Are erectile dysfunction pills safe for men with heart disease?
Erectile dysfunction (ED) affects millions of men, and medications like Viagra, Cialis, Levitra, and Stendra have transformed treatment options. But many men wonder: Are these drugs safe, especially for the heart?
This article breaks down the risks and safety considerations to help you make informed decisions about ED medications.
Common Side Effects of ED Medications
For men without cardiovascular disease, ED pills are generally safe. The four leading drugs—Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil), and Stendra (avanafil)—share similar side effects, including:
Headache
Facial flushing
Nasal congestion
Diarrhea
Backache
A small number of Viagra or Levitra users may experience temporary impaired color vision. Men with the rare eye condition retinitis pigmentosa should consult an ophthalmologist before use.
Why Heart Safety Matters with ED Pills
While side effects like headaches and color changes are mild, cardiac concerns require special attention. ED medications affect arteries throughout the body by enhancing the effect of nitric oxide, which relaxes blood vessels and temporarily lowers blood pressure by 5 to 8 mmHg in healthy men.
However, men taking organic nitrates—drugs used to treat angina and other heart conditions—face serious risks. Both nitrates and ED medications increase nitric oxide levels, and combined use can cause a dangerous drop in blood pressure (up to 51 mmHg), leading to fainting or even life-threatening complications.
Who Should Avoid ED Pills?
Men using any form of nitrates should never use ED medications. This includes:
Nitroglycerin tablets, sprays, patches, or pastes
Isosorbide dinitrate (Isordil, Sorbitrate)
Isosorbide mononitrate (Imdur, ISMO)
Amyl nitrite or “poppers”
The FDA also advises caution or avoidance of ED drugs in men who have had a:
Heart attack or stroke in the past six months
Serious heart rhythm problems
Congestive heart failure or unstable angina
Low or uncontrolled high blood pressure
Certain medications (e.g., erythromycin, some antifungals, and anti-HIV drugs) can increase ED drug levels, requiring lower doses. Older men and those with kidney or liver impairment should also start at reduced doses.
Using ED Pills Safely
Faced with all these warnings, should any man use Viagra, Levitra, Stendra, or Cialis? The answer is yes—but no one should use them needlessly or recklessly. Approximately 20 million American men experience erectile dysfunction, and most can use these medications safely when guided by a healthcare provider.
Start with the lowest effective dose
Avoid alcohol before taking these drugs
Monitor your response and side effects
If a full dose fails two or three times, discuss alternative treatments with your doctor
Confident ED care starts with heart-safe guidance
Managing erectile dysfunction shouldn’t come at the expense of your heart health. Bastion Health connects you with trusted men’s health experts who help you choose safe, effective treatments—covered through your employer-sponsored benefits, so care is always within reach.
