Cream for Erectile Dysfunction: Vitaros, Eroxon and Your Options in the UK

The two licensed options in the UK#

The best-evidenced cream for erectile dysfunction available in the UK right now is Vitaros, a prescription alprostadil cream that can produce an erection within 5 to 30 minutes. If you prefer something you can buy without a prescription, Eroxon Stimgel is a licensed over-the-counter option. Both are approved by the MHRA. Nothing else on the UK market has that regulatory backing.

How Vitaros works#

Vitaros contains alprostadil, a prostaglandin that widens blood vessels in penile tissue. You apply it using a small single-dose plunger directly to the urethral meatus (the opening at the tip of the penis). The medicine absorbs through the local tissue rather than passing through your digestive system, which is why it acts so much faster than an oral tablet.

Clinical trials in men with erectile dysfunction have reported responder rates of around 50 to 60% with alprostadil cream, compared with around 25% on placebo. Effects typically last up to 2 hours.

How to apply Vitaros correctly#

Incorrect application is the most common reason men get poor results or more side effects than necessary.

1. Wash your hands before handling the plunger.
2. Remove the cap and gently place the tip of the plunger against the urethral meatus (the opening at the tip of the penis).
3. Press the plunger slowly to deposit the cream at the meatus. Do not attempt to insert the plunger into the urethra.
4. If any cream remains on the tip of the penis, gently spread it around the meatus with a clean finger rather than pushing it inward.
5. Apply 5 to 30 minutes before sex. Mild warmth or tingling at the site is normal.

Vitaros comes in two doses: 200 micrograms and 300 micrograms. Most men start on the lower dose and move up if needed.

Storing Vitaros#

Vitaros plungers are temperature-sensitive. Keep them in the fridge (2 to 8 degrees C). Each plunger is for single use; refer to the product packaging or your pharmacist for the shelf life applicable to your supply. Do not freeze them. If the cream has been left at room temperature for extended periods, it may be less effective.

How Eroxon works#

Eroxon contains no active drug. It is a gel that works through evaporative cooling, which stimulates thermoreceptors in the penile skin and triggers local vasodilation through a purely physical mechanism. The MHRA authorised it in the UK before the FDA approved it in the United States, making it a UK-first regulatory milestone.

Eroxon is sold without a prescription in pharmacies and some supermarkets, typically retailing for around £20 to £25 for a pack of 4 single-use tubes. It starts working within about 10 minutes. Evidence from clinical trials shows it can help men with mild to moderate ED, though its effect size is generally smaller than that of alprostadil cream or oral PDE5 inhibitors.

How the two creams compare with oral tablets#

Which types of ED respond best to topical treatment#

Vitaros works through a direct local mechanism, so it can be effective even when oral PDE5 inhibitors have failed. It is particularly worth considering for:

• Post-prostatectomy ED: nerve-sparing surgery can leave men unable to respond to oral tablets; alprostadil bypasses that pathway.
• Vasculogenic ED: the direct vasodilatory action can help when blood vessel function is impaired.
• Men who cannot tolerate PDE5 inhibitors: nitrates, severe hypotension, or cardiac conditions may rule out sildenafil or tadalafil.
• Psychogenic ED: some men find a locally applied treatment reduces performance anxiety because it takes the pressure off achieving arousal mentally.

Eroxon is better suited to mild or situational ED where a prescription treatment feels like a bigger step than needed.

Partner safety and transfer risk#

This is something most articles skip over. Alprostadil can transfer to a partner during sex and cause vaginal or anal irritation or burning. The risk is low but real. To reduce it:

• Use a condom during penetrative sex.
• If you do not use a condom, ask your partner to wash the affected area with warm water after sex.
• Partners who are pregnant should avoid direct contact with alprostadil, so condom use is strongly recommended.

Eroxon carries a much lower transfer risk given its drug-free formula, but if your partner notices any irritation, washing the area is all that is needed.

A note on priapism#

Alprostadil, like injectable alprostadil (Caverject), carries a small risk of priapism (a prolonged erection lasting more than 4 hours). If this happens, do not wait it out. Go to your nearest A&E. Untreated priapism can cause permanent damage to erectile tissue.

Interactions to know about#

Vitaros should not be used alongside other topical penile treatments. Because systemic absorption is low, interactions with blood pressure medicines and nitrates are less of a concern than with oral tablets, but you should still disclose all current medications to your prescriber before starting. Men taking anticoagulants (blood thinners such as warfarin) should also mention this to their prescriber before use, as the Vitaros SPC lists anticoagulants as a precaution.

Eroxon has no known drug interactions.

What about topical sildenafil?#

SST-6006, a topical sildenafil cream, has completed Phase I trials but has not received MHRA authorisation. It is not available in the UK through any licensed route. Avoid any product claiming to be a topical Viagra gel; no such product is legally licensed here.

If creams are not the right fit#

Topical treatments are one part of the picture. Oral treatments including sildenafil and tadalafil are effective for most men with ED and are available through the Totiva ED service after a short online clinical questionnaire. For a broader look at how these medicines compare, the guide on tadalafil dosage covers the key differences in how they are taken and timed.

If you have tried a topical option and had limited success, it is worth discussing vacuum erection devices or penile injections with a urologist. Your GP is the standard entry point for NHS referral.