Viagra Side Effects, Precautions and Avoidances

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Who should not take Viagra?

• Patients with bleeding disorders or with patients with active peptic ulceration. The safety of sildenafil citrate is still unknown.
  
  
• Patients with Peyronie’s disease, or any physical deformation of the penis. Sildenafil citrate should be used with caution in these patients, or in patients who have conditions which may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia).
  
  
• If you are taking other Erectile Dsyfunction drugs. Do not combine Viagra with other erectile dysfunction drugs such as Cialis or Levitra.
  
  
• If you take any medications called nitrates. Nitrates are commonly used to treat angina, pain in your chest, jaw, or down your arm, which are common symptoms of heart disease. Medicines called nitrates include nitroglycerin that is found in tablets, ointments, sprays, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. Some recreational drugs called “poppers” also contain nitrates, such as amyl nitrate and butyl nitrate. Do not use Viagra if you are using any of these drugs. Speak with your doctor or pharmacists if you are not sure if any of your medications contain nitrates.
  
  
• If you take any medicines called “alpha blockers”, other than Flomax 0.4 mg daily. Alpha blockers are sometimes prescribed for high blood pressure or prostate problems. If Viagra is taken with alpha 0.4 blockers other than Flomax mg daily, it can cause your blood pressure to abruptly drop to an unsafe level. You might feel dizzy, faint or have a heart attack or stroke.
  
  
• If you are told to refrain from sexual activity. Your doctor may have told you not to have sexual activity because of health problems. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from heart disease or a heart attack.
  
  
• If you are allergic to Viagra or any of its ingredients. The active ingredient in Viagra is sildenafil citrate. The inactive ingredients include: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hydroxypropyl methylcellulose, titanium dioxide, lactose, triacetin, and FD&C blue #2 aluminum lake.
  
  
• If you have certain eye problems. Stop using Viagra if you have any loss in your eyesight. One side effect of Viagra is changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green). If you experience this, stop taking Viagra and see your doctor immediately.

What should you discuss with your doctor before taking Viagra?

Before taking Viagra, tell your doctor if you:

• Are over 50 years old
  
  
• Have heart problems such as angina (chest pain), irregular heartbeats, heart failure or have every had a heart attack
  
  
• Have high or low blood pressure that is not controlled
  
  
• Suffered a stroke
  
  
• Have diabetes
  
  
• Smoke
  
  
• Have a personal or family history of a rare heart condition known as prolongation of the QT interval (long QT syndrome)
  
  
• Have liver problems
  
  
• Have kidney problems and require dialysis
  
  
• Have a family history of retinitis pigmentosa, a rare degenerative eye disease
  
  
• Have stomach ulcers
  
  
• Have a bleeding or clotting disorder
  
  
• Have ever had blood cell problems, including sickle cell anemia, multiple myeloma, or leukemia
  
  
• Have a physical deformity of the penis such as Peyronie’s disease
  
  
• Have had an erection that lasted more than 4 hours

If you have any of the above conditions, you may not be able to take Viagra, or you may require a dosage adjustment or special monitoring during treatment.

What other medicines affect Viagra?

Tell your doctor about all the medicines you take including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines may be affected by Viagra or may affect how it works. Know the medications you take, and keep a list of them with you to show your doctor when needed. Always check with your doctor before starting or stopping any medicines to ensure that the combination is safe. Tell your doctor or pharmacists if you take any of the following:

• Any form of nitrate medication, this combination can result in a severe drop in blood pressure that can trigger dizziness, fainting, or even a heart attack. Nitrate medications include: nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro, others) isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), isosorbide mononitrate (Imdur, ISMO, Monoket), and amyl nitrate (a recreational drug known as “poppers”).
  
  
• Medicines called alpha blockers (other than tamsulosin (Flomax) 0.4 mg once a day). These include terazosin HCI (Hytrin), doxazosin mesylate (Cardura), prazosin HCI (Minipress), alfuzosin HCI (Uroxatral), guanadrel (Hylorel), and others. Alpha blockers are often prescribed to patients who suffer from prostate problems or high blood pressure. If Viagra is taken with certain alpha blockers, it might result in a sudden drop in blood pressure, you may feel dizzy or faint.
  
  
• Medicines that treat abnormal heartbeat, these include quinidine, procainamide, amiodarone and sotalol.
  
  
• Medicines used to treat HIV such as ritonavir (Norvir), indinavir (Crixivan), and others.
  
  
• An antifungal medication such as ketoconazole (Nizoral) or itraconazole (Sporanox).
  
  
• The antibiotic erythromycin, used to fight many different types of bacterial infections, such as tonsillitis, bronchitis, pneumonia, whooping cough, Legionnaire’s disease, Chlamydia, gonorrhea, skin infections, and others.
  
  
• Any other drug used to treat ED or impotence, such as vardenafil (Levitra), Tadalafil (Cialis), alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others).

What should I avoid while taking Viagra?

• Do not take any other drug used to treat ED or impotence, such as vardenafil (Levitra), tadalafil (Cialis), alprostadil (Caveriect, Muse, Edex) or vohimbine (Yocon, Yodoxin, others), without first speaking with your doctor or pharmacist.
  
  
• Viagra should not be taken with excessive amounts of alcohol (for example, 5 glasses of wine or 5 shots of whiskey). Excessive alcohol may increase the risk of getting a headache, feeling dizzy, increasing your heart rate, or lowering your blood pressure.
  
  
• Drinking alcohol can also temporarily impair the ability to achieve an erection. To reduce impairment do not drink excessive amounts of alcohol before sexual activity.
  
  
• Be careful when driving or operating machinery until you know how Viagra affects you. Viagra may cause dizziness or faintness in some patients. The ability to drive and/or operate machinery may be impaired when taking Viagra. If you add in alcohol, dizziness or faintness may be worse.
  
  
• Grapefruit or grapefruit juice may interact with Viagra causing potentially adverse effects and even cause fatal consequences. Talk with your doctor about drinking grapefruit juice while taking Viagra. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

These drugs increase the concentration of Viagra in the blood. You may not be able to take Viagra, or you may require an adjustment in your dosage, or special monitoring during treatment if you are taking any of the medicines listed above.

Side effects of Viagra

Very few drugs work perfectly, and Viagra is no exception. Just about every drug has side effects that arise because the drug is flowing throughout the body and may affect parts of the body unintentionally. Viagra has several side effects that you should be aware of.

One side effect that Viagra has is the result of a spill-over effect. Viagra blocks PDE5, but also has an effect on PDE6. It turns out that PDE6 is used in the cone cells in the retina, so Viagra can have an effect on color vision. Patients who take Viagra may notice a change in the way they perceive green and blue colors, or they see the world with a bluish tinge for several hours. Because of this, pilots cannot take Viagra within 12 hours of a flight.

Another problem comes for people who are taking drugs like nitroglycerin for angina. Nitroglycerin works by increasing nitric oxide, and it help with angina by opening up the arteries that supply the heart with oxygen. If you take nitroglycerin and Viagra at the same time, the increased nitric oxide plus the blocking of PDE5 can lead to problems.

Other side effects include more minor things like headaches (the drug, as a side effect in some men, opens up the arteries in the brain’s lining and causes excess pressure) and major things like heart attacks. The possibility of heart attacks is one reason why Viagra is a prescription drug rather than over-the-counter. Your doctor needs to understand your medical history to ensure Viagra won’t cause a heart attack.

As with any ED tablet, Viagra may cause an erection that won’t go away (priapism). If you get an erection that lasts for more than 4 hours, seek immediate medical help to avoid long-term injury. Priapism must be treated as soon as possible or lasting damage can happen to the penis including the ability to have future erections.

There is also some concern that some men, especially younger men, take Viagra recreationally and don’t really need it for physical reasons. They might end up with a dependency on the drug, and may become unable to maintain an erection without taking Viagra.

It is also important to remember, do not give Viagra to other people, even if they have the same symptoms that you have. They may have other medical conditions you are not aware of and when Viagra is used could potentially harm them.

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