Interactions with ED Medications

Monday 24 May 2021
Erectile Dysfunction
5 minute(s) read

Table of Contents

I. What is Erectile Dysfunction?

II. Alcohol

III. Nitrates

IV. Grapefruit Juice

V. Blood Thinners

What is Erectile Dysfunction?

Erectile dysfunction (ED) is the inability to get or maintain an erection long enough for sexual intercourse. ED typically occurs in older men, but it can affect men of any age. Although it is common, ED is not a normal part of aging, so it is important to seek treatment for this condition.

When a man is sexually stimulated, the muscles in the penis relax and blood flows through the penile arteries and fills two chambers to create an erection. There are several conditions that can lead to a malfunction in this process. ED can be caused by factors such as:

  • Stress
  • Increased age
  • Anxiety
  • Diabetes
  • Hypertension
  • Obesity
  • Low testosterone levels
  • Tobacco use
  • High blood pressure

Luckily, there are many medications like Viagra, Cialis, and Levitra that can help with symptoms of erectile dysfunction. Each medication has its own ingredients, so it is vital to discuss any medications you are taking with your doctor before starting ED treatment. Some substances may have adverse interactions with your erectile dysfunction medications. Read on to learn more about what drugs and substances may interact with your ED treatment. [1]


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Alcohol is the most commonly abused substance in the United States. Alcohol is a depressant that suppresses the nervous and respiratory system. It also causes dehydration, which takes away the blood and oxygen flow needed to bring greater sensation to the genitals. Long-term alcohol use can cause damage to the nervous system, making ED symptoms present even when you are sober. Alcohol is not always conducive to a healthy sex life, but it can become dangerous if you consume alcohol while taking medications to treat your ED. [2]

a couple lying in bed

Obviously, alcohol affects each person differently. The effect of alcohol depends on how much alcohol is consumed, what time it is consumed, how much you’ve eaten, your weight, height, and body fat percentage. Limiting your alcohol can be beneficial to your overall health and wellness, but it is vital to reduce your drinking while taking ED medications. In most cases, it is generally safe to consume alcohol in moderation while taking drugs like Viagra. “Moderation” is considered less than three drinks a day for a man. [3]

The combination of Viagra and alcohol can worsen the side effects of Viagra and, in some cases, render the drug useless. Because alcohol works to slow certain functions within the body, it can undermine the effects of Viagra. If you drink heavily while taking Viagra, you may experience a drop in blood pressure, extreme dizziness, or rapidly blurred vision. [3]

beers on top of a table


Nitrates are medications used to treat or prevent chest pain (angina) caused by heart disease. Angina is a very specific chest pain caused by a narrowing of arteries in the heart. Heart disease is a chronic illness, so most people with heart conditions have to take nitrate medications on an everyday basis. Nitroglycerin is the most common type of nitrate medication. These medications can come in mouth sprays, tablets, and ointments.

Nitrates work by dilating or relaxing the arteries and veins not only in the heart, but in other parts of the body as well. When the blood vessels are dilated, blood flow is improved to the heart muscles and there is less stress on the heart. Viagra is also a vasodilator, so these two medications together can have a fatal effect. Viagra changes how you break down cGMP, which is a substance in the body that releases nitric oxide in the penis. Nitric oxide creates muscle relaxation in the penis, which then improves the ability to maintain an erection. [4]

Nitrates also contain nitric oxide, so combining two drugs with nitric oxide can make your blood pressure plummet. Therefore, it is not advised to take nitrates and ED medications if you have blood pressure issues or heart problems. Always consult your doctor before beginning a Viagra regime. [5]

Grapefruit Juice

It may sound bizarre, but many studies suggest that grapefruit juice can have negative interactions with many medications, including ED drugs. Scientists have found that drinking a glass of grapefruit juice can have a negative impact on the body’s absorption of many widely-prescribed medications.

Scientists believe this interaction is due to flavonoids in the juice. These flavonoids decrease the levels of certain intestinal enzymes that could otherwise break down many drug molecules before they reach the bloodstream. If the enzymes in grapefruit juice inhibit the absorption of drugs, then more medication reaches the bloodstream and may cause an overdose.

Consuming grapefruit juice while taking Viagra or Cialis can make the drugs less effective when the juice is present in the body. Orange and apple juice do not contain the same compounds as grapefruit juice, so they do not cause the same problems with ED drugs. [6] 

a person holding a grapefruit

Blood Thinners

Blood-thinning medications are prescribed to people who are at risk for blood clots. Dangerous blood clots can occur when cholesterol plaques form in the arteries. Sometimes these plaques break open and the clotting process begins. Most heart attacks and strokes happen when a plaque in your heart or brain suddenly bursts.

Blood-thinning medications are used to treat a variety of conditions like deep vein thrombosis and pulmonary embolism. These drugs also reduce the risk of stroke and embolism in those with atrial fibrillation (irregular heartbeat). Interactions with ED and blood thinners like Coumadin are common because the risk factors for blood clots are very similar to the risk factors for ED. Those risk factors include:

  • High blood pressure
  • Heart disease
  • Diabetes
  • Smoking
  • Cancer
  • Other chronic illnesses [7]

Risk factors for blood clots may also be the cause of your ED. Using blood thinners and ED medications may cause you to bleed more easily, so be careful if you are taking both medications. Most doctors do not recommend taking both drugs at the same time, so consult your doctor about the best medical plan for you. [8]

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.


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