Mixing Alcohol and ED Medication: Understanding the Risks

Viagra is a medication used to treat erectile dysfunction (ED).1 Erectile dysfunction is characterized by the inability to get and maintain an erection and can occur sometimes or every time you have sex.2 This condition impacts about 20% to 40% of men ages 60 to 70. However, some men who don’t have erectile dysfunction use Viagra to enhance their sexual satisfaction. Men who use Viagra to enhance sexual satisfaction are more likely to combine alcohol and ED medication.3

Viagra Use and Side Effects

Viagra, which is taken by mouth as a tablet or liquid, is used to treat erectile dysfunction by increasing blood flow to the penis, which can lead to an erection. It is also prescribed to treat pulmonary arterial hypertension (PAH), which causes dizziness and shortness of breath. Viagra belongs to a class of medications known as phosphodiesterase (PDE) inhibitors.1

As with any medication, some Viagra side effects are within the normal range when using it as prescribed. These include:1

  • Headache
  • Heartburn
  • Diarrhea
  • Flushing (feeling warm)
  • Nosebleeds
  • Difficulty falling asleep or staying asleep
  • Numbness, burning or tingling in arms, hands, feet, or legs
  • Muscle aches
  • Changes in ability to accurately see color
  • Light sensitivity

Some sildenafil side effects can be dangerous and require immediate medical attention. These include:1

  • Sudden and severe loss of vision
  • Decrease or loss of hearing
  • Ringing in ears
  • Dizziness or lightheadedness
  • Fainting
  • Chest pain
  • Worsening shortness of breath
  • Erection that is painful or lasts longer than four hours
  • Itching or burning during urination
  • Rash

Why Do Alcohol and Viagra Interact?

Viagra is a PDE inhibitor, which means it blocks a protein that metabolizes a chemical necessary to achieve and maintain an erection, causing the erection to last. This results in vasodilation, which helps improve blood flow to the penis.

The reason alcohol and ED medication interacts is because alcohol also causes vasodilation, which can result in a significant reduction in blood pressure, which can be dangerous and cause dizziness, fainting, blurred vision, and more. For this reason, Viagra should also not be taken with blood pressure medications.1

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What are the Risks of Mixing Alcohol and ED Medication?

Viagra can help with erectile dysfunction by increasing blood flow to the penis during sexual activity or when sexually aroused.1 Alcohol lowers blood pressure and relaxes muscles.3 Taking them together can result in severe side effects and can interfere with Viagra’s desired effects.

Can You Drink Alcohol with ED Medication?

Alcohol can increase the risk of experiencing the side effects of Viagra. One study shows the most common side effects of combining these substances are facial flushing and headache.3 If you mix alcohol and ED medication, you may experience these other side effects:3

  • Skin rash
  • Stomach pain
  • Chest discomfort
  • Visual changes
  • Dizziness
  • Nasal congestion

Does Viagra Work with Alcohol?

Mixing Viagra and alcohol can lead to complications in the body’s ability to control blood flow due to changes in blood pressure, which can result in inability to achieve or maintain an erection during sexual arousal—it can also worsen Viagra’s side effects.3

What Happens if You Take Viagra After Drinking Alcohol?

The side effects of Viagra and alcohol use can increase or become more intense depending on how much you are drinking. Heavy alcohol use may make it less likely that Viagra will be effective.3,4 This is because alcohol decreases blood pressure and muscle tone. This makes it more difficult for blood flow to reach the penis, which is required to have an erection.3

The FDA has not issued guidelines or recommendations for using Viagra while drinking. However, some studies show that limiting the amount of alcohol to less than four drinks in a day can reduce the likelihood of experiencing side effects.3 If you are struggling to limit your alcohol intake, this could be a sign of alcohol use disorder. Call your treatment provider for assistance or give us a call at 800-948-8417 Info iconCalls are forwarded to paid advertisers to speak to a rehab support specialist who can connect you to a treatment facility.

Can Alcohol Use Cause Erectile Dysfunction?

Chronic or heavy alcohol users commonly experience erectile dysfunction. In fact, one study shows that about 72% of people with alcohol use disorder also experience sexual dysfunction.4

The most common sexual issues are erectile dysfunction, premature ejaculation, and low sexual desire. Research also shows that chronic, heavy alcohol use can significantly change hormones that influence sexual functioning.4

This study demonstrates the link between alcohol use and sexual issues. The men who drank heavily experienced more problems with sexual functioning than men who drank less or who don’t drink.4 Heavy drinking for men is having more than four drinks in a day or more than 14 drinks in a week.5

Fortunately, alcohol-induced sexual dysfunction can resolve when someone stops drinking.4

Who is at Risk of Severe Side Effects From Alcohol and Viagra?

The interaction between alcohol and Viagra increases the risk for issues with blood pressure.3 If you experience the following medical conditions, you are more at risk of complications from Viagra use:1

  • Tobacco use
  • Dehydration
  • Pulmonary diseases
  • Eye conditions that impact blood flow to the eyes or vision
  • High or low blood pressure
  • Blood circulation problems
  • Heart disease or other cardiac conditions

A study conducted on alcohol use and Viagra shows that certain groups of people are more likely to combine alcohol and Viagra. These groups are:3,5

  • People who were unaware of the risk factors associated with combining these substances
  • People who drink heavily or misuse alcohol
  • Individuals using Viagra as an attempt to treat alcohol-induced erectile dysfunction
  • Men who are using Viagra as a sexual enhancement rather than using the medication as prescribed

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What Should I Do if I Have Mixed Alcohol and Viagra?

If you have mixed alcohol and ED medication, you may experience more intense side effects of Viagra. If you are planning to drink, consider not taking Viagra. Viagra is taken as needed, so it is okay to miss a dose. Some of the combined side effects are serious and may require medical attention. Serious side effects of alcohol and ED medication include:1

  • Sudden and severe loss of vision
  • Decrease or loss of hearing
  • Ringing in ears
  • Dizziness or lightheadedness
  • Fainting
  • Chest pain
  • Worsening shortness of breath
  • Erection that is painful or lasts longer than four hours
  • Itching or burning during urination
  • Rash

If you are going to drink while using Viagra, side effects can depend on how much you are drinking. Moderate drinking is associated with less severe side effects.3,4 However, if you are experiencing any of the side effects above, you should contact 911 or go to the nearest emergency room.

Erectile Dysfunction and Alcohol Addiction

If you are experiencing erectile dysfunction and alcohol addiction, it can be challenging to avoid drinking while using Viagra. Fortunately, both conditions are treatable. Always see your doctor if you’re experiencing erectile dysfunction. While it’s possible that it may be alcohol-induced, being evaluated can rule out other conditions that could be contributing.2,4

You may have struggled with erectile dysfunction before you began drinking or misusing alcohol. Other factors that can lead to this condition are:2

  • Health conditions like type 2 diabetes, high blood pressure, or low testosterone
  • Side effects of medications, like antidepressants, sedatives, or blood pressure medications
  • Psychological or emotional issues, like anxiety, depression, sexually-induced anxiety, or low self-esteem
  • Smoking
  • Being overweight
  • Drug use

If you are experiencing erectile dysfunction as a result of these factors, alcohol use can worsen the condition.4 If you continue to drink despite experiencing alcohol-induced sexual dysfunction, this could be a sign of alcohol use disorder.

Other symptoms of alcohol use disorder include:6

  • Drinking larger amounts or for longer than intended
  • Spending a significant amount of time obtaining and drinking alcohol, as well as recovering from its effects
  • Failing to cut back or stop drinking despite desires to do so
  • Continuing to drink even if it’s physically or psychologically harmful
  • Continuing to drink despite interpersonal or social consequences caused by alcohol use
  • Drinking in dangerous situations, such as while driving
  • Experiencing strong cravings for alcohol
  • Neglecting previously enjoyed hobbies in favor of drinking
  • Needer a higher number of drinks to get drunk (tolerance)
  • Experiencing alcohol withdrawal symptoms when you quit (dependence)

Treatment Options for Erectile Dysfunction and Alcohol Addiction

Researchers state that addiction specialists and sexual medicine specialists should consider the relationship between alcohol and sexual dysfunction.4 Addiction specialists can assess for sexual dysfunction and then make a referral to a sexual medicine specialist to assess for underlying medical conditions.

If erectile dysfunction is determined to be a result of alcohol use, then an addiction specialist or mental health professional can support you in recovering from alcohol use disorder. Sexual dysfunction may resolve as you recover.4 It’s also possible that erectile dysfunction was made worse by alcohol use but stems from unresolved psychological or emotional issues.2 In this scenario, a mental health professional can support you in working through these issues while also treating alcohol misuse.

Treatment for erectile dysfunction can also include:2

  • Changing medications
  • Injectable medications or suppositories
  • Alternative medicines, such as supplements
  • A vacuum device that pulls blood into the penis
  • Surgery
  • Lifestyle changes such as quitting smoking or exercising more

The different types of treatment for alcohol use disorder include:

  • Alcohol addiction medications, such as naltrexone
  • Therapies, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and contingency management, to help improve coping skills, avoid triggers, and address underlying issues
  • Support groups, such as Alcoholics Anonymous (AA) or SMART Recovery, which offer an opportunity to receive support and feedback from peers who are also experiencing alcohol misuse (these do not constitute treatment on their own, but rather, are helpful when used in conjunction with evidence-based therapies)

If you feel that you can’t control your drinking or you can’t stop drinking while using another substance like Viagra, call 800-948-8417 Info iconCalls are forwarded to paid advertisers to speak with a treatment specialist.

Resources

  1. National Library of Medicine. (2018). Sildenafil.
  2. National Institute of Diabetes and Digestive and Kidney Diseases. Erectile Dysfunction.
  3. Kim, J.N., Jin Oh, J., Park, D.S., Hong, Y.K., & Yu, Y.D. (2019). Influence of alcohol on phosphodiesterase 5 inhibitors use in middle-to-old-aged men: A comparative study of adverse events. The Journal of Sexual Medicine, 7, 425-432.
  4. Arackal, B.S. & Benegal, V. (2007). Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian Journal of Psychiatry, 49(2), 109-112.
  5. National Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help.
  6. American Psychiatric Association. (2013). Substance-Related and Addictive Disorders. Diagnostic and Statistical Manual of Mental Disorders (pp. 481-590). American Psychiatric Publishing.
  7. Korkes, F., Costa-Matos, A., Gasperini, R., Reginato, P.V., & Perez, M.D.C. (2008). Recreational use of PDE5 inhibitors by young healthy men: Recognizing this issue among medical students. Journal of Sexual Medicine, 5(10), 2414-2418.
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