Is it safe to combine alcohol with Viagra?

Good news for all the guys out there who take prescription drugs to treat erectile dysfunction (ED). You don’t have to choose between “the little blue pill” and sharing a bottle of wine with your Valentine’s Day date. As long as your alcohol consumption isn’t excessive, it is generally considered safe to have a drink when you are under the influence of Viagra and medications like it. 

Is there a Viagra and alcohol interaction?

“There does not seem to be a major drug interaction between alcohol and any of the drugs that are used for erectile dysfunction,” says Sharzad Green, Pharm.D., a pharmacy coach and trainer with Advanced Pharmacy Consulting in Tempe, Arizona. Popular ED drugs include Viagra (sildenafil citrate), Cialis (tadalafil), and Levitra (vardenafil). Revatio also contains sildenafil and is prescribed for the treatment of pulmonary arterial hypertension (PAH), but is sometimes prescribed off-label for ED as well.

In fact, having a drink or two might even work in your favor: A 2018 meta-analysis (an analysis of many studies) conducted by the Department of Urology at the West China School of Medicine in Chengdu, China, found that light to moderate alcohol use was actually associated with a decreased risk of erectile dysfunction. 

“Sometimes, a little alcohol helps with sexual response because it can decrease inhibitions, anxiety, and stress,” says Stanley Myers, MD, a urologist and sexual medicine specialist in Portland, Oregon. Although Viagra works within 30 to 60 minutes, sexual desire and stimulation are still needed.

Can alcohol affect erectile dysfunction?

The key phrase here is “a little.” The amount of alcohol matters. The story changes when it comes to men who drink heavily and/or engage in binge drinking (as indicated by the study, and just basic medical advice). Men should not consume more than two alcoholic drinks per day, regardless of whether they take medication (any medication) or intend to engage in sexual activity, according to the Centers for Disease Control and Prevention (CDC). 

What is the threshold for binge drinking? The National Institute on Alcohol Abuse and Alcoholism defines it as consuming five or more drinks on any one occasion. And while that doesn’t change the fact that there aren’t any official drug-drug interactions between alcohol and ED drugs, drinking alcohol excessively can dull sexual response. In other words, it makes the use of Viagra and its counterparts somewhat futile. People who misuse alcohol, specifically, fare very poorly. According to research published in 2007, 72% of male alcoholics experience some type of sexual dysfunction. 

“[Heavy drinking] will definitely cause a negative impact on a man’s ability to achieve and maintain an erection,” says Nefertiti Childrey, DO, a urologist based in New York. Excessive alcohol consumption and alcohol dependence can contribute to a number of other medical issues, like metabolic syndrome and liver disease, Dr. Childrey adds. 

Does it matter what beverage you choose?

Along with the very practical advice to avoid excessive drinking, it is also important to choose the right cocktail when mixing Viagra and alcohol. Some are safer than others.

If you prefer red wine, you are in luck! Data shows there’s no clinically significant reaction between the two. It was studied specifically in relation to Viagra and hypotension (presumably because of worries that the combination could trigger dangerously low blood pressure levels, a speculation Dr. Myers says is likely overstated). Not only that, another Harvard study found that flavonoid-rich consumables, including red wine, have the potential to reduce the incidence of ED. 

If the Greyhound (vodka + grapefruit juice) is your drink of choice, that mixer might interfere with your Viagra (as grapefruit juice does with many medications, according to the FDA). Harvard University reports that while clinical trials and information are incomplete, the Viagra/grapefruit juice combo could trigger side effects such as headaches, flushing, or low blood pressure. If your beverage is citrus-juice free, you’re probably in the clear.

It’s often recommended to take Viagra on an empty stomach, which could be problematic if you’re drinking alcohol. Ask your doctor if you can take your dose after eating. One study found that there was no significant difference when Viagra was taken before a meal or with food.

Side effects of Viagra

Whether you’re mixing Viagra with alcohol or not, it’s important to know which side effects of Viagra you can expect and those that require medical attention. The most common side effects of ED medication are lightheadedness or headache, stomach upset or indigestion, and back or muscle pain. 

Seek medical attention if you experience an erection that lasts longer than four hours. Abnormal vision and hearing loss are also serious side effects that require urgent medical help. Although rare, Viagra can cause a heart attack or stroke in patients with preexisting cardiovascular disease. Go to the emergency room if you experience symptoms like chest pain or irregular heart rate. A popular chest pain treatment is nitroglycerin (a nitrate); however, the combination of Viagra (or any ED medication described above) and nitroglycerin is very dangerous, increasing the risk of dangerously low blood pressure, fainting, or heart attack. 

As always, despite these promising facts, be sure to speak with your own doctor or pharmacist about whether it is safe for you to drink alcohol with your ED meds. If you don’t have any other contraindications, you’ll likely get the green light to enjoy a few drinks in moderation.

“I think if there were an absolute contraindication for a man to have alcohol with these medications, [the medications] probably wouldn’t be as successful as they are,” says Dr. Childrey. “So because of that, I don’t advise patients not to drink. But I do review the general risks associated with medication and alcohol intake.”