Is Viagra Bad for Your Heart ?

Taken alone, Viagra won’t hurt your heart. But don’t take it if you’re already taking nitrates for heart health, Dr. Montague says.

Viagra was originally intended to treat angina (chest pain), which it does well — just no better than other medications. Stiffer erections were a side effect.

“Here’s a drug that not only treats angina and is good for the heart, but it works on the penis when other medications don’t,” he says.

Like nitrates, it helps dilate blood vessels constricted by coronary artery disease.

But it also similarly lowers blood pressure.

If you take the two medications together, your blood pressure could drop too low, putting you at risk for a heart attack.

Is it safe to take Viagra with my heart medications?

Sexual activity plays a crucial role in the psychological health and quality of life scores in patients with cardiovascular disease. Unfortunately, intimacy is frequently an issue in patient with cardiovascular disease.

The causes of sexual dysfunction following myocardial infarction are multiple and include anxiety, depression, medication effect and vascular insufficiency.

Regardless of the cause, the results can be devastating to relationships and the psyche.

There are three phosphodiesterase-5 inhibitors currently available in the United States: sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). For simplicity and because of its name recognition, I will use the trade name Viagra to represent all phosphodiesterase-5 (PDE5) inhibitors even if the studies were completed using one of the other drugs.  I do not endorse Viagra above any of the others.

Viagra has been shown to be effective in the treatment of erectile dysfunction. Viagra works by increasing the amount of nitric oxide available which enhances erectile function.

So can I take Viagra with my heart medications?

Viagra has been shown to be safe in stable cardiovascular diseases including heart failure, hypertension, and coronary artery disease. Although many have looked, there has been no clear evidence that Viagra is associated with increased rate of heart attacks or cardiovascular events. When Viagra is combined with most blood pressure medicines, there is a small but real additive effect but no change in cardiovascular events.

However, when Viagra is combined with doxazosin and tamsulosin, two alpha-blocking medications often used to treat BPH (benign prostate hypertrophy) some patients develop low blood pressures. It is recommended that if these prostate medications are required, the smallest doses of each respective medication should be used.  Patients already receiving Viagra and other PDE5 inhibitors for pulmonary hypertension should not receive a second PDE5 for the treatment of erectile dysfunction.

On the whole, Viagra can be considered safe with almost all of your cardiac medications. Unfortunately, the combination of Viagra with nitrates should never be considered safe. Together they can cause life threatening hypotension, also known as low blood pressure.  Nitrates should not be taken within 24 hours of sildenafil or vardenafil and within 48 hours of tadalafil.

I have included a short list of commonly prescribed nitrates to help you avoid them.

    1. Nitroglycerin
    2. Sublingual nitroglycerin tablets (Nitrostat)
    3. Sublingual nitroglycerin spray
    4. Nitro patch
    5. Nitro paste
    6. Isosorbide mononitrate (Imdur, ISMO)
    7. Isosorbide dinitrate (Isordil)