Can You Take Viagra with Blood Pressure Medications? Expert Advice

Q: Can You Take Viagra with Blood Pressure Medications? Expert Advice

Dear Mr. <br>Tianren：<br>1. <br>Cozaar® (50 mg; generic name Losartan) belongs to the class of Angiotensin II Receptor Antagonists. <br>Common side effects include dry cough, rash, fever, altered taste, hypotension (due to low fluid volume status), angioedema, and hyperkalemia. <

Medication Consultation

I am currently taking antihypertensive medications (Cozaar 50mg and Concor 5mg) daily.
Can I also take Viagra or similar medications? If so, are there any potential side effects? Thank you!

Tianren, 60~69 year old female. Ask Date: 2020/01/22

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Tianren:
1.
Cozaar® (50 mg; generic name Losartan) belongs to the class of Angiotensin II Receptor Antagonists.
Common side effects include dry cough, rash, fever, altered taste, hypotension (due to low fluid volume status), angioedema, and hyperkalemia.
Although the adverse reactions are similar to those of ACE inhibitors, the risk of cough and angioedema is significantly reduced.
2.
Concor-5® (5 mg; generic name Bisoprolol) is classified as a β-Adrenoceptor-blocking agent.
When prescribing a β-blocker, it is important to consider whether hypertensive patients also have asthma, as it can block β2-related bronchial dilation and is not recommended for such patients.
3.
Viagra® (Sildenafil; generic name) is a PDE-5 inhibitor.
The action of PDE-5 inhibitors increases blood flow to the corpus cavernosum during any level of sexual stimulation.
At recommended doses, PDE-5 inhibitors have no effect in the absence of sexual stimulation; they are used to treat erectile dysfunction caused by organic or psychological factors.
The most common side effects of PDE inhibitors include headache, flushing, dyspepsia, and nasal congestion; these effects are generally mild, and men with erectile dysfunction rarely discontinue use due to these side effects.
Sildenafil treatment can cause color discrimination impairment (loss of blue/green discrimination), possibly due to the inhibition of PDE-6, which is important for color recognition in the retina.
Since PDE inhibitors enhance the activity of nitric oxide (NO), they must not be used in conjunction with any products related to organic nitrates.
When PDE-5 inhibitors are used with α-Adrenoceptor antagonists (used to relieve symptoms of benign prostatic hyperplasia), there is an additional hypotensive effect; caution is required when combining PDE-5 inhibitors with α-Adrenoceptor antagonists.
If combination therapy is necessary, the patient should be stabilized on the α-Adrenoceptor antagonist at a fixed dose before starting the PDE-5 inhibitor, beginning with a low dose.
4.
In summary, Cozaar and Concor-5 are not related to organic nitrates; if you have been stable on Cozaar and Concor-5 for more than two weeks, taking Viagra should not pose any issues.
5.
If you have further questions, it is advisable to consult your attending physician or family doctor directly.

Reply Date: 2020/01/22

More Info

When considering the use of Viagra (sildenafil) in conjunction with blood pressure medications such as Cozaar (losartan) and Concor (bisoprolol), it is essential to understand both the pharmacological interactions and the potential side effects involved.

Viagra is primarily used to treat erectile dysfunction by increasing blood flow to the penis. It works by inhibiting an enzyme called phosphodiesterase type 5 (PDE5), which results in the relaxation of blood vessels and increased blood flow. However, this mechanism can also lead to a decrease in blood pressure, which is a critical consideration for individuals already taking antihypertensive medications.

Cozaar (losartan) is an angiotensin II receptor blocker (ARB) that helps lower blood pressure by preventing blood vessels from constricting. Concor (bisoprolol) is a beta-blocker that reduces heart rate and the force of heart contractions, further aiding in blood pressure control. Both medications are effective in managing hypertension, but they can also interact with Viagra.

Can You Take Viagra with Blood Pressure Medications?
Yes, it is generally considered safe to take Viagra with blood pressure medications like Cozaar and Concor, but caution is advised. The combination can lead to additive effects on blood pressure, potentially causing hypotension (low blood pressure). This is particularly important if you are already on medications that lower blood pressure, as the combined effect may lead to dizziness, lightheadedness, or fainting, especially when standing up (orthostatic hypotension).

Potential Side Effects
1. Hypotension: As mentioned, the most significant risk is a drop in blood pressure. If you experience symptoms such as dizziness, lightheadedness, or fainting, it is crucial to seek medical attention.

2. Headaches: Both Viagra and blood pressure medications can cause headaches. When taken together, the likelihood of experiencing headaches may increase.

3. Flushing: Viagra can cause flushing, which may be exacerbated by the vasodilatory effects of blood pressure medications.

4. Heart Rate Changes: Bisoprolol, being a beta-blocker, can lower heart rate. Viagra can also affect heart rate, so monitoring is essential, especially if you have any pre-existing heart conditions.

5. Other Side Effects: Common side effects of Viagra include nasal congestion, upset stomach, and visual disturbances. These may occur independently of your blood pressure medications.

Recommendations
1. Consult Your Doctor: Before starting Viagra, it is crucial to consult with your healthcare provider. They can assess your overall health, review your current medications, and determine if Viagra is appropriate for you.

2. Start with a Low Dose: If approved by your doctor, starting with a lower dose of Viagra may help minimize the risk of side effects and hypotension.

3. Monitor Blood Pressure: Regularly check your blood pressure, especially after starting Viagra. If you notice significant changes, inform your doctor immediately.

4. Be Aware of Symptoms: Pay attention to how you feel after taking Viagra. If you experience any concerning symptoms, such as severe dizziness or fainting, seek medical help.

In conclusion, while it is generally safe to take Viagra with blood pressure medications like Cozaar and Concor, careful monitoring and consultation with your healthcare provider are essential to ensure safety and efficacy. Always prioritize open communication with your doctor regarding any new medications or changes in your treatment plan.

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