I think you are missing the point, Andy - for men for whom it works, the 5mg dose keeps the levels topped up enough for sex on demand. That is a hard thing to give up.
Gilo, the GP is following NICE guidelines. You are entitled to sex 4 times per month, whether that is 4 injections, 4 tablets, 4 pellets. In the areas where the CCG allows the daily dose Cialis (and there are not so many of them any more) it is approved only for nerve repair post-op so you have been very lucky to get it for so long. There is the minor matter of no deal Brexit as well, I understand it is on the list of drugs that will be in short supply along with viagra and most of the BPH drugs.
Not much consolation for you but you could get a pill cutter and take half a tablet every 3 - 4 days instead. Even better, you could ask for 4 x 20mg - the 4 tablets per month is regardless of whether that is 10mg or 20mg. You may have to give up the sex on demand lifestyle though :-(
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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That was exactly my point - if you haven't tried stopping taking it, you don't know if you need it anymore (or indeed for the last ~6 years).
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That is over-simplistic - until you have had PCA treatment related ED for 9 years, you cannot imagine the emotional impact of having your meds taken away. I have been there and am still living it. John does't have mechanical ED but the psychological damage means that without a little magic tablet, nothing is going to rise.
That's not to say that taking 10mg every 3 or 4 days won't keep the levels up enough for Gilo to carry on as before, but it is less likely.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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I was on Tadalafil 5mg daily, and I had a letter from somewhere in the NHS (not my GP) saying my prescription was being changed to Sildenafil for financial reasons, which gives me nausea.
My GP simply over-rode it and carried on prescribing Tadalafil 5mg.
Cheers, John.