Sildenafil has been used to treat erectile dysfunction (ED) for over 20 years and remains one of the most effective and widely prescribed options available (1). Traditionally, it’s taken as a tablet, but a newer option called Hezkue delivers the same medicine as an oral spray instead (2).
As both options contain the same active ingredient, choosing which is right for you is usually about convenience and personal preference rather than effectiveness.
In this article:
What’s the difference between sildenafil tablets and Hezkue spray?
How do sildenafil tablets and sprays compare?
Who might prefer Hezkue sildenafil spray?
Who might prefer sildenafil tablets?
Are sildenafil tablets and Hezkue equally effective?
Can you use sildenafil tablets and Hezkue spray together?
Start your consultation today or get more help and advice on our Erectile Dysfunction Hub.
What’s the difference between sildenafil tablets and Hezkue spray?
The key difference between sildenafil tablets and Hezkue spray isn’t the medicine itself. It is how it is taken and absorbed into the body.
Both treatments contain sildenafil, which belongs to a group of medicines called PDE5 inhibitors and supports erections by increasing blood flow to the penis during sexual arousal (3,4). Equivalent doses are expected to produce the same results, regardless of how the medicine enters the body.
Sildenafil was only available as a tablet until Hezuke came along. Hezkue is the first licensed oral sildenafil spray in the UK, delivering the same medicine but sprayed in the mouth and swallowed rather than taken as a tablet (2). Because the spray does not require swallowing a tablet or water to take, some people find it more convenient, so choice is typically down to personal preference.
However, in a study comparing the spray with tablets, sildenafil from Hezkue was detected in the bloodstream within 5 minutes* (7). This suggests the medicine may start being absorbed sooner than tablet forms.
*In fasted healthy male volunteers. Note, the clinical significance of this faster initial absorption has not been formally evaluated.
How do sildenafil tablets and sprays compare?
Because both treatments contain sildenafil, they work in the same way, are taken at similar times before sexual activity, and have similar side effects (5,6).
The main differences relate to how the medicine is delivered, how doses are adjusted, and how easily the treatment fits into your routine. Although the active ingredient is the same, the experience of taking each treatment can feel slightly different day to day.
Here’s a simple comparison:
Feature | Sildenafil tablets | Hezkue sildenafil spray |
|---|---|---|
Active ingredient | Sildenafil | Sildenafil |
How it’s taken | Swallowed tablet | Oral spray inside the mouth and immediately swallowed |
Water needed | Yes | No |
Dose adjustments | 25mg steps | 12.5mg steps |
Available doses | 25mg, 50mg, and 100mg | 25mg, 50mg, and 100mg, delivered in 12.5mg sprays |
Timing before sex | 30-60 minutes | 30-60 minutes |
Absorption time | Sildenafil was not detected in the bloodstream at 5 minutes* (7) | Sildenafil was detected in the bloodstream within 5 minutes* (7) |
Duration of effect | Around 4 to 5 hours | Around 4 to 5 hours |
Common side effects | Headache, flushing, dizziness, nasal congestion, mild visual disturbances | Similar to tablets; may also include mild mouth or throat irritation |
Prescription or OTC | 50mg available OTC; other strengths prescription only | Prescription only |
Cost | Usually lower | Usually higher |
Discreet to carry | Moderate | High |
In practice, this means both treatments are equally effective but the spray may feel easier to use if you prefer not to swallow tablets or want more flexibility when adjusting your dose. Tablets, however, remain the most familiar and widely used option for most men starting treatment.
*In fasted healthy male volunteers.
Who might prefer Hezkue spray?
The main advantage of Hezkue is that it offers a different way to take a familiar, well-established treatment for erectile dysfunction. It may be a particularly good option if you:
Find it hard to swallow tablets
Prefer the convenience of taking medication without water
Want something more discreet to use
Would benefit from adjusting doses in smaller steps
Are already using sildenafil and are curious about switching delivery formats
Want something easy to carry with you while travelling
Who might prefer sildenafil tablets?
Tablets are the most commonly used version of sildenafil and, for many men, are the most straightforward place to start. They might be a better choice for you if you:
Are already using sildenafil tablets and are getting along with them
Prefer a simple, single-dose format instead of counting sprays
Want the option of buying treatment without a prescription at certain strengths
Are looking for a more cost-effective option
Are taking erectile dysfunction treatment for the first time
Are sildenafil tablets and Hezkue equally effective?
Yes. Because both treatments contain sildenafil, they are expected to work in the same way at equivalent doses. The spray does not make erections stronger than tablets, and tablets are no more effective than the spray. The main difference is delivery.
Interestingly, in a clinical study comparing the two delivery methods, sildenafil from the Hezkue spray was detected in the bloodstream within 5 minutes*, suggesting absorption may begin sooner than with tablets (7). However, this doesn’t change how soon it should be taken before sex — both should be taken around 30-60 minutes before (5,6).
*In fasted healthy male volunteers.
Can you use sildenafil tablets and Hezkue spray together?
Sildenafil tablets and Hezkue spray should not be used at the same time.
Because they contain the same active ingredient, taking both together would increase the total dose of sildenafil and raise the risk of side effects. The maximum recommended dose of sildenafil is 100mg within 24 hours, whether taken as tablets or spray, but never at the same time (5,6).
However, it’s fine to use tablets and the spray interchangeably on different occasions if they’ve both been prescribed or recommended for you. For example, some people prefer to take a tablet at home but keep the spray available when they’re out or travelling.
If you’re planning to switch between formats, a prescriber can help confirm the equivalent dose and make sure you stay within the recommended daily limit.
You should not take more than 100mg (8 sprays) of Hezkue in 24 hours. Seek medical attention immediately if you exceed this dose.
Still deciding which option is right for you?
Choosing between sildenafil tablets and Hezkue spray is usually less about effectiveness and more about convenience and personal preference.
If you’re exploring treatment for erectile dysfunction for the first time, or thinking about switching from tablets to the spray, a simple online consultation with our independent doctors can help you decide which option is best suited for you.
Start your consultation today or get more help and advice on our Erectile Dysfunction Hub.
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FAQs
Does Hezkue spray work faster than sildenafil tablets?
In clinical studies, sildenafil from the spray was detected in the bloodstream within 5 minutes, suggesting that absorption may begin sooner than with tablets (7). However, the clinical significance of this faster initial absorption has not been formally evaluated and both should still be taken about 30-60 minutes before sex for best results (5,6).
Is Hezkue stronger than sildenafil tablets?
No. Both Hezkue and sildenafil come in various doses, typically 25mg, 50mg, and 100mg (5,6). As both treatments contain the same active ingredient, they are equally effective at equivalent doses. For example, 25mg of Hezkue (two sprays) is equal to a 25mg sildenafil tablet.
Is sildenafil spray easier to use than tablets?
It depends. Some men find the spray more convenient because it doesn’t require water and can be easier and more discreet to take while away from home. Others prefer tablets as they are familiar and have a single dose format.
Can I switch from sildenafil tablets to Hezkue?
Yes. Many men switch between formats depending on their preferences and what they find more comfortable taking — just make sure you know how many sprays is equal to your usual sildenafil dose. A prescriber can help confirm the equivalent dose if you decide to change.
References
Smith BP, Babos M. Sildenafil [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023.
Actual Medicinal Product (AMP) - Hezkue 12.5mg/dose oromucosal spray [Internet]. Nhsbsa.nhs.uk. 2025 [cited 2026 Apr 9].
NHS. About Sildenafil (Viagra) [Internet]. nhs.uk. 2022.
Hezkue 12.5 mg/actuation - Summary of Product Characteristics (SmPC) - (emc) | 101466 [Internet]. Medicines.org.uk. 2024.
Hezkue 12.5mg/actuation – Patient Information Leaflet (PIL) – (emc) | 101466 [Internet]. Medicines.org.uk. 2024.
Sildenafil film-coated tablets - Patient Information Leaflet (PIL) - (emc) | 7124 [Internet]. Medicines.org.uk. 2022.
A Kaplan S, Moore J, Niecestro R. Pharmacokinetic Parameters of a Novel Sildenafil Oral Liquid Suspension Administered to Healthy Adult Men Under Fasted Conditions. International Journal of Science and Research (IJSR). 2024 Jun 5;13(6):759–64.