Viagra Interactions: with Food, Alcohol and Other Drugs

In general, Viagra is considered very safe as long as it is taken properly. While there are always risks in taking any medication, if the correct dosage is taken, any dangers can be avoided.

Sildenafil, sold under the brand name Viagra, is becoming more and more popular as a treatment for erectile dysfunction (ED). Though it is effective for the treatment of ED in most cases, like any other drug it’s important to understand the potential dangers and interactions when mixing the medication with other substances.

What Is Viagra Used For?

Viagra is used in the treatment of erectile dysfunction. This condition arises in men due to inadequate blood flow to the penis which makes it difficult to attain and sustain an erection. Viagra works by relaxing the muscles around the penis so the blood vessels can properly dilate thereby increasing blood flow. It’s important to note that Viagra or Sildenafil only works when the man is sexually stimulated and does not in itself increase sexual desire.

Viagra Interactions: with Food, Alcohol, Medications and Drugs

Viagra Interactions

Viagra is generally safe to use, though clinical trials show that adverse interactions do occur. It’s important to know what not to take with Viagra to avoid any ill effects. The following paragraphs include food, medications, and other drugs that are contraindicated with Viagra.

With Food

In general, it is safe to take Viagra with food as long as those foods do not contain high levels of nitrates. However, many men have reported that the drug worked better for them when they took it on an empty stomach.

Viagra should ideally be taken an hour before intercourse for the medicine to have time to take effect. If Viagra is taken right before or after a large meal, particularly one that is heavy in fats, it may take much longer for the drug to be absorbed into the bloodstream. Basically, the Viagra will have to wait it out until the food is digested before it is able to hit the bloodstream and do its job.

Does Viagra Works on Full Stomach?

Viagra will still work when taken on a full stomach or right before a substantial meal. However, a full stomach can slow down the absorption of the medicine into your system since your body is using its energy to digest the food. The action of the drug is much more predictable when taken on an empty stomach.

Taking Viagra with Fruits

While Viagra does not interact with foods directly, there are certain fruits that are best avoided when using this medication. While grapefruit is the main culprit on this list and should be completely avoided, fruits like Pomegranate and Watermelon may also cause adverse interactions and should be eaten with care while using the drug.

Is It Dangerous to Take Viagra with Pomegranate?

Some have called the combination of Viagra and pomegranate “too much of a good thing”. The active ingredient in Viagra, sildenafil, has been known to be more effective when taken with pomegranate. Animal studies have shown that pomegranate can increase testosterone levels and the production of sperm cells and help men to have harder erections. So what’s the issue?

The problem arises when pomegranate plus Viagra begins to work a little too well. There have been cases of men having prolonged erections after orgasm while taking the two together. So although pomegranate juice can have positive effects on erections and on heart health in general, patients should be aware of this possible interaction and proceed with caution.

On a related note, watermelon may also be a risk when taken with the medication since this fruit, like pomegranate and Viagra, has the ability to dilate blood vessels and help the patient achieve an erection. So, watermelon along with pomegranate can be too much of a good thing and should be consumed with care.

Viagra Pills and Grapefruit

There have been many studies done on the interaction between medications and grapefruit or grapefruit juice. So what happens when Viagra and grapefruit are combined? While an erection can still be maintained when combining Viagra and grapefruit, the fruit has been known to prevent the breakdown of the drug in the body.

What this means is that there is greater drug uptake into the bloodstream which can increase Viagra side effects. So taking Viagra and grapefruit together could possibly lead to side effects like headaches, low blood pressure, flushing of the skin and fainting. Because of this, it is best to avoid combining the two.

With Alcohol

Patients frequently ask: can I drink while taking Viagra? Whether or not you can take Viagra with alcohol depends on the level of alcohol being consumed. Since Viagra has no effect on the blood levels of alcohol, the short answer would be yes. However, men should keep in mind that the consumption of alcohol can affect performance and too much alcohol can make it difficult to obtain an erection.

So, a little bit of alcohol to help relax and get in the mood would most likely be fine but it would be better to limit alcohol intake or simply refrain from mixing Viagra and alcohol altogether. Plus, men should keep in mind that both Viagra and alcohol can lower blood pressure. So men with blood pressure issues would do well to avoid alcohol completely.

Can I Drink Wine While Taking Viagra?

As far as taking Viagra with specific alcohol, such as red wine, there have been no adverse effects found from specific types of alcohol other than those mentioned above. Again, taking Viagra with any alcohol may reduce its efficacy particularly since alcohol is known to inhibit the very thing that Viagra is trying to correct.

With Medications

While Viagra is generally safe to take in conjunction with other medications, it is important to discuss any possible interactions with your doctor to avoid risks. Viagra’s effectiveness could be lessened or its use may be dangerous in certain situations.

Medications containing nitrates are the largest concern, although other medications have been known to interact. These include, but are not limited to, low and regular strength aspirin, Lipitor, Crestor, Cialis and Warfarin to name a few.

Antibiotics

Specific classes of antibiotics can interfere with Viagra. Macrolides are a specific type of antibiotic that is used in the treatment of infections. Some Macrolide antibiotics include erythromycin, azithromycin and clarithromycin.

Macrolide antibiotics inhibit the enzyme that metabolizes Viagra. This can, in turn, lead to an increase of Viagra in the blood. If you’re taking a macrolide antibiotic, it is best to either avoid Viagra altogether until your course of antibiotics is finished or limit your Viagra dose to 25 mg.

Furthermore, it’s important to let your doctor know you are taking Viagra when being put on antibiotics since there are alternative antibiotics that do not have this effect.

Warfarin

The combination of Viagra with this drug is generally regarded as safe, but there have been some recorded interactions between Warfarin and Viagra so caution is advised. The main concern with these two drugs in combination is that Warfarin is often prescribed for people with atrial fibrillation (an arrhythmia or problem with the rate or rhythm of your heartbeat). Patients with atrial fibrillation can sometimes develop low blood pressure which Viagra can exacerbate.

L-Arginine

L-Arginine, like Viagra, can dilate the blood vessels and lower blood pressure. Taking it in conjunction with Viagra may cause blood pressure to drop too low. This can lead to dizziness and other unpleasant side effects. Though there have been anecdotal reports of men combining l-Arginine and Viagra with no noticeable effect, it is best to avoid this combination.

With Drugs

Can you mix Viagra with other drugs? Doctors are now beginning to issue warnings to the public on the dangers of Viagra abuse, particularly when the medication is mixed with narcotics like ecstasy.

These drugs are used in combination to increase feelings of euphoria, but mixing the two can lead to a dangerous interaction known as serotonin syndrome. Too much serotonin builds up in the body and can cause disorientation, hallucinations, tremors and even seizures, irregular heartbeat or coma. Similarly, drugs like cocaine are contraindicated for use with erectile dysfunction drugs like Viagra because of the possibility of long term or even fatal consequences.

Viagra and Nitrates – Dangers and Risks

The US Food and Drug Administration (FDA) has warned against taking Viagra in conjunction with food and medication containing nitrates. When Viagra is taken with nitrates, a significant drop in blood pressure may occur due to the relaxation of the muscles that control the blood vessels.

Both Viagra and Nitrates cause these muscles to relax and when used together enable the vessels to enlarge in diameter. This can cause a severe drop in blood pressure which is especially dangerous to patients with angina pectoris, a heart condition where the proper flow of blood to the heart is absolutely essential. Lowering the blood pressure significantly in this way can lead to a heart attack. The following table shows the possible effects of Viagra on blood pressure:

Figure: Mean Change from Baseline in Sitting Systolic Blood Pressure, Healthy Volunteers.

Since November 1998, data has shown that 130 deaths have occurred in men who used Viagra, with 16 of those deaths thought to have a direct correlation to the use of nitrates. While it is possible that the deaths occurred due to other factors such as the increased pressure on the heart, the FDA stated that since there is no way to know when or if nitrates can be safely administered it is best to avoid the combination of Viagra with other drugs and food containing nitrates altogether.

The following is a list of some nitrate drugs to be avoided:

Nitroglycerin:

  • Deponit (transdermal);
  • Minitran;
  • Nitrek;
  • Nitro-BID (and Nitro-BID ointment);
  • Nitrodisc;
  • Nitro-DUR;
  • Nitrogard;
    Nitroglyn;
  • Nitrolingual (spray);
  • Nitrol ointment (APPLI-KIT);
  • Nitrong;
  • Nitro-Par Nitrostat;
  • Nitro-Time;
  • Transderm-Nitro.

Isosorbide mononitrate:

  • Imdur;
  • Ismo;
  • Monoket (tablets).

Isosorbide dinitrate:

  • Dilatrate-SR;
  • Isordil;
  • Sorbitrate;
  • Erythatyl tetranitrate;
  • Pentaerythritol tetranitrate;
  • Sodium nitroprusside.

In general, Viagra is considered very safe as long as it is taken properly. While there are always risks in taking any medication, if the correct dosage is taken and the above contraindicated substances are avoided, any dangers can be avoided. Feel free to order our free generic Viagra samples!