Does Viagra have any Interactions?

Viagra (sildenafil) treats erectile dysfunction by promoting blood flow to the penis when you are sexually aroused. This ED drug works best if you take it about an hour before sex, but it can work in as quickly as 30 minutes.

How long Viagra stays in your body depends on several factors, including your metabolic rate, age, and liver and kidney health. When sildenafil is in your bloodstream, taking other medications may cause an interaction to occur. Read on to learn why some drug interactions are potentially dangerous and how you can avoid them.

What are Interactions?

An interaction occurs when something you eat (or drink) affects how a drug behaves in your body. Some interactions do not alter the drug’s effect too much, but others may cause serious side effects. Other medications, herbal remedies, supplements, and some food and beverages can all potentially cause interactions.

Complications are likely if an interaction reduces the body’s ability to metabolize and excrete the medication, leading to dangerously high concentrations in your bloodstream. An interaction can also significantly reduce the efficacy of a drug, offsetting the benefits entirely.

Can You Take Viagra with Other Erectile Dysfunction Drugs?

The Viagra pill should not be taken with other phosphodiesterase type 5 (PDE5) inhibitors, including tadalafil, vardenafil, and avanafil. PDE5 inhibitors work by dilating the blood vessels and, in doing so, lower your blood pressure ever so slightly. If you combine ED drugs, your blood pressure may drop suddenly and cause symptoms such as blurred vision, nausea, and fatigue. Low blood pressure (hypotension) can potentially be life-threatening and can cause shock if left untreated.

Nitrate drugs can also cause hypotension when taken with Viagra. Nitrates are used to treat chest pain (angina) and are necessary for many people who have heart disease. However, taking nitrates with sildenafil can lead to a heart attack or stroke. ¹ The use of Viagra is contraindicated if you take nitrates. Examples of nitrates include nitroglycerin, glyceryl trinitrate, and amyl nitrate.

If you have high blood pressure, your medications may interact with Viagra. Hypertension is treated with a wide variety of medications that belong to several different categories, depending on their mechanism of action. Some of the classifications are calcium-channel blockers, beta-blockers, alpha-blockers, diuretics, and ACE inhibitors, to name a few. Like nitrates, these blood pressure meds can cause hypotension when taken with sildenafil. However, when taken properly and with the knowledge of your medical doctor, the risk is lower. Specific examples of antihypertensives that interact with Viagra include:

• Doxazosin
• Losartan
• Amlodipine
• Terazosin
• Metoprolol

If you have a condition called pulmonary arterial hypertension (PAH), you may be on a medication called riociguat, which is different than the typical high blood pressure medications, yet can be very dangerous if taken with viagra.

Drugs that Increase Viagra in the Blood

Sildenafil is mostly metabolized and excreted by the CYP3A4 enzyme pathway. If you take any medication that is a CYP3A4 inhibitor, your body may not expel Viagra properly. As a result, high concentrations of sildenafil may accumulate in your bloodstream. Unsafe levels of Viagra increase your risk of prolonged erections. While longer-lasting erections don’t sound like a bad thing, erections that last more than four hours can be painful and lead to irreversible muscle damage. The list of CYP3A4 inhibitors is long, but some examples include:

• Itraconazole/Ketoconazole (antifungals)
• Ritonavir/Indinavir (HIV drugs)
• Verapamil/Digoxin/Amiodarone (heart arrhythmia drugs)
• Clarithromycin/Erythromycin (a class of antibiotics)

Interactions that Offset the Benefits of Viagra

The opposite of a CYP3A4 inhibitor is a CYP3A4 inducer. Again, the list is extensive but includes phenobarbital (a strong sedative and anti-seizure med), phenytoin (an anti-seizure med), and rifampin (a class of antibiotics). Drugs in this class cause the liver enzymes to work more effectively, meaning the Viagra you take can be excreted before it has a chance to work.

If you are a heavy drinker, Viagra may not work well for you. Excessive alcohol use interacts with Viagra the same way nitrate drugs do, lowering your blood pressure and worsening side effects like headaches, dizziness, and flushing. ² Life-threatening interactions with alcohol are very rare, but drinking regularly can still offset the benefits of Viagra and worsen your ED symptoms.

How to Take Viagra with Drugs that Interact

If your medications interact with Viagra, you will likely need to stop taking sildenafil at this time. But stopping any concurrent medication, especially a regularly taken one, can negatively affect your health. During your online consultation, a physician may suggest alternative treatment options like exercise, diet change, or in-person treatment to help your ED symptoms. However, it’s possible that they may adjust your dosage to accommodate both drugs. Reducing the dosage can often minimize the risk of side effects and allow you to continue treatment. ³ Regardless, speaking with a doctor is an essential matter.

If you are unsure whether your medications interact with sildenafil or if Viagra is right for you, visit mailMymeds for an online consultation today. Erectile dysfunction doesn’t have to control your life, and ED drugs like Viagra medication have a high success rate in improving symptoms.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.