Hezkue is a prescription treatment for erectile dysfunction (ED) that contains sildenafil, the same active ingredient used in Viagra and generic sildenafil tablets. But instead of being swallowed as a tablet, Hezkue is a minty spray administered onto the tongue and then swallowed immediately.
It’s the first licensed sildenafil spray available in the UK for men with erectile dysfunction. For some people, its format makes treatment feels easier, more discreet, and more flexible to use.
If you’re curious about whether the spray format might suit you better than tablets, here’s what to expect from Hezkue and how it supports erectile dysfunction.
In this article:
How does Hezkue help with erectile dysfunction?
How much Hezkue should I take and when?
How do I use Hezkue spray?
What makes Hezkue different from sildenafil tablets?
Who might find Hezkue a good option?
Are there any side effects of Hezkue to be aware of?
Who shouldn’t take Hezkue?
Could Hezkue be right for me?
How does Hezkue help with erectile dysfunction?
Because Hezkue contains sildenafil, it works in the same way as tablet treatments: by improving blood flow to the penis during sexual stimulation.
Erections rely on healthy blood flow. When you feel aroused, the brain sends signals that tell the blood vessels in the penis to relax and widen. This allows more blood to flow into the penis and become temporarily trapped there, causing an erection.
The active ingredient in Hezkue belongs to a group of medicines called PDE5 inhibitors. These medicines block an enzyme phosphodiesterase type 5 (PDE5), which normally breaks down the signals that help keep blood vessels relaxed. By slowing this process, sildenafil helps blood to flow into the penis during sexual arousal so that erections become easier to achieve and maintain (1).
Like other sildenafil treatments, Hezkue doesn’t cause an automatic erection. Sexual stimulation is still needed for the medicine to work (2).
How much Hezkue should I take and when?
Hezkue is usually taken about one hour before sexual activity (3). Its effects can last up to four to five hours.
Sprays of Hezkue | Sildenafil dose | Tablet equivalent |
|---|---|---|
2 sprays | 25mg | Equal to one 25mg tablet |
4 sprays | 50mg | Equal to one 50mg tablet |
8 sprays | 100mg | Equal to one 100mg tablet |
Each pump of the spray delivers 12.5mg of sildenafil, allowing the dose to be adjusted in small steps depending on how well the treatment works for you. Below are the typical doses:
A 30ml bottle contains approximately 20 doses at 25mg, 10 doses at 50mg, or 5 doses at 100mg. This depends on the strength prescribed for you and how many sprays you use each time.
Most men begin with four sprays, equivalent to 50mg of sildenafil and the same standard starting strength as sildenafil tablets (2,3). If needed, this can be adjusted. Men taking alpha-blockers require a lower starting dose of 25mg (2 sprays) and caution due to risk of postural hypotension.
The maximum recommended dose is eight sprays (100mg) within 24 hours. Do not exceed this dose. If you do, seek medical attention immediately.
How do I use Hezkue spray?
Before using Hezkue for the first time, the pump needs to be primed according to the instructions in the patient information leaflet (4). Once the bottle is ready:
Shake the bottle gently
Spray the required number of sprays on your tongue
Swallow the liquid immediately
Hezkue can be taken with or without food, although a heavy meal may delay how quickly it starts working. We also recommend limiting your alcohol intake when using this medicine, as alcohol can affect your erections (5).
Once opened, the bottle can be used for up to 10 months.
What makes Hezkue different from sildenafil tablets?
Hezkue and sildenafil tablets contain the same medicine, so the effects are the same. The main difference is in how the treatments are taken.
Instead of swallowing a tablet with water, Hezkue is sprayed onto the tongue and swallowed. This spray format offers a few practical benefits:
No tablet to swallow: Because Hezkue is sprayed directly into the mouth, there’s no need for water. This can be helpful if you find tablets difficult to take.
Doses can be adjusted precisely: Each spray delivers 12.5mg of sildenafil, while the smallest tablets contain 25mg. This allows doses to be adjusted in smaller steps, which may help your prescriber tailor treatment more precisely.
Easier to use when you’re out or travelling: The Hezkue spray bottle is compact and the medicine can be taken discreetly when needed.
Absorption begins quickly: In a study comparing the spray with tablets, sildenafil from Hezkue was detected in the bloodstream within 5 minutes* (6). This suggests the medicine may start being absorbed sooner than tablet forms.
Better absorption in fed state: Clinical data suggests Hezkue maintains consistent absorption whether taken with food or on an empty stomach, unlike conventional sildenafil tablets where a fatty meal can significantly reduce and delay the effect (7).
Despite these practical benefits, some men prefer tablets because they’re already familiar with them. The best treatment usually comes down to what feels easiest and most comfortable for you.
*In fasted healthy male volunteers. Note, the clinical significance of this faster initial absorption has not been formally evaluated.
Who might find Hezkue a good option?
Hezkue is licensed for adult men with erectile dysfunction. It may be particularly suitable if you:
Prefer not to swallow tablets
Want a more discreet treatment option
Are already using sildenafil but would like a different format
Would benefit from flexible dose adjustments
Most patients try sildenafil tablets first due to cost, but Hezkue can be a helpful alternative for anyone on sildenafil who is looking for a different way to take a familiar, well-established medicine.
Are there any side effects of Hezkue to be aware of?
Because Hezkue contains sildenafil, its side effects are similar to sildenafil tablets and are usually mild and short-lived. The most common side effect is headache, but some men also notice (3):
Facial flushing
Nasal congestion
Dizziness
Nausea
Indigestion
Temporary visual changes
Because Hezkue is taken as a spray, a small number of people may also notice a mild change in taste or slight mouth or throat irritation after use.
Serious side effects are rare, but you should seek urgent medical advice if you experience chest pain during sexual activity, sudden vision loss, or an erection lasting longer than four hours.
Who shouldn’t take Hezkue?
Like sildenafil tablets, Hezkue isn’t suitable for everyone with erectile dysfunction. It should not be used if you take nitrate medicines for chest pain or recreational drugs sometimes known as “poppers”, as this combination can cause a dangerous drop in blood pressure (3,8).
Hezkue is also unsuitable for men taking riociguat or another PDE5 inhibitor, those who have recently had a heart attack or stroke, men with severe liver problems, low blood pressure, certain inherited retinal conditions, or those for whom sexual activity is inadvisable due to severe cardiovascular conditions such as unstable angina or heart failure. Men who have previously lost vision in one eye due to a condition called non-arteritic anterior ischaemic optic neuropathy (NAION) should also not take Hezkue (3,8).
Hezkue Sildenafil Spray should also not be used by women or anyone under the age of 18.
If you’re unsure whether Hezkue is safe for you, a doctor or pharmacist can check during your consultation.
Could Hezkue be right for me?
Choosing an erectile dysfunction treatment isn’t just about what works — it’s also about what feels easiest and most comfortable to use. For some men, a spray offers a simpler alternative to tablets without changing how the medicine itself works.
If you’re exploring treatment for ED, an online consultation can help determine whether Hezkue is appropriate for you and whether another option might be a better fit.
Complete your online consultation or discover more about Hezkue here.
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FAQs
1. Does Hezkue work faster than sildenafil tablets?
Early absorption data shows that sildenafil from Hezkue spray was detectable in the bloodstream within 5 minutes*, compared to no detection of sildenafil in the bloodstream at the same time from Viagra 100mg tablets (6). However, both tablets and sprays are typically taken around 1 hour before sexual activity and the clinical significance of this absorption has not been formally evaluated.
*In fasted healthy males.
2. Can I use Hezkue after eating?
Yes. Hezkue has been shown not to carry the same negative food effect unlike sildenafil tablets, meaning a meal is less likely to delay how well it works (7). That being said, Hezkue may still take longer to work after a heavy meal. Timings with food and size of meal are worth considering.
3. How long does one bottle of Hezkue last?
A 30ml bottle contains enough for up to 20 doses at the 25mg strength (2 sprays), 10 doses at the standard 50mg starting dose (4 sprays), or five doses at the maximum 100mg strength (8 sprays). Once opened, the bottle can be used for up to 10 months.
4. Can I take Hezkue if I am on blood pressure medication?
It depends on the specific medication. Hezkue is contraindicated with nitrates and should not be used with other PDE5 inhibitors. If you take alpha-blockers, a lower starting dose of 25mg (2 sprays) is recommended due to the risk of a drop in blood pressure. Just as with Sildenafil tablets, you should always tell your prescriber about any medicines you take before starting Hezkue.
References
NHS. About Sildenafil (Viagra) [Internet]. nhs.uk. 2022.
‌NHS. How and when to take sildenafil [Internet]. nhs.uk. 2022.
Hezkue 12.5 mg/actuation, white to off-white oromucosal suspension with a mint aroma flavour - Summary of Product Characteristics (SmPC) - (emc) | 101466 [Internet]. Medicines.org.uk. 2025.
NHS. Common questions about sildenafil [Internet]. nhs.uk. 2022.
‌Hezkue 12.5mg/actuation, oromucosal spray, suspensionsildenafil – Patient Information Leaflet [Internet]. Medicines.org.uk. 2025.
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.
S Kaplan, G Barnes, K Clarkson, N Guralnik, S Brookman-May. Clinical Pharmacology and Real-World Performance of Hezkue: A Novel Sildenafil Oral Suspension Without the Negative Food Effect Seen in Conventional Formulations. The Journal of Sexual Medicine, Volume 22, Issue Supplement_4, November 2025.
‌NHS. Who can and cannot take sildenafil [Internet]. nhs.uk. 2022.