Sildenafil and Alcohol: The Facts and the Myths

Sildenafil, widely known by its popular brand name Viagra, was first introduced as a treatment for erectile dysfunction and to enhance sexual performance in men. With further studies and advancements, it is now used for a number of different medical conditions. It is a safe and effective drug that is being used for decades. But like any other drug, it is important that you know about its uses, how to take it, the way it works, its side effects, can you take sildenafil with alcohol and sildenafil and alcohol interaction to get the maximum benefit from the drug.

This guide breaks down the facts and clears up the myths about using sildenafil with alcohol, covering what you need to know about their effects and interactions.

What is Sildenafil?

Sildenafil is a medication that helps treat erectile dysfunction (ED), which is the inability to get or maintain an erection. It was the first drug of its type, called a phosphodiesterase-5 (PDE5) inhibitor, to be introduced. Sildenafil is mostly used by middle-aged men who struggle with erections during sex or younger men who have ED due to medical issues. While it has also been approved for other health conditions such as Sildenafil for women to improve sexual desire, its main use is still for treating ED and helping men improve their sexual performance.

How Does Sildenafil Improve Erection?

An erection happens when blood fills the spongy tissue in the penis (called the corpus cavernosum). Sildenafil works by helping more blood flow into this area. It does this by blocking an enzyme called phosphodiesterase-5 (PDE5). Normally, this enzyme breaks down a substance called cGMP, which helps relax the muscles in blood vessels. When you take sildenafil, it stops PDE5 from breaking down cGMP, which means cGMP levels increase. This relaxes the blood vessels, allowing more blood to enter the penis, making it easier to get and maintain an erection.

What Are the Uses of Sildenafil?

Sildenafil is used for the following purposes:

1. Erectile Dysfunction: Sildenafil is most widely recognized for its role in treating erectile dysfunction (ED), a condition where men have difficulty achieving or maintaining an erection. Since it was first introduced, sildenafil has proven to be a highly effective and well-tolerated option for men dealing with ED, regardless of age. It is commonly prescribed for middle-aged and older men who experience ED due to factors such as aging, stress, or health conditions like diabetes or heart disease.

However, younger men may also benefit from sildenafil if their ED is linked to medical issues such as hormonal imbalances, nerve damage, or psychological factors like anxiety or depression

2. Pulmonary Arterial Hypertension: Pulmonary arterial hypertension means increase in pressure in the arteries of the lungs. This causes reduced lung function and difficulty in breathing and exercising. Sildenafil has been approved by FDA for use in pulmonary arterial hypertension. It increases exercise tolerance and delays worsening of the symptoms.
3. Off-Label Use: Sildenafil is used off label for female sexual arousal disorder, secondary Raynaud’s phenomenon and height induced hypoxia.

What are the side effects of sildenafil?

Sildenafil use may cause the following side effects:

1. Hypotension: Sildenafil causes relaxation of the muscles of blood vessels and thus can also decrease blood pressure. This decrease is blood pressure is rarely significant and not enough to cause any problem. But in heart patients who are already using nitrates and other drugs to lower their blood pressure, sildenafil use can significantly lower the blood pressure causing light headedness, and fainting. So, sildenafil should not be used without consultation with a healthcare provider in patients who are on long-acting nitrates.
2. Priapism: Sildenafil causes erection of the penis. But this effect can sometimes last longer than needed causing priapism. Priapism is erection lasting longer than 4 hours causing pain and damage to the penis.
3. Vision Problems: Sildenafil can increase the risk of a serious eye condition called non-arteritic anterior ischemic optic neuropathy (NAION), which can cause sudden vision loss. Other vision-related side effects include blurred vision, changes in how you see light, and difficulty distinguishing between certain colors.
4. Ototoxicity: Sildenafil cause hearing problems like decreased hearing, loss of hearing and dizziness.
5. Others: Other possible side effects of sildenafil include headaches, flushing (feeling warm and red in the face), indigestion, stuffy nose, back pain, muscle aches, nausea, dizziness, and skin rash.

Sildenafil Interactions with Alcohol

The topic of sildenafil and alcohol interaction is one that often leads to confusion. While sildenafil is commonly used to treat erectile dysfunction and improve sexual performance, alcohol is frequently part of social and intimate settings. The combination of sildenafil with alcohol has given rise to various theories and myths. The following is a clear discussion on the potential effects of using alcohol with sildenafil, helping to distinguish between the facts and misconceptions.

1. Increase in side effects: Studies have shown that mild to moderate use of alcohol (less than 15 drinks per week) does not cause significant increase in the side effects of sildenafil. But excessive alcohol consumption (generally more than 15 drinks per week) can cause side effects like facial flushing, headache and chest discomfort.
2. Decrease in blood pressure: Sildenafil and alcohol both can decrease blood pressure. This has led to the belief that using sildenafil alcohol combined can cause too much decrease in blood pressure. But studies have shown that alcohol and sildenafil both independently lower blood pressure. Using sildenafil and alcohol does not increase the hypotensive action of sildenafil.
3. Sildenafil and alcohol interaction: Sildenafil and alcohol interaction is somewhat indirect. Alcohol consumption reduces testosterone levels and causes erectile dysfunction. Sildenafil is then used to treat the erectile dysfunction. Alcohol’s action on the penis muscles is completely opposite to that of sildenafil. So using alcohol will decrease the effectiveness of sildenafil causing increase in the dose of sildenafil and increasing the risk and severity of side effects.

Can You Take Sildenafil With Alcohol?

The desire to combine alcohol and sildenafil can be tempting, as sildenafil is used to enhance sexual pleasure and alcohol is often associated with relaxation and enjoyment. While the combination might seem appealing, the question remains: is it safe? In moderation, such as with mild drinking (one or two drinks), it can generally be safe. Small amounts of alcohol do not interfere with the effectiveness or safety of sildenafil, and consuming a light amount of alcohol with sildenafil is usually considered fine.

However, heavy drinking significantly increases the risk of side effects like headaches and chest discomfort, which can pose serious health risks. So, while one or two drinks are typically safe when using sildenafil during intimacy, heavy drinking should be avoided to prevent dangerous side effects.

Frequently Asked Questions (FAQs) about Sildenafil and Alcohol

1. Can you safely take sildenafil with alcohol?

Sildenafil can be safely used with a small amount of alcohol. However, it is best to avoid combining sildenafil with heavy alcohol consumption, as this can increase the risk of side effects.

2. What are the effects of mixing sildenafil with alcohol?

Alcohol can lower testosterone levels, leading to reduced erectile function. Mixing sildenafil with alcohol may decrease its effectiveness, meaning that a higher dose of sildenafil might be needed to achieve an erection.

3. How does alcohol interact with sildenafil?

Alcohol interacts with sildenafil by lowering testosterone levels in the body. Since testosterone is essential for achieving an erection, reduced levels can lead to decreased erectile function, thereby diminishing the effectiveness of sildenafil.

4. Are there any risks associated with consuming alcohol with sildenafil?

A small amount of alcohol is generally safe to use with sildenafil; however, there are significant risks associated with heavy alcohol consumption while using sildenafil. Heavy drinking can increase the likelihood of adverse effects such as facial flushing, headaches, and chest discomfort.

 References:

1. Smith BP, Babos M. Sildenafil. [Updated 2023 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558978/
2. McMurray, J. G., Feldman, R. A., Auerbach, S. M., Deriesthal, H., Wilson, N., & Multicenter Study Group (2007). Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction. Therapeutics and clinical risk management, 3(6), 975–981.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2387281/
3. Cheitlin, M. D., Hutter Jr, A. M., Brindis, R. G., Ganz, P., Kaul, S., Russell Jr, R. O., … & Wolk, M. J. (1999). Use of sildenafil (Viagra) in patients with cardiovascular disease. Circulation, 99(1), 168-177. https://doi.org/10.1161/01.CIR.99.1.168
4. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=15372a7c-2935-48dc-a55a-8966719b50be
5. Kim, J. N., Oh, J. 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. Sexual medicine, 7(4), 425–432. https://doi.org/10.1016/j.esxm.2019.07.004
6. Fink HA, Mac Donald R, Rutks IR, Nelson DB, Wilt TJ. Sildenafil for Male Erectile Dysfunction: A Systematic Review and Meta-analysis. Arch Intern Med.2002;162(12):1349–1360. doi:10.1001/archinte.162.12.1349 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/211714

Post by:

 Dr.Marcella Jiovanni

Health and Beauty Expert

“Marcella Jiovanni actively promotes the importance of maintaining healthy skin, she envisions the future of dermatology as moving away from pure medical, pharmacological dermatology and flowing more toward a holistic approach to wellness and skincare.”