VIAGRA, often dubbed the little blue pill, helps to get or maintain an erection and millions of Brits take it regularly – but there are certain things it shouldn’t be mixed with to avoid any negative side effects.
The dispenses 4.8 million prescriptions annually in for sildenafil, the active ingredient in Viagra as well as other oral erectile dysfunction (ED) medications, known as PDE5 inhibitors.
However, widely available pills such as Viagra are now being – a painful erection that can last for hours.
Incidents of priapism rose by 11 per cent in a year, from 336 cases a decade ago.
Experts warned that the risk of priapism can be heightened even further for those taking Viagra with , cocaine and/or other medications.
And fake Viagra pills could also be to blame – ED affects roughly one in five men in the UK, but it’s estimated that only a third of men (33 per cent) with ED in the UK are seeking medical help, according to Lloyds pharmacy .
This means many men may be getting their Viagra from unknown or unverified sources.
“An erection lasting four hours or longer is a medical emergency, even if it is not painful,” says Mr Dan Magrill, consultant urological surgeon at Nuffield Health .
“Ischaemic priapism, the most common form of priapism requiring emergency treatment, happens when blood becomes trapped in the erectile tissue.
“This leads to a lack of oxygen that can damage penile tissue and cause permanent erectile dysfunction if treatment is delayed.
“Patients should attend an emergency department immediately if an erection reaches four hours and should not wait for pain to develop.”
If you’re hoping to lower your chances of erection issues by taking Viagra, here’s what not to mix it with.
Alcohol
A few drinks to get you in the mood for lovemaking might not cause much harm, but heavy boozing won’t sit well with Viagra.
Dr Vijay Nayar, and medical director at Healthium Clinics , says: “Viagra (sildenafil) works by dilating blood vessels resulting in increased blood flow to the penis.
“However, this also causes a lowering of blood pressure throughout the body.
“Alcohol has a similar effect of dilating blood vessels and lowering blood pressure.
“Hence, when combined with Viagra, this increases the risk of low blood pressure, which can result in feeling light-headed and faint.”
Plus, too much booze can actually make an erection harder to achieve in the first place.
Dr Nayar warns that drinking alcohol with cocaine and taking Viagra, increases the risk even further.
Heart meds
If you’re already suffering from a heart condition and relying on certain medications, then be wary of taking ED medications containing sildenafil.
Mr Magrill says: “The most important interaction is between sildenafil and nitrate medications, which are prescribed to treat or prevent angina and other cardiovascular conditions.
“Examples include glyceryl trinitrate (GTN), which is often taken as a spray in the mouth or isosorbide mononitrate.
“Sildenafil and nitrates both increase the effects of nitric oxide-related effects that relax blood vessels. When taken together, they can cause a potentially life-threatening fall in blood pressure.”
This can lead to severe dizziness and fainting.
Your vital organs may not get the blood they need, and you may experience what’s known as cardiovascular collapse – where your heart and blood vessels fail to keep blood moving. This can be fatal.
Dr Nayar adds: “Other medications which lower blood pressure such as antihypertensives and alpha-blockers can be taken with Viagra but with caution.
“The risk is that blood pressure can drop excessively especially when standing up, resulting in dizziness and fainting.”
The British Heart Foundation says you should leave at least 12 hours between taking Viagra or other PDE5 inhibitors and using your GTN spray, or if you take nitrate tablets, allow at least 24 hours.
If you suffer from low blood pressure, Viagra is not recommended.
How does Viagra work?
SILDENAFIL – the main ingredient in Viagra – belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors.
It works if you have erection problems by temporarily increasing blood flow to your penis when you get sexually excited.
It also works in pulmonary hypertension by relaxing blood vessels in your chest.
This increases the blood supply to your lungs and reduces the workload of your heart.
Men over 18 can take the pills for ED and most adults and children aged over one can take sildenafil for pulmonary hypertension.
Sildenafil is not suitable for some people.
To make sure it’s safe for you, speak to your doctor or pharmacist before taking sildenafil if you:
- Have ever had an allergic reaction to sildenafil or any other medicine
- Are taking medicines called nitrates for chest pain (angina)
- Have a serious heart or liver problem
- Have recently had a stroke, heart attack or a heart problem – your doctor should carefully check whether your heart can take the additional strain of having sex
- Have low blood pressure (hypotension)
- Have a rare inherited eye disease, such as retinitis pigmentosa
- Have sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells) or multiple myeloma (cancer of bone marrow)
- Have a deformity of your penis or Peyronie’s disease (curved penis)
- Have a stomach ulcer
- Have a bleeding problem like haemophilia
Source: NHS
Other ED meds
Thought that taking multiple treatments for erectile dysfunction would give you better results in the sack? Think again.
Mr Magrill warns that instead of lovemaking, you might experience a big drop in blood pressure, dizziness, fainting, headaches, flushing, visual disturbances and prolonged erections or priapism.
Other ED meds such as tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra), as well as other formulations of sildenafil, act through similar mechanisms.
So, taking them together may increase the risk of adverse effects without providing a proven additional benefit.
Mr Magrill says: “Combining these is generally not recommended unless specifically directed by an appropriately qualified specialist.
“The risk of adverse effects may also increase when sildenafil is combined with other treatments that promote erections, including alprostadil injections, intraurethral alprostadil or certain combination injection therapies.
“These treatments can independently cause priapism, and their combined safety with sildenafil has not been established sufficiently to recommend routine use.”
Certain antibiotics
If you’re taking Viagra, or planning to, make sure to tell your GP before taking an antibiotic prescription.
“The antibiotics erythromycin and clarithromycin may increase sildenafil concentrations in the bloodstream,” warns Mr Magrill.
“This is because they can slow down the body’s breakdown of sildenafil, potentially increasing adverse effects.”
This can then increase the risk of priapism.
Erythromycin and clarithromycin are usually prescribed for skin conditions, STIs and respiratory infections.
Cocaine
Taking cocaine is of course a risk in itself, but mixing it with Viagra can put a serious amount of strain on your heart by on the cardiovascular system.
“Using cocaine and sildenafil together can produce unpredictable cardiovascular effects, particularly in people with underlying ,” says Mr Magrill.
“Cocaine is a powerful stimulant that can increase heart rate and blood pressure, constrict blood vessels and place a lot of strain on your cardiovascular system.”
On the other hand, Viagra , meaning it helps them widen and relax, which can lower blood pressure.
You may experience chest pain, an abnormal heartbeat, heart attack and even .
Mr Magrill says: “The safest advice is to avoid cocaine entirely, [especially] when taking sildenafil, and to avoid excessive alcohol consumption.
“Anyone experiencing chest pain, severe breathlessness, collapse or other concerning symptoms after combining these substances should seek emergency medical assistance and it’s very important to disclose what they have taken.”
He also warns that certain medicines used to treat chest pain, particularly nitrates, can interact dangerously with the sildenafil found in Viagra.
