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Two trial packs, three different ED medicines: read this before you order

Two trial packs, three different ED medicines: read this before you order

Worth knowing first: neither pack is something a Spanish pharmacy would ever hand you; both are bundles we put together ourselves. Every tablet is the maximum dose, and the three medicines must never be mixed: one at a time, never two on the same day. The generic pack names no manufacturer, so there is no way to check whether its tablets are licensed. In Spain, prescription-only medicines may not be sold online, and customs can hold a parcel that contains them. We do not check prescriptions: talk to your doctor before you order.

The idea behind a trial pack is simple: sildenafil, tadalafil and vardenafil in one box, so you can find out which suits you. Wanting to know is reasonable: the three work in much the same way, yet men differ in how well they respond and which side effects they get. The problem is finding out on your own, starting at the top dose and hopping from one to the next within a few days.

The packs side by side

	Generic Trial Pack	Brand Trial Pack
What's inside	10 × sildenafil 100 mg, 10 × tadalafil 20 mg, 10 × vardenafil 20 mg	4 × Viagra 100 mg, 4 × Cialis 20 mg, 4 × Levitra 20 mg
Tablets in total	30	12
Strength	The highest licensed dose of each. Spanish product information starts at half that: 50 mg sildenafil, 10 mg tadalafil, 10 mg vardenafil.
Who makes it	Not stated	Brands owned by Viatris, Lilly and Bayer, but we don't state the supplier, batch or country of origin
Licensed in Spain?	Impossible to say without the manufacturer's name	All three brands are licensed, although Bayer no longer markets its own Levitra packs in Spain
Prescription?	Yes, for all three active ingredients. Not funded by the Spanish health system.

Each pack has its own page with more detail: a true-or-false quiz on the generic one, and a tool on the brand one that helps you work out when you can move on to the next medicine.

Generic Trial Pack

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Brand Trial Packs

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Why a pack can't give you the answer

Urology guidelines suggest giving each medicine several attempts, at the right dose and with sexual stimulation, before deciding it doesn't work. Four tablets of each, as in the brand pack, leaves very little room for that. Starting on the maximum dose also makes headaches, flushing and dizziness more likely, which may put you off a medicine that would have suited you at a lower strength.

Don't cut the tablets to get a lower dose without asking first: we can't tell you whether they are scored or whether the manufacturer allows splitting.

The one rule: one medicine at a time

Check with your doctor that you can take any of the three, and which to start with.
Stick with one active ingredient for several occasions before judging it. Jot down how long it took, how long it lasted and any side effects.
If you switch, do it on another day: at least 24 hours after sildenafil or vardenafil, and about two days after tadalafil, which works for up to 36 hours.
Never take a second tablet, of the same or another medicine, because the first one “hasn't worked”.

Who should not use either pack

Anyone taking nitrates, poppers or riociguat; anyone with a heart condition that rules out sex, or a recent heart attack or stroke; anyone with blood pressure below 90/50; anyone who has lost sight in one eye from ischaemic optic neuropathy. Ask a doctor first if you take alpha-blockers, antifungals such as ketoconazole, clarithromycin or HIV medicines.

Call 112 if, after any of them, you have chest pain, breathlessness or a faint, an erection lasting 4 hours or more, or sudden loss of sight or hearing. If you have taken two different ones, or too many: Servicio de Información Toxicológica (poisons information), 91 562 04 20.

The pharmacy route

If your doctor thinks a comparison is worthwhile, they will prescribe one medicine at the starting dose, then another if needed. Spanish pharmacies stock small packs that suit this: Viagra 25 mg in packs of 4, Viagra 50 mg in packs of 2, 4 or 8, and Cialis 10 mg in packs of 4, according to CIMA, plus cheaper EFG generics. Each comes in its own box with a leaflet, in Spanish. Your GP at the centro de salud can write the prescription, but you pay the full price at the pharmacy, as these medicines are not funded.

If you order here, parcels go by post or courier under our delivery conditions. The individual medicines are listed under erectile dysfunction.

Questions people ask

Can I buy a trial pack without a prescription in Spain?

No. All three active ingredients are prescription-only here, and only a pharmacy may dispense them, each in its own box.

Can I take Viagra and Cialis on the same day?

No. They belong to the same group, the combination has not been studied, and their effects on blood pressure add up.

Which one should I try first?

That's for your doctor to decide, based on your health, your medicines and your habits. Men who prefer spontaneity are sometimes offered tadalafil for its long window; for occasional, planned sex, sildenafil or vardenafil is usually enough.

Why is every tablet the highest dose?

That's how these packs are made up. It is not how treatment normally begins.

Are the brand-name tablets genuine?

We can't guarantee it: we are not a pharmacy and we don't state where the packs come from. In a Spanish pharmacy, every box is checked against its datamatrix code when it is dispensed.

Sources: Spanish product information for Viagra, Cialis, Levitra and generic sildenafil, tadalafil and vardenafil (CIMA, AEMPS); European Association of Urology guidelines on erectile dysfunction; BIFIMED, Spanish Ministry of Health. General information only; it does not replace a consultation. In Spain, prescription-only medicines may not be sold online, and customs can hold a parcel that contains them. We do not check prescriptions: talk to your doctor before you order.