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Does Cialis (Tadalafil) Lower Blood Pressure

Cialis side effects and how to avoid them

Cialis (active ingredient: tadalafil) is a brand-name prescription medication that treats erectile dysfunction, or the signs and symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH). Classified as a phosphodiesterase type 5 (PDE5) inhibitor, tadalafil relaxes smooth muscles and arteries in the penis.

Cialis also allows more blood to flow to the penis for a longer period to maintain an erection. Cialis also requires sexual stimulation in order to work for erectile dysfunction.

Cialis helps to relieve the lower urinary tract symptoms of benign prostatic hyperplasia. It is thought to work for BPH by relaxing muscles in the lower urinary tract.

As can be expected, medicines that affect blood vessels may have unwanted side effects and potentially risky drug interactions. People considering Cialis should be familiar with these side effects and potential interactions as well as any medical conditions that may render the medicine unsuitable.

Common side effects of Cialis

The most common side effects of Cialis are:

  • Headache
  • Stomach upset/diarrhea
  • Back pain
  • Muscle pain
  • Nasal congestion
  • Upper respiratory infection
  • Flushing
  • Pain in the limbs or extremities
  • Swelling of the nose and pharynx
  • Dizziness

Serious side effects of Cialis

Cialis can cause serious side effects such as:

  • Prolonged erections: Though rare, some people have reported prolonged erections (erections lasting longer than four hours) or priapism (painful erections lasting longer than six hours) when taking drugs similar to Cialis. Both prolonged erections and priapism should receive emergency medical treatment. Priapism may damage erectile tissues if it is not treated right away.
  • Sudden loss of vision: Non-arteritic anterior ischemic optic neuropathy or NAION has been reported—rarely—in people taking drugs like tadalafil. NAION can cause a sudden decrease or complete loss of vision in one or both eyes. Immediately stop the drug and get emergency medical help if you notice changes in vision.
  • Sudden loss of or decrease in hearing: Hearing loss has been reported with Cialis and may be accompanied by dizziness or ringing in the ears. Immediately stop the drug and get emergency medical help if you notice hearing loss.
  • Cardiovascular events such as fainting, chest pain, heart attack, or stroke: Most (but not all) people who have had severe cardiovascular events while taking Cialis had pre-existing risk factors.
  • Low blood pressure (hypotension): Tadalafil lowers blood pressure, so low blood pressure is a possible side effect.
  • Severe allergic reactions: Rare but severe (and potentially lethal) hypersensitivity reactions due to Cialis include hives, Stevens-Johnson syndrome, and exfoliative dermatitis.

Blood pressure

Cialis relaxes the smooth muscles in arteries, lowering blood pressure slightly. Because of this, low blood pressure, or hypotension, might be a problem. Hypotension is defined as blood pressure that dips below 90/60 millimeters of mercury (mmHg ). At its mildest, low blood pressure makes people vulnerable to fainting, falls, and injuries. If blood pressure falls too low, vital organs may fail, which could result in death.

In tadalafil’s phase III clinical trials, no patients (out of 949) experienced clinical hypotension. In phase III studies evaluating the safety of tadalafil when taken with drugs that lower blood pressure (called antihypertensives), the combination only slightly increased the risk of low blood pressure. When taken with two or more antihypertensives, tadalafil did not increase the incidence of hypotension.

Another form of low blood pressure is orthostatic hypotension, which is characterized by a sudden decline in blood pressure that happens when a person stands up from a sitting or lying position. While often harmless, producing little more than lightheadedness, orthostatic hypotension can result in serious consequences depending on its cause. In the study (mentioned above) that focused on this issue, tadalafil was found to have no clinically relevant effects on orthostatic hypotension.

How long do Cialis side effects last?

Most common side effects of Cialis are temporary and will abate within a few hours or days after discontinuing the medicine. Some, like headache, back pain, and muscle pain were the main reasons a small number of people in the initial clinical trials stopped using Cialis.

Other side effects, such as severe allergic reactions, prolonged erections, priapism, hearing loss, and cardiovascular events require immediate medical attention and may require long-term attention. Severe but rare possible adverse events such as damage to erectile tissues due to priapism, hearing loss, heart attack, or stroke may have lifelong consequences. Vision loss due to NAION can be permanent .

Cialis contraindications & warnings

Cialis may not be the right drug for all men, particularly because of its effects on the cardiovascular system. Cialis is contraindicated for men:

  • With known serious hypersensitivity to tadalafil
  • With severe kidney disease (renal impairment) or men on dialysis
  • With severe liver disease (hepatic impairment)
  • Who take nitrates or guanylate cyclase stimulators

Some people can take Cialis but may have medical conditions that require caution, that is, careful monitoring and a possible dose reduction. These include:

  • Mild to moderate kidney disease
  • Mild to moderate liver disease
  • High blood pressure
  • Certain cardiovascular problems
  • Diabetes
  • High cholesterol (hyperlipidemia)
  • A history of non-arteritic anterior ischemic neuropathy (NAION) or risk factors such as optic disk crowding
  • Penile deformities such as Peyronie’s disease, cavernosal fibrosis, or angulation
  • Any condition that carries a risk of priapism such as sickle cell anemia, leukemia, or multiple myeloma

According to DailyMed , patients with cardiovascular conditions such as amyocardian infarction, angina, hypotension, stroke or uncontrolled arrhythmias at present, or the recent past, should not take Cialis because no clinical studies have been conducted to evaluate safety and efficacy.

Abuse and dependency

The recreational use of Cialis and other erectile dysfunction medications (EDMs) is surprisingly high, particularly among young men who are sexually active. Besides the risk of side effects, men misusing EDM drugs are more likely to make lifestyle choices that put them at a greater risk for sexually transmitted disease and potential drug interactions with other illicit or recreational drugs such as “poppers.”

There is some uncertainty that medications like tadalafil cause physical dependency, tolerance, or withdrawal. The consensus view is that they don’t. It’s particularly difficult to separate EDM dependency from associated lifestyle choices. Many men abusing EDMs also use recreational drugs that can cause erectile dysfunction, making chronic use of EDMs necessary. Highly active sexual lifestyles may also necessitate chronic or high-dose use of EDMs.

Drugs like Cialis that do not cause physical dependence or withdrawal can still result in abuse and behavioral dependence . Mental health professionals diagnose this condition as “substance abuse disorder,” which can be mild to severe depending on how much the misuse of a drug impairs relationships and functioning. In some cases, the recreational use or misuse of tadalafil can certainly justify a diagnosis of substance abuse disorder. Successfully ending the misuse may require therapy.

Children

Cialis is never to be given to people younger than the age of 18.

Pregnancy and breastfeeding

Cialis is not approved for use in women.

Senior citizens

The manufacturer does not recommend dosage adjustment based on age alone. However, the full picture of age and other conditions should be taken into account when deciding on the appropriate dosage of Cialis.

Cialis interactions

Cialis can be taken with or without food. However, that does not mean that Cialis can be taken with all foods. Grapefruit has substances that slow down the body’s metabolism of tadalafil. It takes longer for the body to break down the drug, so the concentration of tadalafil in the blood goes up, making side effects more likely.

Men taking tadalafil should also limit alcohol intake. Like Cialis, alcohol lowers blood pressure. Combining too much alcohol with Cialis could cause severely low blood pressure. The FDA recommends no more than four drinks per day when taking Cialis, but check with your healthcare provider regarding a safe amount of alcohol consumption based on your other conditions and/or medications you take.

Cialis has several drug interactions men should be aware of when taking the medication.

  • Nitrates—CONTRAINDICATED: Nitrates are medications used to treat chest pain (angina). They act in a way very similar to Cialis. They increase the levels of a molecule (cyclic guanosine monophosphate) that causes artery muscles to relax. Arteries rapidly widen, allowing blood flow to increase to the heart. Nitrates include nitroglycerin , nitroprusside, isosorbide mononitrate, and isosorbide dinitrate. Combining nitrates with Cialis risks reducing blood pressure so drastically that it results in a heart attack or stroke. If nitrates are ever required, they cannot be used until 48 hours after the last dose of Cialis.
  • Guanylate cyclase (GC) stimulators—CONTRAINDICATED: Cialis is never given to people taking the GC stimulators Adempas (riociguat) or Verquvo (vericiguat). Adempas treats pulmonary arterial hypertension (high blood pressure in the arteries that go from the heart to the lungs). Verquvo is used in certain patients with chronic heart failure. GC stimulators work in much the same way as Cialis and nitrates by increasing the chemical that widens arteries. The combination risks causing severely low blood pressure.
  • Nitrites: Nitrites are similar to nitrates. They relax smooth muscles in the arteries, so combining them with tadalafil increases the risk of low blood pressure. Nitrites can be found in some recreational drugs known as “poppers,” including amyl nitrite or butyl nitrite.
  • Erectile dysfunction medications (EDMs): Hypotension and other side effects are at greater risk if Cialis is used with other erectile dysfunction medications that, like Cialis, are PDE5 inhibitors. These drugs, which include Viagra (sildenafil) and Levitra (vardenafil), should be avoided when taking Cialis.
  • Blood pressure medications (antihypertensives): Combining Cialis with medications that lower blood pressure carries a small risk of low blood pressure, so therapies may require monitoring blood pressure. Doses may sometimes need to be changed. Other drugs, such as opioids, antidepressants, and antipsychotic medications may also lower blood pressure, so blood pressure monitoring may be required when they’re combined with Cialis.
  • Alpha-blockers: Alpha-blockers are used to treat high blood pressure or an enlarged prostate. Because of the risk for low blood pressure, combining Cialis with these drugs is generally not recommended.
  • CYP3A4 inhibitors: Besides grapefruit, several drugs also slow down the metabolism of tadalafil by blocking an enzyme, called CYP3A4, which breaks down tadalafil. These drugs include some types of antibiotics, some types of HIV medications, some types of antifungals ( ketoconazole and itraconazole), some types of benzodiazepines, and some types of corticosteroids. Combining tadalafil with a strong CYP3A4 inhibitor may cause serious side effects. A lower dose of Cialis may be required.
  • CYP3A4 inducers: Alternatively, some drugs speed up the body’s metabolism of tadalafil, reducing the benefit of a Cialis dose. Called CYP3A4 inducers, these drugs do not cause serious problems. Examples of CYP3A4 inducers include rifampin, phenobarbital, phenytoin, and carbamazepine. At worst, the Cialis dose might need to be increased. Healthcare providers and pharmacists are well-versed in these drugs, so they can easily spot the combination and offer advice.

How to avoid Cialis side effects

The risk of Cialis side effects can be minimized by following a few general pointers:

1. Take Cialis under the care of a healthcare provider

Do not take Cialis or other erectile dysfunction medications without a prescription from a licensed healthcare provider. To avoid potentially hazardous side effects, the prescribing healthcare provider should perform an in-person physical examination and medical history review. For people with certain conditions, regular medical visits may be required to ward off serious side effects.

2. Only purchase Cialis from a licensed pharmacist

Purchasing Cialis or other erectile dysfunction medications through alternative channels carries the risk of purchasing counterfeit or unsafe medications. Dose strengths may be wrong, raising the risk of ineffectiveness or side effects. Purchase Cialis by prescription only, and through a licensed pharmacy, such as your local pharmacy or your insurance’s mail order facility.

3. Take Cialis as directed

Take the dose as prescribed. Read, understand, and follow the medication guide or patient instructions that come with the medicine. A pharmacist, doctor, or other healthcare professional can answer any questions or clear up any confusion. Above all, do not increase or decrease the dose without consulting your doctor. If effectiveness or side effects are a problem, talk to your healthcare provider about adjusting the dose.

4. Tell the doctor about all medical conditions and medications

Because of the risk of side effects, always make sure the prescribing doctor or healthcare professional knows about a ny medical conditions, particularly:

  • Heart or circulation problems
  • Stroke
  • Blood pressure problems
  • Blood cell problems (such as sickle cell anemia)
  • Bleeding problems
  • Kidney problems
  • Liver problems
  • Eye problems (such as retinitis pigmentosa or severe vision loss)
  • Stomach ulcers
  • Deformed penis shape or
  • A history of prolonged (> 4 hours) erections
  • Any medical condition that may make sexual activity potentially hazardous
  • History of alcohol abuse
  • All medications, over-the-counter medications, supplements, and remedies being taken

5. Do not take more than one dose of Cialis per day

Tadalafil, the active ingredient in Cialis, stays in the body for a long time. When taking Cialis as needed, a single dose (taken at least 30 minutes before sexual activity) will allow for sexual activity for up to 36 hours. When taking Cialis as a daily dose, take the dose at approximately the same time every day.

6. Avoid grapefruit

Cialis can be taken with or without food. The one exception is grapefruit, which has substances that interfere with the body’s ability to eliminate tadalafil from the body. To lower the risk of side effects, avoid eating grapefruit or drinking grapefruit juice when taking Cialis.

7. Do not drink too much alcohol

Cialis lowers blood pressure. So does alcohol. A moderate amount of alcohol is okay, but the FDA has set a safety limit of four drinks when taking Cialis. By that, they mean four 5-ounce glasses of wine or four shots of liquor. Consult your healthcare provider on safe alcohol intake, though, because you may have other conditions or take other medications that could interact with alcohol.

8. Use protection against sexually transmitted diseases

Cialis does not protect against sexually transmitted diseases. Use appropriate protection such as condoms and spermicide. Consult your healthcare provider for medical guidance.

Does Cialis (Tadalafil) Lower Blood Pressure?

No fancy packaging. No unwanted subscriptions. Delivered discreetly.

  • The 10mg and 20mg ‘when required doses’ have a 36-hour window of action
  • The 2.5mg and 5mg doses can be taken daily, providing a sustained low dose in the body. This prevents scheduling doses allowing men to get an erection spontaneously.

What effect does Cialis have on blood pressure?

Approximately one in two men suffer from erectile dysfunction (ED) at some point in their life. ED is a common condition, so there’s no need to feel as though you’re alone or unusual for experiencing these common symptoms. It may also come as a relief to learn that there are several ED tablets available, that can treat – and potentially reverse the effects of ED. Cialis, the branded version of the drug, tadalafil, is a very popular and proven treatment for men to achieve and maintain an erection hard enough for sexual intercourse. However, Cialis can slightly lower blood pressure. In order to increase blood flow to the penis, tadalafil, the active ingredient in Cialis, widens blood vessels. This is to make it easier for blood to enter the penis and cause an erection. In turn, this can temporarily cause a drop in blood pressure. Most men will not notice any effects, as the drop in blood pressure is usually too low to have a meaningful impact. This article explores the link between Cialis and blood pressure in more detail.

What is Cialis (tadalafil)?

Tadalafil is a drug that belongs to a class of medication known as PDE-5 inhibitors. It is often referred to as ‘generic Cialis.’ A relatively newer impotence treatment, tadalafil doesn’t increase sex drive, and will only work in situations where sexual stimulation occurs. Tadalafil tablets can also be used to treat an enlarged prostate, and high blood pressure in the lungs.

Cialis is a tablet that is taken by mouth, and the onset is typically within half an hour of ingestion. The effects of Cialis may last for up to 36 hours, hence the nickname ‘the weekend pill.’ There are two ways you can take Cialis – it is available in a daily dosage, or the aforementioned ‘use when ready’ form.

Cialis Daily (2.5mg & 5mg)

Cialis Daily is available in 2.5mg and 5mg tablets. Cialis Daily is taken every day as opposed to taking it before sexual activity. The benefit of taking these lower dosages means that there is always a steady stream of the mediation in your system, and that you’re prepared for sexual activity whenever the need arises.

Cialis daily takes effect from around 3-5 days, and the medication has a continuous effect until you stop taking it.

If you’re interested in taking tadalafil daily, you should begin by taking Cialis or the generic version in the 2.5mg dosage. Should you feel that the effects of this dosage are unsatisfactory, speak to your doctor or pharmacist about increasing the dosage to 5mg.

The continuous effect provided by taking tadalafil can help you maintain spontaneity in your sex life and remove the need to schedule sexual activity aligned with medication dosages from some other common ED treatments. Whether taken daily, or as needed, Cialis may remain in your system for up to 1.5 days after your last dosage.

Cialis 36 hour (10mg & 20mg)

Cialis 36 hour is taken 30-60 minutes before sexual activity and has a duration of action for up to 36 hours, which is why these higher dosages are so aptly named as ‘the weekend pill.’ Although you may not take these pills every day, you’ll still be able to enjoy a long window of action from an appropriately timed single dose.

Cialis 10mg & 20mg take approximately 30-60 minutes to kick in, and the effects can last for up to 36 hours.

If you’re looking to begin a treatment protocol, the most commonly prescribed starting dose is 10mg, as this dosage leaves you less susceptible to any side effects. If you’re a man with a history of low blood pressure, you will want to consult your doctor or healthcare provider to ensure this medication is right for you.

You should only take one tablet at a time, approximately half an hour before you plan to engage in sexual activity. Avoid alcohol consumption prior to taking tadalafil, as this can have a negative effect on your ability to achieve and maintain an erection. Do not take more than one tablet in a 24-hour period

How does Cialis work?

Cialis – or tadalafil – similar to other erectile function medications like Viagra, works by facilitating blood flow to the penis. When you’re sexually stimulated, your nervous system releases nitrous oxide, which acts as a vasodilator, relaxing blood vessels and allowing oxygen and other nutrients to pass through the body.

For men suffering from ED, the PDE-5 enzyme blocks this action. Cialis works to lower PDE-5 levels. This allows blood vessels to widen, increasing blood flow around the body, including the penis. This action has an effect on blood pressure, lowering it.

How does Cialis affect people with low blood pressure?

Cialis lowers blood pressure by causing blood vessels to widen, with the aim of increasing blood flow to the penis. This is usually safe for most men.

Where this becomes a problem, is if you have uncontrolled blood pressure, or a history of excessive fluctuation. Temporarily lowering your blood pressure before it increases again can put you at risk of a cardiovascular event, or potentially even a heart attack.

Another area of concern is if you’re taking any alpha-blockers or nitrates (such as glyceryl trinitrate or Isosorbide Mononitrate) which are used to treat angina, then you should avoid taking Cialis. A combination of tadalafil and nitrates can cause a sudden drop in blood pressure to a dangerously low level. If you are taking an alpha-blocker, you will need to be initiated on Cialis at the lowest dose, as a combination of the two can cause a significant drop in blood pressure.

If you are taking medication to treat high blood pressure, Cialis is usually safe to take, provided that your blood pressure is under control. Beta blockers, ACE-inhibitors or diuretic medications shouldn’t pose a danger to your health if combined with Cialis. There is a small risk of experiencing a drop in blood pressure, but this risk is usually managed by starting with a low dose and working your way up if necessary. This should only be done under the supervision of your doctor. You may be asked to monitor your blood pressure after taking a tablet and record the readings.

A clinical study looking at the effect of Cialis 20mg on blood pressure, found that on average, Cialis lowers systolic blood pressure (the top reading) by 4.8 mmHg, and diastolic blood pressure by 2.9 mmHg. This drop in blood pressure is too small to have a meaningful impact.

To put it into perspective, your blood pressure would need to drop 5 times more, to feel any side effects such as headache and dizziness.

What are the side effects of Cialis (Tadalafil) on blood pressure?

Aside from the risk of hypotension, or a significant lowering of blood pressure, the medication presents few other side effects directly related to blood pressure. Since tadalafil works as a vasodilator, the medication slightly lowers blood pressure, but it shouldn’t dramatically affect your levels unless you’re also taking a nitrate medication.

Common side effects of Cialis include:

  • A slightly lower than normal blood pressure level
  • Headaches
  • Blurred, or changes in colour of your vision
  • Abnormal ejaculation
  • Priapism – A prolonged erection that is painful or lasts longer than 4 hours
  • Dyspepsia (a condition where proper digestion is impaired, resulting in upper abdominal discomfort)
  • Nasal congestion
  • Indigestion
  • Flushing (sense of warmth in the face, ears, neck, and trunk)
  • Nosebleeds

Remember, tadalafil tablets will only work in the event that you’re sexually aroused: The treatment itself (or any other type of ED drugs) will not increase your libido.

The verdict

Whilst tadalafil has the ability to lower blood pressure, the effects are not usually a cause for concern in healthy individuals. It is important to discuss your medical history in full with your healthcare provider, including any medication being taken.

If you are taking medication that can interact with tadalafil, your healthcare provider may wish to start you on a lower dose, to minimise any chances of experiencing side effects.

FAQ:

Is Cialis good for your heart?

Cialis is generally safe for men with healthy hearts – in fact, the medication was created as a result of exploring heart condition treatments. Even if you are taking medication to treat high blood pressure, there is a good chance that it is safe for you to take Cialis. Whilst there is evidence to suggest that Cialis is good for the heart, overall, the data is not robust enough to be confident of this.

Does Cialis raise or lower blood pressure?

Cialis does not raise blood pressure, in fact, it lowers blood pressure. Additionally, Cialis can cause your blood pressure to drop to an unsafe level very rapidly if it is combined with any nitrate medication. This could result in symptoms ranging from feeling dizzy, to having a heart attack or stroke. As with any new medication, it is wise to consult your doctor if you’re thinking of taking Cialis.

Is Cialis good for high blood pressure?

Cialis can lower blood pressure, which in principle, can be good for those with uncontrolled high blood pressure. However, it does not lower blood pressure to the extent that antihypertensives do, so it is unlikely to have a meaningful impact on lower blood pressure. If you have uncontrolled high blood pressure, you should not use Cialis. Lowering blood pressure and allowing it to increase above the normal range can put you at risk of having a heart attack.

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.

Taking Cialis With Blood Pressure Medicine

In our latest question and answer, the pharmacist discusses the risks of taking blood pressure medication while using Cialis (tadalafil).

Billy asked

Can I take 10mg of Cialis along with a 25mg pill i take for blood pressure?

Answer

In general, Cialis (tadalafil) is OK to use with most blood pressure medication and there are no serious interactions. The one exception may be with a specific class of blood pressure medication known as ‘alpha blockers’.

A well known side effect of erectile dysfunction drugs such as Cialis is possible hypotension, or too low blood pressure. While fairly uncommon when taking Cialis alone (~2% incidence in clinical trials), the chance is augmented when used in combination with other medications that can drop blood pressure.

In addition to alpha blockers, we commonly hear that Cialis should not be taken with nitrates, as the combination could result in a significant and potentially serious drop in blood pressure. There have been reports of severe side effects such as hypotension, dizziness and heart attack in those using Cialis while taking a nitrate or are on nitrate therapy. Common ‘nitrate’ medications include:

Aside from nitrates, most other blood pressure medications classes do not represent a significant risk. Beta blockers, ACE-Inhibitors, ARBs and diuretic medications are blood pressure medications that are generally considered to be OK to use while on Cialis as long as your blood pressure is well controlled and isn’t dropping too low from medication use.

As mentioned above, there is a class of blood pressure medications that is considered risky to use, the ‘alpha blocker’ class of medications. The risk of hypotension with the use of Cialis and alpha blockers is far greater when compared to other blood pressure medications.

Per the prescribing information for Cialis, patients should be stabilized on alpha blockers medication before starting on Cialis and Cialis should be started at the lowest possible dose (2.5 mg to 5 mg). If you are already on Cialis and your doctor wants you to begin therapy on alpha blockers, they are recommended to be started at the lowest possible dose and tapered to appropriate effect. Common alpha blocker medications include:

So, to reiterate, most blood pressure medications are considered to be safe to use in combination with Cialis. The main medication classes of concern are alpha blockers and nitrates. Nitrates are contraindicated in those taking Cialis while alpha blockers need to be used with caution. If you experience symptoms of low pressure while taking Cialis and blood pressure medication, it is important to let your doctor know as your therapy may need to be adjusted.

High Blood Pressure and Erectile Dysfunction Treatments

Even if your high blood pressure (or hypertension) has caused erectile dysfunction (ED), you have every reason to be optimistic about the future and a healthy sex life. ED is a common problem associated with high blood pressure, but there are many proven treatments you can try.

A doctor’s first choice for treating erection problems is usually one of the pills called PDE5 inhibitors. First there was Viagra. Now there’s also Cialis, Levitra, and Staxyn. All of these drugs work in similar ways. They don’t increase sexual desire. They make it physically possible to get an erection when you are aroused.

No one of them has been proven to work better than the others. But the time they take to start working and the duration of their effects vary. That’s something you may want to consider based on your sexual habits. For example, does spontaneity matter to you, or do you usually plan sex ahead of time?

Viagra starts working in about 15 to 30 minutes and its effects last about two to four hours. Levitra starts working in about 30 to 60 minutes and lasts four to five hours . Cialis starts working in about 30 to 60 minutes and lasts as long as 36 hours.

Staxyn is an orally disintegrating tablet that contains the same active ingredient as Levitra but is not interchangeable with Levitra tablets.

Men whose blood pressure isn’t under control and those who take alpha-blockers (for high blood pressure or prostate problems) shouldn’t take Cialis, Levitra, Staxyn, or Viagra.

Also, you may not be able to take these drugs if you:

When Erectile Dysfunction Pills Aren’t an Option

If erectile dysfunction pills are out of the question, or if pills haven’t worked for you, don’t worry. There are other options.

Alprostadil is another drug for erectile dysfunction. However, it’s not a pill. One brand, called MUSE, is an alprostadil pellet that you insert into the tip of your penis with an applicator. It widens blood vessels and relaxes smooth muscle tissue in the penis, allowing blood to fill the spongy tissue that makes the penis erect.

Injections directly into the penis are another way to deliver alprostadil. Phentolamine and papaverine are additional drugs that are injected into the penis to treat erectile dysfunction. When injecting these drugs there is some risk that your erection may last too long, a condition that can require medical treatment.

Next, you may want to try a vacuum device, or “penis pump.” This is typically a clear plastic cylinder with a bulb or plunger and a constriction band.

You put your penis in the cylinder and start pumping. The suction creates a vacuum, so blood rushes in to fill the spaces in the spongy tissue of the penis, creating an erection. The erection lasts only as long as the blood stays in, so you slide the band down around the base of your penis, trapping the blood. It’s safe to keep the band on for up to 30 minutes.

These devices are available without a prescription, but it’s important to buy one from a reputable manufacturer. The device must include a safety control so you can’t harm your penis with too much suction.

Surgery for Erectile Dysfunction

Most men would prefer to avoid surgery, but for some men with erection problems, penis implants are another option for regaining sexual function.

There are two kinds of penis implants. One kind is a rigid but flexible rod implanted in the penis. You bend it up for sex or down for daily living. The other kind is an inflatable implant. The device stores fluid in a reservoir under the skin of your abdomen or scrotum. You press on the reservoir to pump fluid into cylinders in the penis. That creates an erection. A valve drains the fluid out of the penis when you’re done.

There are drawbacks to implants. An erection you get with an implant may be slightly shorter than a natural erection. The device itself may malfunction, in which case it would require another surgery to remove or replace it.

Getting a penis implant is a big decision. Once you have it, you may not be able to try other treatments. That’s because the implant replaces the chambers in the penis that fill with blood for a natural erection.

Alternative Treatments for Erectile Dysfunction

Before Viagra hit the market in 1998, there was no proven treatment for erectile dysfunction that men could take in pill form. Doctors were interested in yohimbe, an herb that increases heart rate and blood pressure. Some doctors prescribed it to their patients in combination with other treatments for erectile dysfunction. Even then it was not a recommended treatment and is still not today. Studies have not proven that it works.

Men with high blood pressure especially shouldn’t take either the prescription form or the herb. It can dangerously raise blood pressure.

Currently, no herb or supplements have been proven to help with erectile dysfunction. Herbs and supplements that some believe are helpful for erection problems include:

Before trying any alternative treatment, be sure to ask your doctor about it. Herbs and supplements, whether they help with erections or not, have real effects on the body. They could cause dangerous reactions with other medicines you might be taking.

Show Sources

American Urological Association: “Erectile Dysfunction Clinical Guidelines Panel. The Treatment of Organic Erectile Dysfunction: A Patient’s Guide,” 1996; and “AUA Guideline on the Management of Erectile Dysfunction: Diagnosis and Treatment Recommendations,” 2005.

Gaines, K. Urologic Nursing, February 2004.

Lamm, S. The Hardness Factor, HarperCollins, 2005.

Medscape Drug Reference from First DataBank: “Alprostadil Urethral” and “Sildenafil Oral.”

Can I Take Erectile Dysfunction Medication If I Have High Blood Pressure?

Thanks to television, commercials, and other media, you may already be familiar with the correlation between erectile dysfunction (ED) and cardiovascular disease. Because of this, many men have questions about whether they can safely take ED medication with an underlying condition, such as high blood pressure. When starting any new prescription, including medications for ED, it is important to discuss it with your doctor.

The expert team at Kasraeian Urology, including renowned board-certified urologists Drs. Ahmad and Ali Kasraeian, provides advanced solutions for ED in Jacksonville, FL to help men regain a more enjoyable, reliable, and fulfilling sex life. Learn more about ED and hypertension here, including what treatment options you may have that are both safe and effective.

What causes erectile dysfunction?

Erectile dysfunction, which is primarily characterized by the inability to achieve or maintain an erection adequate for sexual intercourse, has a number of potential causes. These may include:

  • Cardiovascular disease (heart disease)
  • Hypertension
  • Elevated cholesterol
  • Diabetes
  • Being overweight
  • Underlying medication conditions
  • Drug/alcohol use
  • Previous treatment or surgery for prostate cancer and/or BPH
  • Trauma
  • Andropause (low testosterone)
  • Age
  • Psychological factors (anxiety, depression, stress)
  • Relationship/marital problems

In a great number of cases, erectile dysfunction is multifactorial, meaning there are several physical and/or psychological issues contributing to the patient’s symptoms.

Can high blood pressure cause ED?

One of the most common causes of ED is poor blood flow to the penis, which makes it difficult – or even impossible – for the patient to achieve reliable and satisfactory erections. Because high blood pressure (hypertension) narrows blood vessels and restricts blood flow, it can certainly be a contributing factor to a patient’s erectile dysfunction.

Can I take Viagra if I have high blood pressure?

For many patients with hypertension, taking Viagra and other ED medication – such as Stendra, Cialis, and Levitra – is safe, effective, and appropriate. However, it is essential that patients consult with their cardiologist, urologist, and other providers before beginning any new medication. Even though ED therapies may not necessarily impact your blood pressure, it is important to know whether there are any drug interactions between your blood pressure medicine and Viagra, or what other risk factors you may have for taking these prescriptions.

What medications can you not take with Viagra?

Patients who are taking nitrates, alpha-blockers, and other classes of drugs are not eligible to take certain erectile dysfunction medications, including Viagra, Cialis, and others. Mixing these medications can actually lead to a life-threatening or even fatally low blood pressure level. Keep in mind that nitrates and alpha-blockers are not the only medications that should not be combined with Viagra and other ED drugs. Before beginning any new prescription for ED, Dr. Kasraeian will thoroughly evaluate your health history, current list of medications, and other factors to determine the safest and most appropriate course of treatment for you.

What if I can’t take Viagra?

If you are not a candidate for phosphodiesterase inhibitors (Viagra, Cialis, Stendra, Levitra, etc.) because of another prescription or an underlying condition with risk factors, you still have options. During your initial consultation for erectile dysfunction in Jacksonville, FL, Dr. Kasraeian will discuss all of your available ED treatment options, which may include:

How does shockwave therapy for ED work?

Kasraeian Urology is proud to offer shockwave therapy for erectile dysfunction without the use of drugs. A handheld probe is used to send low-intensity shockwaves directly into the penis. The energy from shockwave therapy stimulates new blood vessel growth to help improve erectile dysfunction. Each shockwave therapy session takes around 20 minutes and many patients notice improvement after a few treatments.

Even with high blood pressure, you can still have a fantastic sex life!

Hypertension may be worsening your ED symptoms, but it doesn’t have to mean your sex life is over. Even with high blood pressure, many men can receive safe, effective, and long-lasting ED treatments, though it is imperative that they have the clearance of their physicians before starting any new medications. To learn more about the exciting possibilities of ED treatments in Jacksonville, FL, call Kasraeian Urology to speak with one of our knowledgeable team members and to schedule your consultation with either of our board-certified urologists Drs. Ahmad and Ali Kasraeian, today!