Can Viagra Cause a Stroke?

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 3/31/2021

For the upward of 47 percent of U.S. men that suffer from erectile dysfunction  (ED), drugs like Viagra® can offer much-needed relief. Taken orally 30 to 60 minutes before intercourse , Viagra (sildenafil citrate) allows men to develop and maintain an erection for around four hours.

Given the benefits of what’s now known as the “little blue pill,” it can be all too easy to ignore the potential common side effects of popping one before sex. They include dizziness, headache, vision changes, flushing and stomach upset, just to name a few.

Another biggie — particularly for men who have a history of cardiovascular issues or regularly take nitrates? Stroke.

That’s nothing to ignore, especially for the millions of men who suffer from cardiovascular disease,  including high blood pressure, hypertension or a hardening of the arteries,  and take nitrates for these heart conditions. That’s because mixing these drugs with Viagra can be risky and potentially fatal.

How Viagra Works

Viagra is part of a class of drugs called PDE5 inhibitors, which work to block the degradative action of the PDE5 enzyme. This enzyme helps regulate blood flow to the erectile tissues of the penis. This means that if you suffer from erectile dysfunction and take Viagra, it will help send blood to your penis, allowing you to get and maintain an erection.

The penis isn’t the only part of the body affected by Viagra, however. When you take this medication or others like it, your blood vessels dilate, increasing blood flow to your penis and other parts of your body, which also affects your blood pressure. Blood pressure is the force of blood pushing through your arteries as your heart pumps it.

In healthy men taking Viagra, blood pressure decreases slightly. The average man experiences a decrease in 8.4/5.5 mmHg shortly after taking a normal dose of Viagra.

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What Men With Heart Conditions Need To Know

For most guys, this slight drop in blood pressure shouldn’t be concerning. But if you suffer from cardiovascular disease and take nitrates as a result, Viagra’s effect on your blood pressure can have serious adverse effects.

That’s because both Viagra and nitrates dilate your blood vessels and arteries. When taken together, this double-whammy combination can be significantly detrimental to your health, potentially causing you to feel dizzy, faint or even have a heart attack or stroke.  

In some cases, however, this combination can cause your blood pressure to drop to too-low levels, called hypotension. This can result in ischemic stroke.  Though typically caused when a blood vessel supplying blood to the brain is obstructed, significantly low blood pressure can also reduce flow to the brain. Cardiac arrest can also result from hypotension.

Symptoms of ischemic stroke include dizziness, nausea and vomiting, abnormal or slurred speech, arm, leg or face numbness or weakness (especially on one side of the body), loss of balance and an unusually severe headache. 

Sufferers require immediate medical attention, as brain cells begin to die within minutes when they are starved of the oxygen supplied by blood. 

Left untreated, ischemic strokes can result in memory loss, paralysis, and speech and language problems.

How To Identify Nitrates

If you’re on medication for a heart condition, you may not be aware you’re taking nitrates, especially if your drug isn’t generic. 

Nitroglycerin, isosorbide dinitrate and isosorbide mononitrate are commonly used nitrates used to treat systemic hypertension. All can interact with Viagra. 

Others include riociguat (sold as Adempas®), alpha-blockers and other medications that are used to treat hypertension.

If you’re unsure what you’re taking, carefully read the packaging to see if it contains any of these nitrates and  consult your healthcare provider.

Recreational drugs such as amyl nitrate and butyl nitrate, which are also called “poppers,” should not be used while taking Viagra.

Three Other Erectile Dysfunction Treatments

If you have a heart condition and take nitrates, and also suffer from ED, you may be feeling a bit hopeless.

Don’t. There are plenty of ways to improve sexual performance without drugs like Viagra.

Quitting smoking and moderating alcohol intake can help you achieve and maintain an erection, and improve your overall sexual performance. 

You may also want to limit your watching of porn, which, along with masturbation, has been shown to contribute to erectile dysfunction in some men.

Talking to your healthcare provider about testosterone deficiency, which is known to be a cause of erectile dysfunction, may also help uncover alternative treatments.

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Conclusion

Are strokes common side effects of Viagra? No — not by a long shot. For most healthy guys, the most common adverse side effects to worry about with Viagra are headaches, flushing, indigestion, changes in vision, back pain, nausea, dizziness, nasal congestion, rash and muscle pain. 

However, for men who have a history of cardiovascular issues, or men who are taking nitrate to treat those cardiovascular problems, taking Viagra can lead to some major, major complications — up to and including death. 

The most important thing to remember is to communicate clearly with your healthcare provider about any and all medications you’re taking before you start taking Viagra or generic Viagra. They’ll know the potential interactions or contraindications you should be aware of, and will be able to prescribe Viagra accordingly.

13 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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