Hezkue Sildenafil Suspension Spray

Hezkue Spray for Erectile Dysfunction Treatment

What is Hezkue spray used for?

Hezkue sildenafil spray is a prescription medicine used to treat erectile dysfunction (ED), sometimes called impotence, in adult men. ED is when you can’t get or keep an erection firm enough for sex.

ED is very common, affecting around half of men aged 40 to 70 to some degree. It can have physical or psychological causes, including stress and anxiety and being overweight.

Hezkue will only help you get an erection if you’re sexually stimulated. It doesn’t cause an erection on its own.

How does Hezkue spray work?

Hezkue contains sildenafil, which belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. It’s the same active ingredient found in Viagra.

When you’re sexually excited, sildenafil relaxes the blood vessels to increase blood flow to your penis. This helps you get and maintain an erection.

Hezkue is the first and only liquid sildenafil treatment licensed for ED in the UK. Instead of a tablet, it comes as a mint-flavoured liquid that you spray onto your tongue and swallow with your saliva. Each spray releases 12.5mg of sildenafil, so your prescriber can adjust your dose by changing the number of sprays.

Who can use Hezkue Sildenafil oral spray?

Hezkue is suitable for men aged 18 and over with erectile dysfunction. It isn’t for women or anyone under 18, and you shouldn’t use it if you don’t have ED.

Don’t take Hezkue if you:

• Are allergic to sildenafil or any of the other ingredients
• Take nitrates, which are often prescribed for angina (chest pain)
• Use nitric oxide donors such as amyl nitrite (“poppers”)
• Have a severe heart or liver problem
• Have recently had a stroke or heart attack, or have low blood pressure
• Have a rare inherited eye condition such as retinitis pigmentosa
• Have ever lost vision due to non-arteritic anterior ischaemic optic neuropathy (NAION)
• Take riociguat for high blood pressure in the lungs

Speak to your doctor or pharmacist before taking it if you:

• Have sickle cell anaemia, leukaemia or multiple myeloma
• Have a deformity of the penis or Peyronie’s disease
• Have any heart problems, as your doctor will need to check your heart can cope with the extra strain of sex
• Have a stomach ulcer or a bleeding problem such as haemophilia
• Have kidney or liver problems, as you may need a lower dose

How to Use Hezkue Spray

The usual starting dose is 4 sprays (50mg) about an hour before sex. Your prescriber may lower this to 2 sprays (25mg) or raise it to 8 sprays (100mg), and you shouldn’t use Hezkue more than once a day.

1. Shake the bottle well for about 20 seconds.
2. Remove the child-resistant cap by pushing it down firmly and turning it anticlockwise.
3. Slide the plastic tube of the dosing pump into the bottle and screw the pump on clockwise until it’s firmly attached.
4. Turn the nozzle to the open position.
5. Prime the pump by pressing it three times into a tissue or other absorbent material. Do this before every dose.
6. Tilt your head back a little, open your mouth and hold the bottle next to your chin.
7. Press the pump the number of times you’ve been prescribed, spraying onto your tongue, and swallow straight away with your saliva. Try not to let the pump touch your mouth or tongue.
8. Turn the nozzle to the closed position, unscrew the pump and tap the tube against the inside of the bottle to remove any excess liquid.
9. Put the child-resistant cap back on straight away.
10. Wash the pump with water, press it a few times into absorbent material to clear it and let it dry fully before your next dose.

How long does Hezkue take to work?

Use Hezkue about an hour before you plan to have sex. In clinical studies of sildenafil, the typical time for men who hadn’t eaten to get an erection firm enough for sex was 25 minutes, with times ranging from 12 to 37 minutes.

It may take longer to start working if you use it after a heavy meal. You’ll also need to be sexually stimulated for it to work.

How long does Hezkue spray last?

In studies of sildenafil, men were still able to get an erection in response to sexual stimulation around 4 to 5 hours after taking a dose.

This doesn’t mean you’ll have an erection for that whole time. Sildenafil only helps you get an erection when you’re sexually aroused.

How does Hezkue spray compare with Viagra tablets and other ED treatments?

Hezkue, Viagra and generic sildenafil tablets all contain the same active ingredient, sildenafil, and are used in the same way: about an hour before sex and no more than once a day. The doses match too, as 2, 4 or 8 sprays of Hezkue give 25mg, 50mg or 100mg of sildenafil.

The main difference is the format. Hezkue is sprayed onto your tongue and swallowed with your saliva, so there’s no tablet to swallow and no water needed. This may suit men who find tablets difficult to swallow.

In one study comparing 100mg doses, sildenafil was detected in the blood within 5 minutes of using the spray, earlier than with tablets, although overall absorption was similar. This doesn’t necessarily mean Hezkue will work faster for you, so it’s still best to use it about an hour before sex.

Other ED treatments work in a similar way but differ in how long they last. Cialis tablets contain tadalafil and can last up to 36 hours, while Cialis Daily is a low dose taken every day so you don’t need to plan around sex. If you’d prefer a tablet with the same active ingredient as Hezkue, sildenafil tablets such as Aronix are another option.

Choosing between a sildenafil spray and tablets usually comes down to personal preference. Our pharmacists can help you work out which option suits you during your consultation.

Hezkue Spray Side Effects

Like all medicines, Hezkue can cause side effects, although not everybody gets them.

Very Common Side Effects

These may affect more than 1 in 10 people:

• Headache

Common Side Effects

These may affect up to 1 in 10 people:

• Nausea or indigestion
• Flushing of the face or a sudden feeling of warmth in the upper body
• Blurred vision, changes to your vision or colours looking different
• Blocked nose
• Dizziness

Uncommon Side Effects

These may affect up to 1 in 100 people:

• Vomiting, upper stomach pain, heartburn or a dry mouth
• Skin rash
• Eye irritation, pain, redness, discharge or watery eyes
• Seeing flashing lights, sensitivity to light or changes in how bright things look
• Palpitations or a fast heartbeat
• High or low blood pressure
• Muscle pain or pain in your arms or legs
• Feeling drowsy, tired or hot
• Reduced sense of touch
• Vertigo or ringing in the ears
• Blocked sinuses, a runny nose or sneezing
• Nosebleeds
• Blood in your urine

Rare Side Effects

These may affect up to 1 in 1,000 people:

• Fainting
• Stroke, heart attack or an irregular heartbeat
• A temporary reduction in blood flow to parts of the brain
• Tightness in the throat or numbness in the mouth
• Bleeding at the back of the eye, double vision or less sharp vision
• Swelling of the eye or eyelid, an unusual feeling in the eye, spots in your vision, halos around lights, widened pupils or a change in colour of the whites of the eyes
• Bleeding from the penis or blood in your semen
• A dry or swollen nose
• Feeling irritable
• A sudden decrease or loss of hearing

Unstable angina and sudden death have also been reported rarely in men using sildenafil. Most of the men affected had heart problems before taking it, and it isn’t possible to say if sildenafil caused these events.

Serious Side Effects

These may affect up to 1 in 100 people or fewer. Contact a doctor straight away if you have:

• Signs of an allergic reaction, such as sudden wheezing, shortness of breath, dizziness or swelling of the eyelids, face, lips or throat
• Chest pain during or after sex. Get into a semi-sitting position, try to relax and don’t use nitrates to treat the pain
• An erection that lasts more than 4 hours
• A sudden decrease or loss of vision
• A serious skin reaction, such as severe peeling and swelling of the skin, blisters in the mouth, bumps on the genitals or around the eyes, or a fever
• Seizures or fits

If you get any side effects, including any not listed here, talk to your doctor or pharmacist. You can also report them through the MHRA Yellow Card scheme.

Hezkue Spray Ingredients

Active ingredient: sildenafil 25mg per ml (12.5mg per spray)

Other ingredients: sodium benzoate, anhydrous citric acid, sucralose, acesulfame potassium, hypromellose, xanthan gum, peppermint flavour, masking flavour and purified water

Warnings and Precautions

• Don’t use Hezkue with any other oral or local ED treatment, or with treatments for pulmonary arterial hypertension that contain sildenafil or another PDE5 inhibitor.
• Tell your doctor or pharmacist about any other medicines you take. If you take protease inhibitors for HIV, you may be started on a lower dose of 2 sprays (25mg).
• If you take an alpha-blocker for high blood pressure or an enlarged prostate, you may feel dizzy or light-headed when sitting or standing up quickly, most often within 4 hours of using Hezkue. You should be on a regular daily dose of your alpha-blocker before you start, and you may be given a lower dose.
• Tell your doctor or pharmacist if you take sacubitril/valsartan for heart failure.
• In a medical emergency, tell the doctor, pharmacist or nurse treating you that you’ve used Hezkue and when.
• Hezkue can cause dizziness and affect your vision, so know how you react to it before you drive or use machinery.
• Hezkue is for use in the mouth only. Don’t spray it into your nose or onto your skin.
• Always prime the pump before each dose, as skipping this can give you a lower dose than prescribed.
• Stop using the bottle once the liquid drops below the red line on the bottom, and don’t use it more than 10 months after first opening. Write the date you opened it on the box.
• Hezkue contains less than 1mmol (23mg) of sodium per ml, so it’s essentially sodium-free.