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* Priapism is a long-lasting and sometimes painful erection that doesn’t go away. It’s a medical emergency because it can damage the tissues in your penis and lead to permanent ED. This includes certain prescription drugs, such as nitroglycerin, used to treat angina (a type of chest pain). It also includes certain illicit drugs called poppers, such as amyl nitrate. Taking Viagra with nitrates can cause a dangerous drop in your blood pressure that can lead to heart attack or stroke. Examples of nitrate drugs that should not be taken with Viagra include: nitroglycerin (Nitromist, Nitro-Dur, Nitrolingual Pumpspray, Gonitro, others) isosorbide mononitrate (Monoket) isosorbide dinitrate (Dilatrate SR, Isordil) glyceryl trinitrate amyl nitrate alkyl nitrate butyl nitrate. Viagra and drugs for pulmonary arterial hypertension. You shouldn’t take Viagra if you’re taking the pulmonary arterial hypertension (PAH)* drugs listed below. Taking Viagra with these medications can cause your blood pressure to drop too low. Examples of drugs used to treat PAH that should not be taken with Viagra include: riociguat (Adempas) sildenafil (Revatio) tadalafil (Adcirca) * With PAH, you have high blood pressure in the artery between your heart and lungs. Taking Viagra with drugs used to treat high blood pressure can cause your blood pressure to drop even lower. Examples of drugs used to treat high blood pressure include: If you take a drug for high blood pressure, your doctor might prescribe a dose of Viagra for you that’s lower than the typical dose. If you’re taking a type of blood pressure drug called an alpha-blocker, the extra drop in blood pressure from Viagra could make you feel dizzy or lightheaded. If you’re taking an alpha-blocker, your doctor will recommend a starting dose of 25 mg of Viagra, which is lower than the usual starting dose. Examples of alpha-blocker drugs used for high blood pressure include: If you take one of the drugs listed above, tell your doctor if you feel dizzy or lightheaded, or faint after taking Viagra. You shouldn’t take Viagra with illicit drugs called poppers. Poppers contain nitrate drugs such as amyl nitrate, alkyl nitrate, and butyl nitrate. Taking Viagra with poppers can cause a dangerous drop in your blood pressure that can lead to heart attack or stroke. Viagra hasn’t been tested for use with illicit drugs other than poppers. But it’s possible that taking Viagra with certain other illicit drugs could also have dangerous effects on your heart and blood pressure. Examples of illicit drugs that could have dangerous effects if taken with Viagra include: stimulants, such as cocaine, ecstasy, amphetamines, and speed anabolic steroids. If you’re thinking of using illicit drugs with Viagra, talk with your doctor about whether this is safe for you to do. Certain drugs used to treat benign prostatic hyperplasia ( BPH)* can also cause low blood pressure. Taking Viagra with alpha-blockers can cause your blood pressure to drop even lower. This could make you feel dizzy or lightheaded, or even cause you to faint. Examples of alpha-blockers that are used to treat BPH include: alfuzosin (Uroxatral) doxazosin (Cardura) tamsulosin (Flomax) silodosin (Rapaflo) terazosin. If you’re taking an alpha-blocker, your doctor will recommend a starting dose of 25 mg of Viagra, which is lower than the usual starting dose. And if you take one of the drugs listed above, tell your doctor if you feel very dizzy, lightheaded, or faint after taking Viagra. Viagra hasn’t been tested for use with Adderall, so it’s not known what effects the drugs would have if taken together. But that doesn’t mean there wouldn’t be an interaction. Adderall, which contains amphetamine salts, is approved to treat attention deficit hyperactivity disorder (ADHD). Adderall has stimulant effects in your body, and it could cause serious heart-related side effects. Viagra, on the other hand, may cause low blood pressure. So it’s possible that taking it with Adderall could have dangerous effects on your heart or blood pressure. If you take Adderall, ask your doctor if it’s safe for you to take Viagra as well. Viagra hasn’t been tested for use with Xanax, so it’s not known what effects the drugs would have if taken together. But that doesn’t mean there wouldn’t be an interaction. Xanax, which is a benzodiazepine, contains the active drug alprazolam. Xanax can sometimes cause low blood pressure, dizziness, and fainting. So it’s possible that taking it with Xanax could have dangerous effects on your heart or blood pressure. If you take Xanax, ask your doctor if it’s safe for you to take Viagra as well. It’s usually fine to take Viagra with antidepressants. It’s important to note that erectile dysfunction (ED) is a common side effect of certain antidepressants. This is particularly true for selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft). And Viagra is sometimes prescribed to treat ED that’s caused by antidepressants. If you have questions about whether you can take Viagra with an antidepressant, talk with your doctor. Taking Viagra with certain antimicrobials (drugs used to treat infection) can slow the breakdown of Viagra in your body. This can cause Viagra to build up inside your body, which may increase your risk of side effects from the drug. Examples of antimicrobial drugs that can increase the risk of side effects from Viagra include: certain antibiotics, such as: clarithromycin erythromycin telithromycin (Ketek) certain antifungals, such as: ketoconazole (Nizoral) itraconazole (Sporanox) posaconazole (Noxafil) voriconazole (Vfend) certain antivirals used for HIV, such as: atazanavir (Reyataz) cobicistat (Tybost) ritonavir (Norvir) indinavir sulfate (Crixivan) nelfinavir mesylate (Viracept) saquinavir mesylate (Invirase) If you take one of the drugs listed above, your doctor will recommend you take a starting dose of 25 mg for Viagra. (This is lower than the typical starting dose of Viagra.) And if you take ritonavir, you shouldn’t take more than one 25-mg dose of Viagra within a 48-hour period. There aren’t any herbs or supplements that have been specifically reported to interact with Viagra. However, you should still check with your doctor or pharmacist before using any of these products while taking Viagra. There aren’t any foods that have been specifically reported to interact with Viagra. If you have any questions about eating certain foods with Viagra, talk with your doctor. Grapefruit juice can affect the levels of some medications in your body. But there’s not much evidence to show that the fruit or its juice can affect Viagra levels. It showed that drinking grapefruit juice with Viagra slightly increased people’s blood level of the drug. This could possibly increase the risk of certain side effects such as headaches, flushing, or dizziness. But these side effects weren’t specifically reported in the study. If you want to drink grapefruit juice or eat grapefruit while you’re taking Viagra, talk with your doctor. They can recommend whether this is safe for you to do. If you do have increased side effects with this combination, try avoiding grapefruit while you’re taking Viagra. You should take Viagra according to your doctor’s or healthcare provider’s instructions. For most people, it’s recommended that you take Viagra as needed, about 1 hour before you plan to have sex. But Viagra can actually be taken anywhere from 30 minutes to 4 hours before sexual activity. It’s important to remember that you shouldn’t take the medication more than once a day. But if you take it with a meal, the drug may take about an hour longer than usual to start working. This is especially the case if you eat a high-fat meal, such as a cheeseburger with fries. You don’t need to wait to take Viagra if you’ve recently eaten a meal. Just be aware that it might take a bit longer for the drug to work. It’s also important to remember that if Viagra gives you indigestion, taking the drug with food may help to reduce this side effect. The safety and effectiveness of Viagra tablets that are crushed, split, or chewed haven’t been tested. And Viagra tablets are meant to be swallowed whole. It’s not known if crushing or chewing the tablets will make them work any differently than usual. If you have trouble swallowing Viagra tablets, you might find it easier to swallow the tablet with different drinks, such as water, juice, or milk. Or talk with your doctor or pharmacist about how else you can take the drug. If you want to crush, split, or chew Viagra tablets, ask your doctor or pharmacist if this is safe to do. The Food and Drug Administration (FDA) approves prescription drugs such as Viagra to treat certain conditions. Viagra may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition. Viagra is FDA-approved to treat erectile dysfunction (ED) in males ages 18 years and older. With ED, you’re not able to get and keep an erection that’s firm enough to have sex. This condition is a common problem that’s experienced by many men. These include psychological or emotional problems, such as: performance anxiety relationship problems depression stress. But ED may also be caused by physical problems, such as: Viagra increases blood flow to your penis, which helps you have and maintain an erection. However, the drug itself doesn’t give you an erection. In several clinical studies, Viagra was effective in treating ED. In these studies, men who used the drug had an improved ability to have and keep erections that allowed for successful sex. Across the studies, between 43% and 83% of men who took Viagra had improved erections. (These success rates varied depending on the cause of their ED and the dosage of Viagra being used.) In comparison, improved erections occurred in 10% to 24% of men who took a placebo (no active drug). Some studies looked at the effect of different doses of Viagra. These studies, which involved 1,797 men, lasted up to 6 months. Improved erections were reported in: 63% of men who took 25 mg of Viagra 74% of men who took 50 mg of Viagra 82% of men who took 100 mg of Viagra 24% of men who took a placebo (no active drug) Effectiveness of Viagra for ED with different causes. Other studies have looked at the effect of Viagra in men whose ED had different causes. For example, one study specifically looked at men with ED that was related to complications of diabetes. Improved erections were reported in: 57% of men who took Viagra 10% of men who took a placebo. One study only involved men with ED that resulted from a spinal cord injury. Improved erections were reported in: 83% of men who took Viagra 12% of men who took a placebo. Also, using information from multiple studies, researchers looked at how well cheap generic sildenafil Viagra worked in men with ED that developed after they’d had surgery to remove their prostate gland. Improved erections were reported in: 43% of men who took Viagra 15% of men who took a placebo. In addition, men whose ED had psychological causes were specifically looked at as part of one study. Improved erections were reported in: 84% of men who took Viagra 26% of men who took a placebo. In addition to the use described above, Viagra may be used off-label. Off-label drug use is when a drug that’s approved for one condition is given for a different condition that’s not approved. Below is an example of an off-label use for Viagra. Viagra isn’t approved to treat Raynaud’s disease, but sometimes it’s used off-label for this condition. With Raynaud’s disease, the blood vessels in your hands and feet spasm and temporarily become narrowed. These narrowed blood vessels restrict blood supply to your fingers or toes. This can cause your fingers and toes to look white and feel cold, painful, or numb. Episodes of spasm can be triggered by cold temperatures or emotional stress. Viagra works to treat Raynaud’s disease by relaxing and widening certain blood vessels in your body. One review of studies found that PDE5 inhibitors, including Viagra, can improve Raynaud’s disease. (PDE5 inhibitors describes a certain class of drugs. Medications in the same class of drugs work in a similar way inside your body.) In fact, in the studies, these drugs reduced the number of Raynaud’s disease episodes people had. And the drugs also decreased how long the episodes lasted. If you have questions about using Viagra for Raynaud’s disease, talk with your cheap generic sildenafil doctor. Viagra is only approved for use in adult males with ED. It hasn’t been studied in people younger than 18 years of age. Viagra is approved to treat erectile dysfunction (ED) in men. But you may have questions about whether Viagra can be used in women. Or you may be wondering if there’s a drug similar to Viagra that can help women with sexual dysfunction. And there isn’t enough evidence to show that Viagra works for treating sexual problems in women. One review of studies showed that current research has conflicting results on how Viagra affects women. For example, in women with female sexual arousal disorder, the review showed the following findings: In one study, some women who’d gone through menopause were given Viagra. These women had improved arousal, vaginal lubrication, and orgasm when they took the drug. In another study, both women who’d gone through menopause and those who hadn’t were given Viagra. These women reported no significant positive effects from taking the drug. In men, Viagra improves blood flow to their penis by blocking the action of a chemical called PDE5. This chemical is also found in the vagina and the clitoris of women. So in theory, if a woman takes Viagra, it could increase blood flow to her genitals. But in reality, there’s less PDE5 in a female’s genitals than there is in a male’s penis. This could explain why Viagra has less of a physical effect in women than it does in men. And keep in mind that sexual problems in women often have a lot to do with reduced sexual desire and arousal. While Viagra isn’t approved for use in women, a drug called Addyi is approved for use in certain women. Some people refer to Addyi as “female Viagra.” However, Addyi doesn’t work like Viagra does. Below, we describe the condition Addyi is approved to treat and how the drug works. If you have questions about using Addyi, talk with your doctor. Addyi is a brand-name prescription drug that’s approved to treat hypoactive sexual desire disorder (HDSS). It’s prescribed for women who haven’t yet gone through menopause. It’s not known for sure how Addyi works to treat HDSS. With HDSS, you have very low sexual desire that’s troublesome for you. The condition can have various physical or psychological causes. Unlike Viagra, which improves blood flow to male genitals, Addyi doesn’t work by improving blood flow to female genitals. Instead, Addyi affects the activity of certain neurotransmitters that are involved in sexual desire and arousal. (Neurotransmitters are chemicals found in your brain.) The neurotransmitters affected by Addyi include dopamine, noradrenaline, and serotonin. But it’s not known for sure how the drug’s action affects sexual function. For some women with HDSS, Addyi can improve sexual desire and increase the number of sexually satisfying events. But the drug hasn’t been found to be very effective. For example, in clinical studies, treatment with Addyi was compared with that of a placebo (no active drug). The number of women whose HDSS was “much improved” or “very much improved” was only about 10% higher in women who took Addyi compared with women who took the placebo. And keep in mind that it can take up to 8 weeks for Addyi to start working to treat HDSS. When you get Viagra from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication. The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it. How long a medication remains good (also called shelf-life) can depend on many factors. These factors include how and where you store the medication. Viagra tablets should be stored at room temperature between 68 o F and 77°F (20 o C and 25°C). It should be kept in a tightly sealed container away cheap generic sildenafil from light. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms. If you no longer need to take Viagra and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment. This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication. Using more than the recommended dosage of Viagra can lead to serious side effects. Do not use more Viagra than your doctor recommends. What to do if you think you’ve taken too much Viagra. If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away. Before taking Viagra, talk with your doctor about your health history. Viagra may not be right for you if you have certain medical conditions or other factors affecting your health. These include: History of allergic reaction to Viagra or sildenafil. Don’t take Viagra if you’ve ever had an allergic reaction to Viagra or sildenafil (the active drug in Viagra). If you’re not sure of your medication allergies, talk with your doctor. If you have a heart problem, or you’ve had a heart problem or stroke in the past, talk with your doctor about whether Viagra is safe for you. Heart problems include conditions such as angina (a type of chest pain), heart attack, heart failure, and aortic stenosis (narrowing of the main artery that leaves your heart). Heart problems also include irregular heartbeat patterns, such as atrial fibrillation (A-fib). Taking Viagra and having sexual activity may not be recommended if your doctor thinks that doing so will put too much strain on your heart. If you have a heart problem and you take Viagra, stop sexual activity if you get any chest pain, dizziness, or nausea. And don’t take nitrate medications to treat chest pain while you’re using Viagra. If you have any heart-related symptoms, call 911 if the symptoms feel life threatening or if you think you’re having a medical emergency. And be sure to see your doctor before taking Viagra again. If you’re taking medication to treat high blood pressure, taking Viagra could cause your blood pressure to drop even further. In some cases, this could make you feel dizzy or lightheaded, or cause you to faint. And if you have high blood pressure that’s not controlled (measuring higher than 170/110 mmHg), your heart may not be healthy enough for sex. If you have high blood pressure, talk with your doctor about whether Viagra is right for you. If you’re able to take Viagra, your doctor will usually prescribe a dosage for you that’s lower than the typical dosage. If you already have low blood pressure, taking Viagra can make it drop even further. This could make you feel dizzy or lightheaded, or cause you to faint. If your blood pressure is below 90/50 mmHg, talk with your doctor about whether Viagra is right for you. If you are able to take Viagra, your doctor will usually prescribe a dosage for you that’s lower than the typical dosage. If you have problems with your penis, such as bending, scarring, or Peyronie’s disease, it might not be safe for you to take Viagra. (With Peyronie’s disease, you have an abnormal curvature of your penis.) Rarely, Viagra may cause priapism (a long-lasting and sometimes painful erection). If you have a physical problem affecting your penis, getting priapism with Viagra could cause further damage to your penis. Talk with your doctor about whether Viagra is right for you. If you have a blood cell problem, such as sickle cell anemia, multiple myeloma, or leukemia, Viagra may not be safe for you. This is because having these conditions could increase your risk of priapism (a long-lasting and sometimes painful erection) with Viagra.
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