Do you know you can pass out and even risk dying if you take Viagra® or Cialis® with the wrong blood pressure drug? Of these drugs, do you know which ones are deadly and which ones are not as bad when taken with ED drugs? In this article, I will show you everything you need to know about the 6 types of conflicting medications that can be unsafe when taken with Viagra® or Cialis®, AND sort them by danger level, AND for each type of drug, give you a list of brand names that you might see on your drug bottles.
Why should you care?
So why should you care whether or not you mix Viagra® or Cialis® with non-ED drugs? The reason is that drugs like Viagra® or Cialis®, chemically known as sildenafil or tadalafil, do not just improve erections. They can actually lower blood pressure as well. So when they are used together with certain other non-ED drugs that also lower blood pressure, the result might possibly lead to a massive drop in blood pressure, and, if severe, you might possibly even die. But there is a range of danger levels though. At the other end of the spectrum, there are blood pressure drugs that cause some, but not a huge, fall in blood pressure.
Viagra® or Cialis®: which is worse in this case?
Some of you might ask: I really want to use Viagra® or Cialis® for my erectile dysfunction, but I am on blood pressure drugs. In this situation, which ED drug is definitely a bad idea? Of the two drugs, Cialis is certainly a very bad idea because it can stay in your blood for 24-36 hours. We covered Viagra® vs Cialis® in detail in a past post, so please check it out. Viagra® is still not a good idea in this situation though. However, it does have a short half life of 4 hours, which means that only half of it remains in your blood after 4 hours. So theoretically, not much Viagra® should be left in your body to conflict with blood pressure drugs after about 20 hours, unless you have kidney or liver problems, in which case the half life of Viagra might be a lot longer. Now, because everyone’s health situation is different, you must check with your doctor to see what’s right for you.
Drug type 1: Nitrates
This type of drug is frequently prescribed for chest discomfort. When you feel chest pain, aka angina, it’s because your heart is not getting enough oxygen. So drug type #1, nitrates, bring relief for chest pain because they help you widen the blood vessels that go to your heart so that your heart gets more oxygen.
So is it okay to use nitrates with Viagra® or Cialis®? 100% NO! DO NOT USE any ED drugs with nitrates!
According to the American College of Cardiology expert consensus, use of nitrates within 24 hours of taking Viagra® can cause such an extremely large drop in blood pressure that you might die.
What about Cialis®? Cialis®, aka tadalafil, has an even longer time period. According to this analysis in the American Journal of Cardiology, after taking Cialis® you might need to wait at least 48 hours before using a nitrate like nitroglycerin.
So for danger level, we have to go with the highest 5 stars. Again, do not use it with any ED drugs!
You might know nitrates as nitroglycerin and isosorbide dinitrate. Those are the chemical names though. What you might see on your drug bottle are brand names like: Nitrostat®, Nitrolingual®, Nitro-Dur®, Nitroquick®, Minitran®, Rectiv®, GoNitro®, Isordil®, ISDN®, Dilatrate-SR®, Isochron®, Sorbitrate®, Isotrate®.
Drug type 2: Alpha Blockers
When you have symptoms of an enlarged prostate or high blood pressure, doctors will often prescribe this drug type: alpha blockers. These lower high blood pressure by preventing hormones like norepinephrine from making your arteries and veins tighter.
So can alpha blockers be dangerous when taken with ED drugs?
Unfortunately, the answer is a yes! According to this article in Vascular Health Risk Management, alpha blockers must only be used with lots of caution. The reason for this is because when the ED drug vardenafil first came out, some initial studies showed a big drop in blood pressure when vardenafil was used together with alpha blockers. Of course vardenafil is not Viagra® or Cialis®, but it is a very similar drug. And according to this review, sildenafil should be used with extreme care in patients who take alpha blockers because using them at the same time may lead to symptomatic decline in blood pressure.
So it looks like alpha blockers are not as deadly as nitrates when used with ED drugs, but patients should still be really careful with it, so we are going to put 4 stars for its the danger level.
Alpha blockers include: tamsulosin, prazosin, doxazosin, terazosin. Their brand names are: Flomax®, Contiflo®, Harnalidge®, Contiflo®, Faramsil®, Flomaxtra®, Minipress®, Prazopress®, Cardura®, Doxadura®, Larbex®, Raporsin®, and Slocin®, Hytrin®, Zayasel®.
Drug type 3: Beta Blockers
This is the most commonly prescribed drug type for high blood pressure. So, drug type #3, beta blockers, lowers high blood pressure by preventing hormones and neurotransmitters from constricting your blood vessels. Leading to the enlargement of your blood vessels.
So will beta blockers cause any sharp drop in blood pressure when used with viagra or cialis?
Well, according to the previously mentioned ACC consensus, most experts believe beta blockers do not seem to cause big declines in blood pressure with used with ED drugs. But, they are calling for more studies. Also, according to this analysis, taking Viagra® with beta blockers appears to cause just some extra reduction in blood pressure.
So, beta blockers are not that bad, but may not be first choice. So we will put two stars for its danger level.
Beta blockers include drugs such as metoprolol, carvedilol, atenolol, and propranolol. The brand names include: Lopressor®, Toprol®, Coreg®, Tenormin®, InnoPran ®, Normodyne®, Trandate®, Bystolic®, Zebeta®.
Drug type 4: Calcium Channel Blockers
People usually use this third most prescribed type of drug to treat high blood pressure when their arteries contract too much. So drug type #4, calcium channel blockers, relax those arteries by blocking the calcium that make arteries contract. Lowering your blood pressure.
But can calcium channel blockers such as amlodipine be extremely unsafe if you take them together with ED drugs like Viagra®?
According to this study in the American Journal of Cardiology, for men who took 5 or 10 mg of amlodipine who then took 100 mg of sildenafil (aka Viagra®), their systolic blood pressure dropped 8 and their diastolic pressure dropped 7 mm Hg. In other words, some drop in blood pressure, but not a huge drop for these men. A word of caution though: just because their blood pressure didn’t drop like a rock doesn’t mean yours won’t, so you need to ask your doctor.
So, it looks like we can put down two stars for the danger level of calcium channel blockers.
Examples of calcium channel blockers include: amlodipine, diltiazem, nifedipine, and verapamil. Check for these brand names for calcium channel blockers on your bottles: Norvasc®, Cardizem®, Cartia®, Diltzac®, Taztia®, Tiazac®, Procardia®, Adalat®, Calan®, Isoptin®, Verelan®.
Drug type 5: ACE Inhibitors
Too much of a protein called “angiotensin II” makes the pressure in your arteries go up. So, drug type #5, the ACE inhibitor, works to lower blood pressure by targeting this protein. The ACE inhibitor does so by preventing angiotensin II to be made. By the way, besides blood pressure, ACE inhibitor is also prescribed for diabetic kidney disease and heart failure.
Do ACE inhibitors cause a big drop in blood pressure or just a small one if taken with ED drugs?
According to the ACC consensus, experts currently do not believe ACE inhibitors generally cause sharp drops in blood pressure. Also mentioned in this analysis, ACE inhibitors usually just create some additional decreases in blood pressure when used with ED drugs.
So I think ACE inhibitors require just two stars for its danger level.
ACE inhibitors include the drug chemicals known as lisinopril, benazepril, quinapril, and ramipril. Brand names of these include: Prinivil®, Zestril®, Lotensin®, Accupril®, Altace®.
Drug type 6: Angiotensin II Receptor Blockers (ARB)
One reason why you have high blood pressure is because your arteries squeeze together too much due to too much of this protein: angiotensin II. So drug type #6, angiotensin II receptor blockers or ARB for short, lowers blood pressure by blocking this protein from binding with your arteries. The result is a widening of your blood vessels.
So how bad is it if you take ARBs with Viagra® or Cialis®?
As mentioned in this expert review, ARBs may reduce some extra blood pressure when taken with ED drugs.
What is extremely interesting is that of all the 6 types of high blood pressure drugs, ARBs, specifically irbesartan, actually seem to improve erectile function along with blood pressure. In this 2008 German study with 1069 men, erectile function increased substantially after 6 months of using irbesartan.
So the ARBs have a danger level of about two stars.
ARBs are, for example, losartan, valsartan, irbesartan, olmesartan, and telmisartan. But you might know those as: Cozaar®, Diovan®, Avapro®, Benicar®, and Micardis®.
Conclusion
In terms of danger levels, it’s a tie between ARBs, calcium channel blockers, ACE inhibitors, and beta blockers.
But of the four, ARBs might actually improve erections, so I personally would sort them like this.
Alpha blockers though, should be used with a lot of caution. AND nitrates should be avoided at all costs as those can be deadly when used with ED drugs.
Please check the drug names on your drug bottles, and see if they are listed in this article. If so, taking them together with ED drugs like Viagra® or Cialis® might have risks. You really should ask your doctor whether you can use them together before actually doing so.
Disclaimer: All content is educational in purpose, not to be used as medical advice. Please consult your doctor for medical advice. Ask your doctor whether any presented information applies to your situation. Video clips, images, and music courtesy of creators on Pexels, Freepik, and Pixabay. All characters in images and videos are of actors for illustrative purpose only.
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References:
Use of sildenafil (Viagra) in patients with cardiovascular disease
Sexual function in hypertensive patients receiving treatment
Cardiovascular safety of sildenafil citrate (Viagra®): An updated perspective
Effect of irbesartan on erectile function in patients with hypertension and metabolic syndrome