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Highlights
- Viagra (generic name sildenafil), keeps the body’s blood vessels open by inhibiting a specific enzyme, PDE5.
- Viagra’s mechanism of action and effect on the body are the main reasons for its possible side effects.
- Relatively few men experience side effects while taking Viagra, and many side effects will stop after a week or so of using Viagra.
- The most common side effect is headache, which usually goes away after a week or so of taking Viagra.
- More serious side effects are extremely rare, and in some cases are still being researched.
- Viagra should be taken only by prescription and with a full understanding of its impacts.
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Any prescription medication will have side effects, and that includes Viagra. The specific nature and mechanism of action with Viagra presents specific concerns that every man should know before he takes it. Learn what Viagra’s side effects are, how common they are, who shouldn’t take Viagra and why, and how to best enjoy the effects of Viagra without worry.
What is Viagra (Sildenafil) and How Does it Work?
Viagra (sildenafil) is a phosphodiesterase type 5 (PDE5) inhibitor. PDE5 is an enzyme that degrades cGMP, a signaling molecule. By inhibiting PDE5, sildenafil increases the levels of cGMP, which leads to the relaxation of smooth muscle cells in blood vessels.
This allows more blood into the penis, leading to firmer erections and greater ability to get an erection in an intimate context. Viagra doesn’t work in the absence of sexual stimulation.
However, while PDE5 is most common in the smooth muscle and tissue of the penis, it also affects other areas in the body, most notably the heart and the digestive system. What’s more, there are 11 types of PDE enzymes, and while Viagra is highly targeted toward PDE5, it may also inhibit others. This is the most common cause of side effects when you take Viagra.
What Does the FDA Safety Information Say about Viagra?
The U.S. Food and Drug Administration (FDA) is the key arbiter of whether a drug can be sold in the U.S. and what it can be prescribed to treat. Viagra was the subject of extensive clinical trials with a large sample size of subjects to assess its safety and effectiveness. The FDA ensures that all drug packaging includes important safety information, including known side effects, drug interactions, and contraindications.
In addition, the agency runs the MedWatch system, a reporting system for healthcare providers to report possible rare side effects or other important data after a drug enters the market. This system helps the FDA continuously monitor drug safety in the real world, including situations researchers can’t anticipate in clinical trials. The FDA has the power to issue safety alerts and recalls if the situation warrants it.
Although sildenafil has been on the market for decades, the FDA’s ongoing monitoring helps limit the risk and track data, so you can take Viagra with confidence.
Contraindications: Who Should Not Take Viagra?
A contraindication is a disease or other medical issue that increases the risks of a medication. Viagra’s major contraindications include:
- Heart disease. Because Viagra opens up the blood vessels, it raises the risk of a sudden and possibly dangerous drop in blood pressure.
- Kidney disease or kidney problems. Low blood pressure can also aggravate kidney problems in some circumstances. Check with your doctor about taking sildenafil with a kidney condition.
- Pulmonary disease. Viagra is used to treat pulmonary arterial hypertension (PAH) under the brand name Revatio, and may interfere with other PAH treatments unless vetted by your medical team first.
Common Side Effects of Viagra
“Common” side effects are defined by percentages; a very common side effect happens to approximately 10% or more of the people who take the drug, while a common one happens to between 1% and 10% of patients. Remember, though, that everyone’s different, so your experience might be substantially different than someone else’s.
Common and very common side effects usually don’t require medical attention and also tend to fade after a week or so as your body adjusts to the drug. If common side effects keep happening, talk to your doctor before taking Viagra again.
Clinical trials have found that Viagra side effects tend to be more likely at higher doses. Start at a lower dose to see if you experience side effects.
The most common side effects of Viagra are:
- Headaches. Up to 1 in 4 men reported headaches in clinical trials, making it the most common side effect. The headaches generally fade over time.
- Flushing. A sudden rush of blood to the face, roughly 1 in 5 men reported this side effect.
- Indigestion. Possibly related to PDE5 action in the colon, this was much rarer at lower doses in the trials, 3% for 25 milligrams compared to 17% at 100 milligrams. Between 2% and 3% of men also reported nausea.
- Nasal congestion. Related to widening blood vessels in your sinuses, this affected between 4% and 9% of men in the trials.
- Impaired vision. Viagra shows a slight tendency to inhibit PDE6, which is found in the eye. Between 1% and 2% of men experienced vision concerns at lower doses, which moves up to 11% at 100 milligrams.
- Dizziness. Regardless of dose, 3% to 4% of men experienced dizziness while on Viagra, likely due to a drop in blood pressure.
- Rash. Only 1% to 3% of men got a rash while taking Viagra, making it the least common side effect.
Rare but Serious Side Effects of Viagra
A very small percentage of men may have more serious side effects. Some of these are so rare that they only emerged after Viagra arrived on the market.
- Non-arteritic anterior ischemic optic neuropathy (NAION), a condition that can cause vision loss
- A sudden decrease or loss of hearing
- Priapism — a potentially painful erection lasting more than four hours
In all cases, if you’re experiencing any of these, or think you might be, seek medical attention right away.
Read: The Comprehensive Guide to Viagra and Sildenafil Side Effects to learn about all the side effects of Viagra, from mild to severe, and how to deal with them.
Potential Drug Interactions With Viagra
While Viagra is proven to be safe for most men, as with any drug, there are potential interactions with other medications, ranging from annoying to severe.
The Drugs.com Drug Interaction Checker lists 37 major interactions with Viagra and 285 considered moderate. We recommend checking these lists before you begin taking Viagra.
Read: The Comprehensive Guide to Viagra and Sildenafil Side Effects for important information and lists of drugs that interact with Viagra.
Is It Safe To Take Viagra with Alcohol or Other Drugs?
Recreational or “street” drugs can present multiple risks with prescription medications, depending on both the quality of the drug and how much is taken. This includes common substances, and you should approach any substance that acts on your body, recreational or otherwise, with caution when using Viagra.
- Alcohol. Alcohol is a vasoconstrictor, which can prevent Viagra from working, while making the side effects worse.
- Cannabis. Tetrahydrocannabinol (THC) can interact with Viagra, keeping it in your bloodstream for longer.
- Energy drinks. High doses of caffeine can serve as a vasoconstrictor, much like alcohol, which interferes with Viagra’s functioning.
- Amyl nitrate (“poppers”). Amyl nitrate is also a vasodilator, and in combination with sildenafil increases the risk of a dangerous drop in blood pressure.
- Cocaine. In addition to cocaine’s overall health risks, it’s also a vasoconstrictor, fighting Viagra in your system.
Reducing Viagra Side Effects
While there’s no way to completely get rid of the risk of Viagra side effects, there are a few steps you can take to help limit both the possibility and the severity.
- Drink less alcohol. Men who consumed more than 15 drinks of alcohol a week reported more side effects, particularly headaches, when taking Viagra. Reducing your alcohol intake can help Viagra do its job.
- Cut out grapefruit. Like many other medications, grapefruit and grapefruit juice affect how Viagra is processed in the body, keeping levels higher in the blood for longer.
- Be detailed with your doctor. In many cases, side effects minor and major come about in part either because men were too embarrassed to discuss a medical condition or thought it was unimportant. Get into the nitty-gritty details of your health and your medications with your doctor when considering Viagra.
What to Do in Case of Severe Side Effects
If you think you’re experiencing severe side effects from Viagra, seek medical help right away. Even if you’re not sure it’s related to Viagra, it’s better to err on the side of caution. Review possible signs of severe side effects with your doctor before you start taking Viagra.
Can You Overdose on Viagra?
While it’s possible to overdose on any drug, Viagra has so far not seen any pattern of major problems. However, overdosing on Viagra does raise the risk of side effects, including severe side effects. If you’ve accidentally taken too much Viagra, call your local poison control board and follow their instructions.
Alternatives to Viagra
If you’re struggling with the side effects from Viagra, remember there are other drugs in the same class. Vardenafil (Levitra) and tadalafil (Cialis) use the same mechanism but can have different and perhaps more manageable side effects. If you’re using Viagra frequently, Cialis daily offers the same benefits in a daily pill.
Long-term Effects of Using Viagra
In most cases, most men won’t take Viagra often enough to worry about long-term effects. There are some reports of gastrointestinal problems and vision issues with frequent and long-term usage, but these are still being studied.
However, remember that over time, your medical circumstances can change. Whenever you go to the doctor, make sure they know that you’re taking Viagra and to talk through possible concerns if they find a condition you need to treat.
Conclusion
Even if you’re otherwise healthy, it’s important to know the possible side effects of Viagra. You’ll be better able to protect your health and if a rare side effect surfaces, you’ll spot it faster and know what to do.
If you want to try Viagra, first speak with a doctor about your overall health and your ED. ED often has several different factors, such as lifestyle, and prescription medication is just one facet of the approach. As there are several PDE5 inhibitors on the market that are as well understood as Viagra, a doctor can guide you to your best options to treat and mitigate your ED.
To learn more about each side effect, check out our detailed articles linked above. And to learn more about getting erectile dysfunction medication at the best price, shipped straight to your door, visit our erectile dysfunction page!
Dan is a long-time freelance writer focusing on technology, science, health, and medicine, with a lifelong interest in physics, biology, and medicine. His work has taken a particular focus on scientific studies “beyond the headlines,” reading the study to more closely examine the results.