A new brand of sildenafil drug used for the treatment of erectile dysfunction(ED) has been launched. Aronix (sildenafil) is classified as a pharmacy-only medication (P), available without a prescription from a pharmacy or registered online pharmacies. Aronix is not the first pharmacy medication available without a prescription for the treatment of ED. Viagra Connect has been available since 2018 as over the counter pharmacy medication; however, what is exciting about Aronix is the price, which is much lower as compared to Viagra Connect.
How does Aronix (sildenafil) work?
Each Aronix tablet contains 50mg of sildenafil.
Sildenafil belongs to a group of drugs called phosphodiesterase type 5 (PDE-5) inhibitors. PDE-5 inhibitors cause vasodilation of blood vessels in the penis, causing an erection. Aronix will only be effective when sexual stimulation happens. Currently, there are four PDE5 inhibitors licensed in the UK for the management of ED:
Sildenafil is the only PDE-5 inhibitor available over the counter without a prescription. Sildenafil is well studied with a number of clinical trials supporting its effectiveness and tolerance as medication for erectile dysfunction (Goldstein et al 2016).
Aronix (sildenafil): who can have it?
Aronix is licensed for adult men, 18 years of age and above, who have difficulties in getting and/or maintaining an erection.
Patients who request Aronix in the pharmacy will need to have a consultation with a pharmacist to assess the suitability of the product. At the end of successful consultation, patients may be given a tear-off slip with a pharmacy stamp for future reference. Patients who are supplied with Aronix are also advised to consult their doctor within six months of first use.
During the consultation, a pharmacist will ask questions (Aronix: Pharmacy Checklist) to confirm the following (eMC, 2019):
1. Patient’s age
2. Cardiovascular health, for example:
- Physical fitness
- Recent episode (is any) of heart attack or stroke
- Presence of any heart-related conditions, such as low blood pressure or uncontrolled high blood pressure or angina
3. Current use of any other medication
4. Health conditions other than heart-related, for example:
- Liver disease
- Galactose intolerance
- Bleeding issues
Aronix (sildenafil): who cannot have it
Certain patients should not take Aronix:
- Individuals who are not 18 years of age
- Individuals who do not have erection problems
- Patients who take a drug called nitrates or nitric oxide donors, ‘poppers’ are on the list of drugs
- Patients who take riociguat or other guanylate cyclase stimulators.
- Patients who take ritonavir
- Patients had damage to the optic nerve and had a loss of vision or have an inherited eye condition, such as retinitis pigmentosa.
- If they are allergic to sildenafil (Aronix’s active ingredient)
- Patients with low blood pressure
- Patient with liver problems
- Patients with deformity of the penis (Peyronie’s Disease)
- If they are a women
How to take Aronix?
- One tablet should be taken around 1 hour before sexual activity.
- Only one tablet should be taken in 24 hours.
- Food may affect Aronix’s onset of action; time it takes to work may be delayed when taken on a ‘full stomach.’
- Patients are advised not to consume grapefruit o grapefruit juice when Aronix is taken.
- The response time may vary between individuals. It may take 30-60 minutes for Aronix to work.
It may take more than one occasion to achieve a satisfactory result; therefore, it is advised to try Aronix on a few different occasions (different days). If a satisfactory response is not attained, patients are advised to speak to their doctor. Higher strengths of sildenafil can be prescribed by a doctor.
Where to buy Aronix (sildenafil)?
At this moment, Aronix is only available online through different pharmacy websites. Aronix will be available to buy from the 19th of February, exclusively in Lloyds Pharmacy branches only.
The table below lists / compares the prices of Aronix and Viagra Connect. Aronix will be available in packs of 4 and 8 tablets (the same pack size as Viagra Connect).
|Aronix price 4s||Viagra Connect price 4s|
|Aronix price 8s||Viagra Connect price 8s|
Aronix (sildenafil): possible side effects
Side effects are usually grouped according to the possible occurrence as very common, common, uncommon, and rare.
Aronix: very common side effect
Very common side experienced by more than 1 in 10 patients include:
Aronix: common side effects
Common side effects may affect up to 1 in 10 patients takin Aronix:
- hot flush
- blurred vision and visual disturbance
- stuffy nose
Patients need to be aware of possible serious side effects which may be experienced. Urgent medical attention is required when the following side effect(s) are experienced:
- an allergic reaction (listed as an uncommon side effect)
- chest pains
- serious skin reaction
- a painful erection lasting longer than 4 hours
- sudden decrease or loss of vision
Sildenafil: other options for supply
There are few alternative options for getting sildenafil over the counter and on prescription. In brief summary, sildenafil can be:
- Prescribed on NHS prescription. A limit of 4 sildenafil tablets per month is commonly applied to NHS patients.
- Prescribed privately by a doctor. Any medical doctor, including an NHS doctor, can produce private prescriptions for sildenafil. To learn more about private prescriptions, read my separate post. This post will give you some ideas on how to get a private prescription for any drug. The supply of sildenafil on private prescription can be the cheapest option out of all possibilities discussed. However, the total cost will depend on the cost of the private prescription itself (e.g., you need to pay a fee to get one) and pharmacy used to supply the medication (some pharmacies have a higher minimum charge for a private prescription than others).
- Sildenafil can be bought online from registered pharmacies. Many online pharmacies sell sildenafil online, for example, through an erectile disfunction service (e.g., Boots Online ED service). Sildenafil can also be purchased as part of a broader range of drugs offered privately (e.g., Lloyds Pharmacy Online Doctor).
- Supplied by a pharmacist as a part of in-pharmacy private service. Some pharmacies offer in-store service to supply sildenafil privately. For example, Tesco Pharmacy offers erectile dysfunction service to male patients aged 40-65 (exclusion criteria apply). The first consultation involves taking blood pressure, weight, sugar, and total cholesterol levels. Four (generic) sildenafil 50mg tablets cost around £10, making it cheaper than any over the counter sildenafil product.
- Viagra Connect. Sildenafil 50mg tablets can be purchased over the counter. When a request is made to purchase Viagra Connect a consultation with pharmacist need to take place, with assessment and questions similar to those seen during the supply of Aronix.
- Sildenafil by Perrigo. Sildenafil 50mg by Perrigo is the newest over the counter product available without a prescription from pharmacies including supermarket pharmacies such as Tesco. Sildenafil Perrigo is priced almost the same as Aronix Sildenafil with the same supply requirement. Read more about Sildenafil Perrigo here.
eMC (2019). Aronix 50mg film-coated tablets (sildenafil). Pharmacy Checklist. Available at: https://www.medicines.org.uk/emc/rmm/1671/Document Accessed on 31/01/2020
Goldstein I, Tseng LJ, Creanga D, Stecher V, Kaminetsky JC. Efficacy and Safety of Sildenafil by Age in Men With Erectile Dysfunction. J Sex Med. 2016;13(5):852–859. doi:10.1016/j.jsxm.2016.02.166 Available at: https://doi.org/10.1016/j.jsxm.2016.02.166 Accessed on 31/01/2020