Is Viagra Safe for ED?
If you’ve ever looked into treatment options for erectile dysfunction (ED), you’ve almost certainly heard of Viagra®.
First launched in the late 1990s, Viagra is arguably the most well-known medication for treating ED.
Viagra contains the active ingredient sildenafil, a PDE5 inhibitor that improves blood flow to your penis and makes it easier to get and maintain an erection.
How safe is Viagra? For most men, Viagra is a safe and effective medication. However, as with all medications, Viagra can potentially cause side effects and interactions that you should know about before taking it to treat ED.
Below, we’ve explained how Viagra works, as well as the side effects and interactions that it can cause.
We’ve also addressed a few of the most common safety myths about Viagra and other common ED medications.
How Does Viagra Work?
Sildenafil, the active ingredient in Viagra, belongs to a class of drugs called phosphodiesterase type 5 inhibitors, or PDE5 inhibitors.
These medications work by inhibiting the effects of the PDE5 enzyme, which is responsible for contracting the blood vessels that supply blood to your penis.
This increases blood flow, making it easier for you to get an erection. It also can make it easier to maintain an erection during sex, especially if you’re prone to developing erections that aren’t quite firm enough for penetration.
Like many other drugs, sildenafil is also used for other conditions, including pulmonary arterial hypertension (a form of high blood pressure that affects the lungs).
Our guide to how Viagra works goes into more detail about how brand-name Viagra and generic sildenafil work for the treatment of erectile dysfunction.
Is Viagra Safe to Take?
When it’s used as prescribed, Viagra (sildenafil) is generally a safe medication. It was approved by the FDA in 1998, meaning it’s been on the market for more than 20 years. During this time, it has been used by millions of men in the United States and many more worldwide. Overall, Viagra’s safety record is very good. However, like almost every medication, it can cause certain side effects. Most of these side effects are mild and transient, meaning they gradually go away as Viagra is processed by your body.
Common side effects of Viagra include:
Headaches
Flushing
Dyspepsia (indigestion)
Nasal congestion
Back and/or muscle pain
Dizziness
Skin rash
Vision issues, such as blurred vision, changes in color vision or other abnormal vision
Of these side effects, headaches are generally the most common, affecting between 16 and 28 percent of men who used Viagra in clinical trials.
Viagra can also cause more serious side effects, including the following:
Ringing in the ears
Shortness of breath
Chest pain
Fainting
Sudden hearing decrease or loss of hearing
Priapism (painful and/or long-lasting erections)
An itching or burning sensation during urination
These side effects are uncommon. If you develop any serious side effects after using Viagra, it’s important to contact your healthcare provider or seek medical assistance as soon as you can.
Side effects such as fainting or long-lasting, painful erections may sound alarming. However, it’s important to put these side effects in context.
Only a small percentage of men who use either Viagra or generic sildenafil develop any adverse effects, with an even smaller percentage experiencing serious issues. Currently, there is no high quality evidence to suggest that Viagra causes long-term side effects or health issues.
For example, priapism (painful and prolonged erections) is one of the most well-known sildenafil side effects, largely thanks to sensational media reporting.
Despite being so well known, priapism from sildenafil is extremely rare. In fact, just 74 cases of priapism involving sildenafil were recorded in the FDA’s adverse event reporting system during the entire year of 2007, despite millions of men using sildenafil on a regular basis.
Put simply, although mild side effects from Viagra do occur on a somewhat regular basis, major or dangerous effects are very uncommon. Most men who take Viagra have a good experience, with real improvements in erectile function and few issues worthy of concern.
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How Often Can You Take Viagra?
Viagra is generally safe and effective when it’s used as prescribed. However, taking Viagra on an overly frequent schedule, or taking an excessive amount of Viagra, may cause your risk of experiencing side effects to increase.
Viagra is typically prescribed for use as needed, meaning before sexual activity. Most men who have ED and are prescribed Viagra as a treatment are advised to take this medication one hour before they plan to have sex.
You should not take Viagra more than once per day. If you plan to have sex more than once per day and find that Viagra doesn’t last long enough for you, you may want to consider talking with your healthcare provider about switching to a different type of ED medication.
Some ED medications, such as tadalafil (the active ingredient in Cialis®), can be used daily and offer longer-lasting relief from erectile dysfunction.
Can Viagra Cause Drug Interactions?
Like other medications, Viagra has the potential to interact with other drugs. Some interactions that involve Viagra may be dangerous, particularly those involving other medications that affect your smooth muscle tissue, blood cells, blood flow and/or blood pressure.
Sildenafil, the active ingredient in Viagra, causes a mild drop in blood pressure. In a study from 2002, researchers found that a typical dose of sildenafil decreased systolic blood pressure by 6 mm Hg and diastolic blood pressure by 4.5 mm Hg in a small group of men.
By itself, this small drop in blood pressure usually isn’t enough to cause health issues. However, when Viagra is combined with other medications that also reduce blood pressure, it can cause a sudden, significant drop in blood pressure that may be dangerous or life-threatening.
Cardiovascular medications that may interact with Viagra include nitrates (including recreational drugs that contain nitrates), alpha-blockers and other antihypertensive medications.
Viagra can also interact with medications that inhibit the CYP3A4 enzyme, such as itraconazole, ketoconazole and the antiretroviral medication ritonavir.
Some recreational drugs, such as “poppers” containing amyl nitrite, amyl nitrate or butyl nitrate, can also cause dangerous changes in blood pressure when used with Viagra or other drugs for erectile dysfunction.
To avoid interactions, it’s important to inform your healthcare provider about all medications and recreational drugs you currently use or have recently used before using Viagra.
Your healthcare provider will determine if Viagra is safe for you, and if appropriate, provide help to make sure you use this medication properly.
Our detailed guide to Viagra and nitrates offers more information on these drug interactions and their risks, as well as specific medications to avoid while using Viagra.
Is Viagra Bad for Your Heart?
There’s a common misconception that Viagra and other ED medications have a negative effect on cardiovascular health, or that they can trigger myocardial infarction (heart attack) and other medical emergencies.
There’s currently no scientific evidence that shows that sildenafil, tadalafil, vardenafil (Levitra®) or avanafil (Stendra®) directly cause heart damage.
This means that if you’re in good health and don’t suffer from any cardiovascular health issues, you can use these medications safely as directed by your healthcare provider.
However, if you’ve been diagnosed with a heart condition, it’s best to exercise caution when it comes to ED medications.
Before using Viagra or similar medication, make sure to inform your healthcare provider about your condition.
Let them know if you currently use or have previously used medication for any heart conditions, or if you’ve previously suffered a cardiovascular event.
It’s important to keep in mind that sex itself is a mild form of exercise. In fact, a 2012 article in the journal Circulation notes that sex is comparable in physical exertion to climbing up several flights of stairs or walking briskly for a short period of time.
If you have a heart condition, the physical activity involved in sex may cause you to experience chest pain or other symptoms.
Make sure to inform your healthcare provider if you experience any concerning problems while having sex, or if you feel out of breath or unable to perform during sexual activity.
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Can Viagra Damage Your Penis?
Another common misconception about Viagra is that it can damage your penis, or cause you to become dependent on medication to get an erection.
Contrary to popular belief, Viagra doesn’t have any significant impact on your sex drive or level of sexual stimulation. All it does is make it easier for blood to flow into your penis when you feel sexually aroused.
In very rare cases, men who use Viagra may experience priapism -- a type of persistent, painful erection that can last for several hours. This issue develops when blood becomes trapped in the penis.
Priapism is a serious issue that requires urgent medical attention. When untreated, it may cause damage to the penis.
The good news is that priapism is extremely rare and affects only a tiny percentage of men who use Viagra or similar medications to treat ED.
As for physical dependency, there’s no scientific evidence that Viagra is physically addictive, nor is there any evidence that Viagra can make ED or other forms of sexual dysfunction worse.
Who Should Not Take Viagra?
Most men can take Viagra without any issues. However, as we mentioned above, it’s important not to use Viagra -- or at least to talk to your healthcare provider before you consider using this medication -- if you:
Have a history of cardiovascular health issues. Viagra may not be safe to use if you have cardiovascular disease, or if you’ve previously suffered from a heart attack, stroke or life-threatening arrhythmia.
Have blood pressure issues. Viagra may not be safe to use if you have hypertension (high blood pressure) or hypotension (low blood pressure), including if you currently use medication to control your blood pressure levels.
Have heart failure or unstable angina. These conditions may also make using Viagra or similar ED medications unsafe for you.
Take medication for high blood pressure or angina. Some medications for managing high blood pressure, such as nitrates, can cause dangerous interactions when used with Viagra or other PDE5 inhibitors.
Have risk factors for non-arteritic anterior ischemic optic neuropathy (NAION). In some cases, Viagra can contribute to an elevated risk of NAION, a rare cause of loss of vision or decreased vision that can occur with PDE5 inhibitors. Make sure to inform your healthcare provider if you have a history of vision issues, or if other members of your family have eye conditions.
Experience hearing loss while using Viagra. If you experience sudden hearing loss, tinnitus or dizziness while using Viagra, it’s important to stop taking this medication and talk to your healthcare provider as soon as you can.
Our list of Viagra warnings and precautions goes into more detail about factors that could make Viagra unsafe for you as an ED treatment.
How to Use Viagra Safely
Used as directed, Viagra can improve your sexual performance and provide relief from erectile dysfunction without any negative effects on your health. Apply these tips to safely get the best results from Viagra:
Start with a low or moderate dosage. Viagra comes in several strengths, from 25mg to 100mg per tablet. If you’re concerned about side effects, consider starting with a low or moderate dosage of Viagra.
Take Viagra around one hour before sex. Viagra should be taken one hour before you plan to have sex. A single dose of Viagra will last for around four hours. You can take Viagra with or without food.
Never take Viagra more than once a day. Viagra is designed for use one time per day, and not more. If you prefer a longer-acting medication for ED, consider talking to your healthcare provider about tadalafil (the active ingredient in Cialis).
Avoid drinking alcohol with Viagra. Using Viagra with alcohol can increase your risk of dealing with side effects. It’s best to reduce your alcohol consumption or avoid drinking while using Viagra or other ED medications.
Avoid over-the-counter Viagra alternatives. Contrary to popular belief, over-the-counter products are not safer than Viagra. Many contain unlabeled, illicit ingredients, including ingredients that are potentially harmful.
If Viagra doesn’t work, tell your healthcare provider. You may need to try several doses of Viagra to identify the one that works best for you. Make sure not to change your dose of Viagra without first talking to your healthcare provider.
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The Bottom Line on Viagra Safety
Viagra is one of the most well-known and effective treatments for erectile dysfunction. When it’s used as directed, it’s a safe medication that can produce real, noticeable improvements in your sexual function, all without any negative effects on your health or wellbeing.
Like all prescription drugs, Viagra should be used responsibly. This means closely following your healthcare provider’s instructions and informing them if you experience any issues.
Interested in using Viagra? We offer sildenafil, tadalafil and other FDA-approved medications for ED online, following a consultation with a licensed physician who will determine if a prescription is appropriate.
You can also learn more about your options for stopping erectile dysfunction and improving your sexual performance in our full guide to the most common ED treatments.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.