Can You Safely Use Viagra with Blood Pressure Medications?

Q: Can You Safely Use Viagra with Blood Pressure Medications?

Dear Mr. <br>Tianren：<br>1. <br>Currently, there are three commonly approved PDE-5 inhibitors for the treatment of erectile dysfunction： Sildenafil, Vardenafil, and Tadalafil. <br>All three PDE-5 inhibitors have similar efficacy in treating erectile dysfunction, and their side ef

Medication Consultation

Currently, I am taking BLOPRESS 8mg (Candesartan) once daily and Norvasc 5mg (Amlodipine) half a tablet daily for hypertension.
Can I also take Viagra (Sildenafil) or similar medications? If so, will there be any side effects? Thank you!

Tian Ren, 60~69 year old female. Ask Date: 2022/12/25

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Tianren:
1.
Currently, there are three commonly approved PDE-5 inhibitors for the treatment of erectile dysfunction: Sildenafil, Vardenafil, and Tadalafil.
All three PDE-5 inhibitors have similar efficacy in treating erectile dysfunction, and their side effects are comparable; however, the duration of action varies among these medications, and food can affect the rate of drug absorption.
PDE-5 inhibitors enhance blood flow into the penile corpus cavernosum in response to any level of sexual stimulation.
2.
The most common side effects of PDE-5 inhibitors include headache, flushing, dyspepsia, and nasal congestion; these effects are generally mild, and men with erectile dysfunction rarely discontinue the medication due to these side effects.
3.
Since PDE inhibitors promote 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 alpha-adrenergic antagonists (used to relieve symptoms of benign prostatic hyperplasia), there is an additional blood pressure-lowering effect; therefore, caution is required when combining PDE-5 inhibitors with alpha-adrenergic antagonists.
If combination therapy is necessary, patients should start PDE-5 inhibitors only after stabilizing on a fixed dose of alpha-adrenergic antagonists, beginning with a low dose.
4.
If other strong CYP3A4 inhibitors are being used, such as protease inhibitors, Clarithromycin, or Erythromycin, the dose of PDE-5 inhibitors should be reduced.
5.
Theoretically, Blopress and Norvasc do not belong to the classes of organic nitrates or alpha-adrenergic antagonists; therefore, significant interactions are not expected.
However, please discuss this with your primary care physician before making any decisions.

Reply Date: 2022/12/25

More Info

When considering the use of Viagra (sildenafil) alongside blood pressure medications such as BLOPRESS (which contains olmesartan) and Norvasc (amlodipine), it is essential to understand the potential interactions and safety concerns associated with this combination.

Viagra is primarily used to treat erectile dysfunction by increasing blood flow to the penis, which is achieved through the relaxation of blood vessels. This vasodilatory effect can also influence blood pressure levels. Therefore, when combining Viagra with antihypertensive medications, there are several factors to consider.

1. Safety of Combination: According to current medical guidelines and research, Viagra can generally be used safely with blood pressure medications like BLOPRESS and Norvasc. There is no significant interaction between Viagra and these specific medications. However, it is crucial to monitor blood pressure, as Viagra can cause a slight decrease in blood pressure due to its vasodilatory effects.
2. Potential Side Effects: While the combination is typically safe, patients may experience side effects. Common side effects of Viagra include headaches, flushing, nasal congestion, and dyspepsia. When combined with blood pressure medications, there is a risk of hypotension (low blood pressure), especially if the patient is already on multiple antihypertensive agents. Symptoms of hypotension may include dizziness, lightheadedness, or fainting, particularly when standing up quickly.

3. Monitoring and Consultation: It is advisable to consult with your healthcare provider before starting Viagra, especially if you have underlying health conditions or are taking multiple medications. Your doctor may want to monitor your blood pressure closely after initiating Viagra to ensure that it remains within a safe range. They may also adjust the dosages of your blood pressure medications if necessary.

4. Contraindications: It is important to note that Viagra should not be taken with nitrates (commonly prescribed for chest pain) or certain alpha-blockers, as this can lead to severe hypotension. Since you are taking BLOPRESS and Norvasc, which are not nitrates, this combination is generally acceptable. However, always disclose all medications you are taking to your healthcare provider.

5. Individual Variability: Each patient’s response to medications can vary based on individual health conditions, other medications, and overall cardiovascular health. Therefore, what is safe for one person may not be safe for another. Your healthcare provider can provide personalized advice based on your specific health profile.

In conclusion, using Viagra with BLOPRESS and Norvasc is generally considered safe, but it is essential to approach this combination with caution. Always consult your healthcare provider before starting any new medication, and ensure that you are monitored for any potential side effects or interactions. This proactive approach will help you manage your blood pressure effectively while addressing erectile dysfunction safely.

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