Eroxon Gel vs Vitaros Cream: How Two Topical Erectile Dysfunction (ED) Options Differ

• GPhC registered UK pharmacy (registration number 9012878)
• Online consultation with UK registered prescribers for prescription ED medicines
• Independent prescriber review before any prescription medicine is supplied

If you are comparing Eroxon gel vs Vitaros cream, the key difference is that Eroxon is a drug-free UKCA-marked medical device you can buy without a prescription, while Vitaros is a brand of alprostadil cream: a prescription-only medicine that contains an active drug to widen blood vessels and needs a clinical assessment before use.

For adult men in the UK looking at topical erectile dysfunction treatment, that difference shapes almost everything else: how each product works, where and how it is applied, how often it can be used, how it is stored, the side effects to consider and who it may suit. This guide sets those points out side by side so you can make a more informed choice based on your health, preferences and access to prescription treatment before speaking to a pharmacist or prescriber.

Key things to know about erectile dysfunction

• Eroxon gel is a UKCA-marked medical device. It contains no active drug and works through a physical cooling and warming effect
• Vitaros cream is a prescription-only medicine. Its active ingredient, alprostadil, widens blood vessels in the penis
• Eroxon is applied to the head of the penis. Vitaros cream is applied to the opening at the tip of the penis using a single-use applicator
• Neither option creates an erection entirely on its own. The body's natural erection response is still needed
• Vitaros cream should not be used more than once in 24 hours, and never twice to make up for a missed or ineffective use
• Vitaros cream usually needs to be stored in a fridge. Eroxon does not
• Treatment suitability for Vitaros cream depends on an individual clinical assessment

What is the main difference between Eroxon gel and Vitaros cream?

The main difference is that Eroxon is a drug-free medical device and Vitaros cream is a prescription medicine. Eroxon stimulates nerve endings on the surface of the penis. Vitaros cream delivers a medicine, alprostadil, that acts directly on blood vessels.

Neither option is "better" for everyone. The right choice depends on your health, your other medicines and what matters most to you.

How does each option work?

Both products work locally on the penis rather than through a tablet, but the mechanisms are completely different.

How does Eroxon gel work?

Eroxon contains water, ethanol and gel-forming ingredients, but no drug. When it is massaged onto the head of the penis, the liquid evaporates quickly. This creates a cooling sensation followed by warming, which stimulates nerve endings and helps support the natural erection response during sexual stimulation rather than causing arousal on its own.

Because it works physically rather than chemically, Eroxon is regulated as a medical device. Our guide to Eroxon gel explains its ingredients and use in more detail.

How does Vitaros cream work?

The active ingredient in Vitaros cream is alprostadil, a man-made version of prostaglandin E1, a substance the body produces naturally. It is a vasodilator, which means it relaxes and widens blood vessels.

When Vitaros cream is applied to the tip of the penis, alprostadil is absorbed into the surrounding tissue. It relaxes the smooth muscle and blood vessels to help boost blood flow into the penis. The cream also contains ingredients that help the medicine pass through the skin. Vitaros does not create sexual arousal by itself. It is used alongside sexual stimulation, which helps the erection develop.

Alprostadil has been used to treat ED for many years in other forms, including injections. Vitaros cream offers a treatment option for men who want to avoid tablets.

How do you get Eroxon gel or Vitaros cream?

Eroxon can be bought without a prescription from a pharmacy. Vitaros cream can only be supplied with a prescription, after a prescriber has reviewed your health and decided it is appropriate, and it is used with a specialised single-use applicator.

For Vitaros cream, an online consultation with UK registered prescribers usually follows these steps:

1. Complete a health questionnaire. You answer questions about your ED, general health, heart health and current medicines
2. Prescriber review. A UK registered prescriber checks whether Vitaros cream is safe and suitable for you. They may ask follow-up questions
3. Decision. If Vitaros cream is appropriate, your prescriber will issue a prescription. If it is not, they will explain why and may suggest alternatives
4. Supply. The medicine is dispensed by a GPhC registered pharmacy. Because Vitaros cream usually needs refrigeration, it is sent in packaging designed to keep it cool

Even though Eroxon does not need a prescription, a pharmacist can still help you decide whether it is suitable.

How is each option applied?

Eroxon is spread over the surface of the head of the penis. Vitaros cream is placed into the opening at the tip of the penis using a plunger-style applicator. Always follow the leaflet supplied with the product.

What does applying each one involve?

Some men find the Vitaros applicator takes practice. Your pharmacist or prescriber can explain the technique, and the leaflet includes diagrams.

How often can each option be used?

Eroxon is used one tube at a time, and each tube is for a single use. Do not split or reuse a tube.

Vitaros cream has stricter limits because it contains a medicine. The product information states that it should:

• Not be used more than once in any 24-hour period
• Not be used more than 2 to 3 times a week

If Vitaros cream does not work, do not apply a second dose to try again. Wait at least 24 hours before your next use, and speak to your prescriber if it is not working for you.

How should each option be stored?

Eroxon can be stored at room temperature. Keep it out of the reach of children.

Vitaros cream usually needs to be kept in a fridge, but not frozen. According to the product information, unopened applicators can be kept outside the fridge at 25°C or below for a short period, up to 3 days, and should then be discarded if unused. Check the leaflet for the exact storage instructions for your pack.

What does the evidence show for each option?

Both products have been tested in clinical trials. Direct head-to-head trials comparing Eroxon with Vitaros cream have not been identified, so any comparison is indirect.

What does the evidence show for Eroxon?

Eroxon was studied in two main clinical studies:

• FM57: 250 men used Eroxon over 12 weeks in a double-blind study across nine European countries. More than 60% were reported to have a meaningful improvement in erectile function compared with their starting point
• FM71: 96 men used either Eroxon or tadalafil 5mg over 24 weeks. Many men using Eroxon reported an erection within 10 minutes

These results come from the product's clinical programme and are presented as reported.

What does the evidence show for Vitaros cream?

Vitaros cream (alprostadil 300 micrograms) was studied in large placebo-controlled trials involving around 1,700 men with mild to severe ED over 12 weeks, and it has been shown to be effective for mild to moderate ED. Men using Vitaros showed greater improvement in erectile function than men using a placebo cream.

Not every man responded. Results vary between individuals, and a clinical assessment helps decide whether Vitaros cream is a reasonable erectile dysfunction treatment for you.

How do side effects compare?

Both options mainly cause local side effects where they are applied, and ed creams primarily cause localized side effects like burning. Eroxon works locally and contains no active drug, so it has a very low risk of systemic side effects. Vitaros cream contains a medicine, so it can also occasionally cause effects elsewhere in the body.

If irritation occurs, it is usually mild irritation and settles, but if it does not, stop using the product and speak to a pharmacist or prescriber. This kind of erectile dysfunction cream can still cause application-site reactions, and Eroxon may cause skin irritation, including burning or itching. Priapism is a rare but serious side effect of Vitaros cream. You can report suspected side effects to the MHRA through the Yellow Card scheme.

When should you get urgent help from a healthcare provider?

Seek urgent medical help if an erection lasts longer than four hours or is painful. This is called priapism and needs prompt treatment to prevent lasting damage.

Also seek urgent help if you feel faint, have chest pain or develop signs of a serious allergic reaction, such as swelling of the face or difficulty breathing. Call 999 in an emergency.

Who might each option suit? Causes of erectile dysfunction

Eroxon may suit men who want a drug-free topical option available without a prescription. Vitaros cream may suit men with mild to moderate ED who want a medicine-based option after assessment.

This table is a starting point, not a recommendation. Treatment suitability depends on an individual clinical assessment, including whether symptoms affect your ability to maintain an erection during sexual activity. A prescriber can also advise whether topical treatment or oral medications are the most appropriate treatment.

Who should not use Vitaros cream?

Vitaros cream is not suitable for everyone. It may not be prescribed if you:

• Are allergic to alprostadil or any of the cream's ingredients
• Have a condition that increases the risk of priapism, such as sickle cell anaemia, some blood disorders or multiple myeloma
• Have a deformity of the penis, such as Peyronie's disease
• Have inflammation or infection of the penis or urethra
• Have low blood pressure that causes fainting, or certain serious heart conditions
• Have been advised by a healthcare professional to avoid physical exertion because of a heart condition

Your prescriber will review these and other factors during your consultation, including your medical history and current medicines.

Who should not use Eroxon gel?

Do not use Eroxon if you:

• Are allergic to any of its ingredients
• Have red, sore, irritated, damaged or broken skin on the penis
• Have a disease or deformity of the penis
• Have been advised to avoid physical exertion because of a medical condition

If you have a heart condition, speak to a prescriber before using any ED treatment.

What if you cannot take ED tablets?

Men who take nitrates, nitric oxide donors such as amyl nitrite, or riociguat must not take PDE5 inhibitor tablets such as sildenafil, tadalafil or vardenafil, because the combination can cause a dangerous drop in blood pressure. PDE5 inhibitors are first-line oral medicines for many men and have an estimated 76% success rate for ED.

For these men, a topical option may be worth discussing. Eroxon contains no drug. The alprostadil in Vitaros cream works differently from PDE5 inhibitors, but it can still lower blood pressure in some people, so a prescriber must check whether it is safe alongside your heart medicines.

Do not start any ED treatment without discussing it with a prescriber if you take medicines for your heart or blood pressure.

What if neither option works for you?

If neither Eroxon nor Vitaros cream helps, other treatments may be available. These include prescription PDE5 inhibitor tablets, where suitable, alprostadil injections given by a specialist, and vacuum pumps.

Ongoing ED can also be an early sign of an underlying health condition, such as heart disease, high blood pressure or diabetes. ED can have both physical and psychological causes, and common ones include heart disease, high cholesterol, long-term health conditions, stress, too much alcohol and certain medicines. Our erectile dysfunction guide explains the common causes and when to seek a health check.

Treatment may also include lifestyle changes to improve erectile dysfunction.

Speak to a prescriber or your GP if:

• ED is regular or has lasted several weeks
• You have risk factors such as diabetes, high blood pressure, smoking or excess weight
• ED started suddenly or after starting certain medicines
• You also have chest pain or breathlessness

Medical Disclaimer

This article is for general information only and does not replace advice from a pharmacist, prescriber or other qualified healthcare professional. Eroxon is a medical device and Vitaros cream (alprostadil) is a prescription-only medicine. Neither is suitable for everyone. Always read the leaflet supplied with any product. Vitaros cream should only be used under the supervision of an appropriately qualified prescriber, following an individual clinical assessment. Results vary between individuals. If you have ongoing erectile dysfunction symptoms or any other symptoms, seek professional advice.