Viagra

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 02, 2022

Warnings

What are the risks of taking Viagra (sildenafil)?

Viagra (sildenafil) is not for everyone. It is prescribed to adult men aged 18 and above to treat erectile dysfunction. It is not given to women and children. Viagra can cause serious health problems in certain high-risk patients.

Some of the serious risks of Viagra (sildenafil citrate) use include:

Stroke or heart attack: Viagra is not recommended in patients who have had a stroke, heart attack, or symptoms of heart failure in the last six months. The safety of Viagra has not been studied in such patients. Talk to your doctor about other treatment options for erectile dysfunction if you have an existing heart condition.
Low blood pressure: You should not use Viagra if you are on treatment for chest pain (angina) with nitrate medications. This can lead to a dangerous drop in blood pressure. Likewise, patients treated with a class of drugs called alpha-blockers for high blood pressure should use Viagra with caution. If you’re taking alpha-blockers for hypertension and use Viagra, keep an eye on your blood pressure readings. Also, be sure to rise from a sitting or lying position slowly—rising quickly can lead to dizziness and falls. Restrict your alcohol consumption as it can cause a drop in blood pressure.
Priapism: This is a condition in which an erection lasts beyond 4 hours. It is a rare side effect of Viagra but a serious one that requires emergency treatment. If you don’t get medical attention, it can lead to permanent and irreversible damage to the penis.
Hearing loss: Rarely, Viagra can cause an adverse effect of hearing loss. If you experience symptoms such as tinnitus (ringing in the ears), dizziness, or difficulty hearing after taking Viagra, go to the emergency room without delay.
Vision difficulties: Viagra can cause vision changes or vision loss in one or both eyes. Although rare, this adverse effect requires immediate medical attention to prevent permanent eye damage. If you experience any vision changes after taking Viagra, go to the emergency room immediately.
High-risk groups: Elderly patients (ages 65+), patients with liver or kidney disease, and those taking blood pressure medications, nitrates, alpha-blockers, or certain HIV drugs are at increased risk of Viagra side effects. Talk to your doctor about other treatment options for erectile dysfunction if you are in any of these categories.

Your doctor can prescribe other treatments for erectile dysfunction if you are at a high risk of side effects or complications from Viagra use.

Talk to your doctor or pharmacist about other treatment options if Viagra is not an option for you.

What should I tell my doctor before starting Viagra (sildenafil)?

Viagra is not for women or children. Only adult men aged 18 and over should use Viagra after obtaining medical advice, diagnosis, or treatment options from a healthcare professional.

Tell your health care professional about all your medical conditions—Viagra tablets may not be suitable for people with certain medical conditions such as heart disease, liver disease, or kidney disease. Viagra should also be used with caution in patients with anatomical (structural) defects of the penis and patients at risk of priapism.

Also, tell your doctor about all your current medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal products. This can help avoid serious drug interactions.

Be sure to tell your doctor if you have previously had an allergic reaction to Viagra (sildenafil) or other PDE-5 inhibitors that are used to treat erection problems or pulmonary arterial hypertension.

What precautions should I take while on Viagra (sildenafil)?

Tell all your doctors that you take Viagra. If you need emergency medical care, especially for chest pain where you potentially will be receiving nitroglycerin, your health care providers should know when you took your last dose of Viagra.

Do not use Viagra if you are on treatment with nitrate drugs for angina (chest pain), such as nitroglycerin, isosorbide, Nitro-Bid®, Imdur®, Nitro-Dur®, Nitrostat®, and Nitrolingual® spray.

Tell your doctor if you drink alcohol or use recreational drugs. For example, taking Viagra with poppers, which contains nitrites, can cause serious and potentially fatal cardiovascular complications.

Do not use Viagra with other medications or devices for erection problems.

Get emergency medical care if you experience priapism (an erection that lasts more than 4 hours), sudden vision loss in one or both eyes, sudden decrease in hearing, or hearing loss.

Viagra will not protect you against sexually transmitted infections, including HIV/AIDS. Talk to your doctor if you have questions about preventing sexually transmitted diseases.

What drugs can interact with Viagra (sildenafil)?

Taking Viagra with some other medications can affect its efficacy or lead to severe adverse reactions. Therefore, your physician may decide not to treat you with Viagra or change some of your medications if interactions occur.

Using Viagra with the following medications is not recommended:

Certain antiretroviral drugs used for HIV treatment
Riociguat (Adempas) used for pulmonary hypertension treatment
Nitrates used in patients with heart disease

There can also be interactions between Viagra and the following medicines:

HIV drugs such as indinavir, ritonavir, atazanavir
Certain antibiotics such as clarithromycin, erythromycin, or telithromycin
Certain antifungals such as voriconazole, itraconazole, fluconazole

Certain hepatitis medication such as simeprevir

Cancer agents such as lorlatinib

This list does not describe all possible Viagra interactions. Give your health care provider a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal products to avoid any potential interactions. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with Viagra.

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