Alert
Close

Think you know AARP? What you don't know about us may surprise you. Discover all the 'Real Possibilities'

HIGHLIGHTS

Open

REAL POSSIBILITIES

AARP Real Possibilities

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Dream Vacation Sweepstakes

10 weeks. 10 amazing trips. Seize your chance to win!
See official rules. 

CHECK OUT OUR
NEW IPAD APP!

ATM Mobile App for iPhone and Ipad

Enjoy the best of AARP’s award-winning publications

on the go with the new

AARP ePubs iPad App

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

Learning Centers

Get smart strategies for managing health conditions.


Arthritis

Heart Disease

Diabetes

Most Popular

Viewed

Health Discovery

Viagra and Heart Risks

Men should not take erectile dysfunction drugs with certain common heart medicines

En español | Men who use nitrates — medicine to treat occasional chest pain — should not take them with popular erectile dysfunction drugs because the combination could trigger a dangerous drop in blood pressure, the American Heart Association warns.

Sign up for the AARP Health Newsletter.

New heart risks for patients mixing Viagra and the like with certain medications - mature couple on bed

Combining erectile dysfunction drugs and heart medication can cause a severe drop in blood pressure. — Photo by Ryan McVay/Getty Images

Nitrates such as nitroglycerin must be avoided within 24 hours of using Viagra or Levitra and within 48 hours of taking Cialis, according to the recommendations contained in Sexual Activity and Cardiovascular Disease: A Scientific Statement from the American Heart Association.

“Anecdotal” reports of death from combining the drugs have surfaced in recent years, says Glenn Levine, M.D., a cardiologist and professor at the Baylor College of Medicine in Houston who chaired an expert panel studying the issue.

Concerns about the interaction between erectile dysfunction (ED) drugs and nitrates were first aired a decade ago, says Randall Zusman, M.D., a cardiologist at the Massachusetts General Hospital Heart Center who conducted some of the early research. All three ED drugs now carry warnings about the risk.

Men with ED typically have some artery blockage, Zusman says, and these drugs work by dilating the blood vessels to improve blood flow. Patients whose artery blockage is severe enough to cause chest pain may be prescribed nitrates — whether in a patch, a long-lasting oral form or a fast-acting nitroglycerin pill placed under the tongue — to alleviate their symptoms.

When the drugs are combined, there may be a powerful reaction, with blood pressure dropping 50, 60 or 80 points in 30 minutes, Zusman said. The mildest side effect might be a feeling of light-headedness, or a patient may faint. A more severe blood pressure drop could trigger kidney failure or a stroke. A patient who visits an emergency department complaining of chest pains should volunteer whether he has taken an ED drug.

Although sexual activity slightly raises the risk of triggering a heart attack, the good news is that for most patients with cardiovascular disease the risk is minuscule, according to Levine. “In the hour around and immediately after sexual activity, the risk of heart attack does go up by two to three times,” he says, “but when you look at a patient’s total overall risk of having a heart attack, this really represents a very small contribution.”

It’s vital for both patient and physician to discuss these issues forthrightly, Zusman said. “If the physician doesn’t inquire whether the patient is sexually active and has ED and the patient doesn't offer, then you never get to the discussion of whether you can [take ED drugs] safely.”

Also of interest: How to talk to — and understand — your doctor.

Michael Haederle is a freelance writer whose work has appeared in People, the New York Times and the Los Angeles Times.

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Health blog

Discounts & Benefits

bring health To Life-Visual MD

AARP Bookstore

AARP Bookstore - woman reaches for book on bookshelf

VISIT THE HEALTH SECTION

Find titles on brain health, drug alternatives and losing weight. Do