedom from food timing requirements are its most consistently reported practical advantages, and the clinical evidence base, drawn from studies in over 3,000 patients, demonstrates meaningful improvement in erectile function compared to placebo across a range of severities and underlying causes.

The main limitations of the pharmacy route are the fixed 10 mg dose, the eight-tablet pack limit, and the absence of the daily low-dose option. For men who find tadalafil works well for them and want ongoing cost-effective access or daily dosing, a prescription route is worth discussing with a GP or prescriber.

FAQ

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The DoktorABC medical advisory board

Dr. Roland Ruiken

Medical advisor, Norway

Dr. Viktor Simunovic

Medical advisor, Croatia

To the medical advisory board