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Know More About Sildenafil Interactions

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Written by- Julian Carter

Sildenafil is a medication used to treat Erectile Dysfunction (ED), the inability to get or maintain an erection when sexually stimulated. 

Known by its brand-name Viagra, it belongs to a class of medicines known as Phosphodiesterase 5 (PDE5) inhibitors. 

These medications block an enzyme known as PDE5 from obstructing blood flow to the penis, thus, boosting the erectile response. 

However, various Sildenafil interactions have been discovered, which can hinder the pill’s capacity to function correctly.

In this article, you will further know about Sildenafil interactions.

Sildenafil interactions: in depth

Sildenafil is generally safe when prescribed to treat Erectile Dysfunction by a healthcare provider.

However, it may not be suitable for everyone, particularly those who have certain medical conditions or take specific medicines.

These medicines and medical conditions can alter the working of Sildenafil, reduce its effectiveness, or cause harmful side effects.

Due to this, it is important to disclose your health history, current medicines, and any conditions you may have to your doctor.

Your doctor will analyze your medical profile an determine if Sildenafil is suitable for you or not.

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  • Sildenafil interactions with other medicines

    Sildenafil, or Viagra, has been shown to cause interactions with 328 other medicines. It is best to avoid to not take any of these drugs with Viagra.

    Sildenafil should not be consumed along with other ED pills as they may lead to severe side effects.

    Nitrates, Azole antifungals, Alpha-blockers, and other Erectile Dysfunction pills are known to interact with Sildenafil.


    If Sildenafil is combined with Nitrates, your blood pressure may drop significantly. 

    A severe drop in blood pressure can cause fainting, lightheadedness, and, in rare cases, heart attack or stroke. 

    Never combine Sildenafil with any recreational substances containing Amyl Nitrate, Butyl Nitrite, or some medications used to treat Angina or chest pain.

    Discover what happens if you take Viagra with Nitroglycerin or other Nitrates. Read: Why Viagra and Nitroglycerin Shouldn’t be Taken Together?


    Your blood pressure may drop too low if you take Sildenafil with Alpha-blockers (such as Doxazosin or Tamsulosin). 

    These medicines are used to treat an enlarged prostate/BPH or high blood pressure.

    Both Viagra and Tamsulosin (and other alpha-blockers) have blood pressure-lowering effects. Low blood pressure can cause lightheadedness or fainting.

    To reduce the risk of low blood pressure, your doctor might start your Erectile Dysfunction treatment with a lesser dosage of Sildenafil.

    Other Medicines

    The excretion of Sildenafil from your blood might be impacted by other medications, which may change how Sildenafil functions. 

    Therefore, you should avoid taking HIV Protease inhibitors like Saquinavir, Azole antifungals like Itraconazole, and Ketoconazole with Sildenafil. 

    Additionally, Macrolide antibiotics like Clarithromycin and Erythromycin, Rifampin, and Ritonavir, among others, might interact.

    Other ED Pills

    Do not use Sildenafil with other Erectile Dysfunction pills like Tadalafil (Cialis) or Vardenafil (Levitra) or Pulmonary Hypertension medications. 

    Also, avoid taking this pill along with other products containing Sildenafil. Combining more than one ED pill can worsen the side effects, leading to vision problems or a prolonged and painful erection.

    Your healthcare provider must be aware if you are taking any of the medications mentioned above while you are also taking Sildenafil.

    Recommended read: Discover who should avoid Viagra in this informative article – Who Should Not Take Viagra: The Medicines to Avoid

    See your doctor before quitting current medications or starting new ones. This is because they might negatively interact with Sildenafil, leading to side effects.

    Sildenafil interactions with food

    Avoid alcoholSource: Africa_Image
    Addicted to alcohol

    Sildenafil shouldn’t be taken at or close to mealtimes.

    Also, blue pills should be avoided when consuming specific foods. 

    This may cause serious interactions. There could be problems if you combine Sildenafil with alcohol and grapefruit juice. 


    Taking alcohol and Viagra (Sildenafil) together may have an even greater blood pressure-lowering impact. 

    Dizziness, lightheadedness, fainting, flushes, headaches, and heart palpitations may be more frequent symptoms if alcohol is combined with Sildenafil.

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  • Learn more about the connection between Sildenafil and alcohol. Read Sildenafil and Alcohol: Understanding the Risks.


    Avoid consuming grapefruits and grapefruit juice daily if you use Sildenafil as part of your ED treatment. 

    According to a research report published by NIH, grapefruit should not be consumed along with Sildenafil.  

    The consumption of grapefruit might increase the levels of the medicine in your body and prolong the time it takes for the pill to start working. 

    In addition, it may worsen the side effects of Sildenafil, such as dizziness, headaches, and nausea.

    Always consult your doctor before changing the amount of grapefruit products in your diet.

    Recommended read: Discover which foods not to consume while using Viagra! Read now for safer usage: Your Guide on Foods to Avoid When Taking Viagra

    Sildenafil interactions with diseases

    Sildenafil is found to interact with cardiovascular diseases, kidney disease, and liver disease.

    Cardiovascular disease

    According to a journal published in NCBI, Sildenafil should not be recommended to heart patients. 

    In individuals with prior cardiovascular illness, sexual activity is not advised owing to the possible cardiac risk.

    Read: Explore the link between Viagra and heart health. Learn about potential risks in this informative article: Can Viagra Cause a Heart Attack?

    Kidney disease

    In individuals with severe renal impairment, Sildenafil’s removal from your body may be slow. 

    This might lead to the build-up of the pill in your body.

    Liver disease

    Sildenafil clearance from the human body is mostly driven by the liver’s metabolic processes. 

    Sildenafil medication should not be given to individuals with severe liver impairment. 

    As an initial treatment, a lower dosage of Sildenafil should be given to individuals with moderate hepatic impairment.


    Sildenafil interactions can negatively affect your health, despite being a safe and effective prescription medication for Erectile Dysfunction.

    People who use organic Nitrates, blood pressure tablets, or specific HIV treatments shouldn’t take Sildenafil. 

    Some Protease inhibitors can raise the level of Sildenafil citrate in your blood. 

    Additionally, it has interactions with some foods. Therefore, speaking with your doctor before taking the medication is wise.

    Frequently Asked Questions

    What medicines should not be taken with Sildenafil?

    Sildenafil and certain medications should not be combined. 
    If you are taking Nitrates, which include Nitroglycerin, Isosorbide Dinitrate, and Isosorbide Mononitrate, let your doctor or chemist know. 
    Consult your doctor or chemist before starting, stopping, or changing medications.

    Can you take Sildenafil and Ibuprofen together?

    Yes. Ibuprofen and Sildenafil were not found to interact with one another. It does not imply that there are no interactions, though. 
    Always get advice from your doctor before combining Sildenafil with any other medicine.

    Does Sildenafil interact with milk?

    No scientific research demonstrates that taking Sildenafil with milk results in any interactions or adverse effects.

    Can Sildenafil be consumed along with coffee?

    Yes. Caffeine significantly affects the cardiovascular system by raising blood pressure and heart rate, which increases cardiac output. 
    As a result, the liver will receive more blood flow, which might increase Sildenafil metabolism when coffee is present.

    Can you consume antibiotics along with Sildenafil?

    No. Before combining Sildenafil and any antibiotic, see a medical professional. 
    The combination of these medicines may markedly enhance the blood levels and effects of Sildenafil. 
    Depending on the severity of your disease, you might not be able to take these pills together or require a dose change or more regular medical check-ups.

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