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Erectile Dysfunction Medications and Alcohol Interactions

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on March 23, 2022.

Low blood pressure may be a concern when alcohol (also called ethanol) is mixed with erectile dysfunction (ED) drugs. These agents, in the drug class known as phosphodiesterase-5 (PDE5) inhibitors, cause vasodilatation and increase blood flow to the penis to help with an erection. Dilatation of blood vessels decreases blood pressure. Alcohol can also cause vasodilation and lower blood pressure, so mixing the two can have an added effect.

Erectile dysfunction drugs include:

Cialis is also used to treat enlargement of the prostate gland (benign prostatic hypertrophy). Some PDE5 inhibitor brands (Adcirca, Alyq, Revatio) are also approved to treat high blood pressure in the arteries of the lungs (pulmonary hypertension).

Learn more: The Drugs.com Drug Interaction Checker

Patients taking PDE5 inhibitors should avoid consuming large amounts of alcohol, which may cause a sudden decrease in blood pressure when getting up from a standing or reclining position. Studies with some PDE5 inhibitors have shown a decrease in blood pressure and symptomatic effects when combined with alcohol.

Although effects can be variable, symptoms may include a faster or irregular heart beat, dizziness or lightheadedness, flushing, headache and fainting. Injury from a fall, such as a bone fracture or head injury, could occur.

  • In general, either avoid or limit the use of alcohol while being treated with PDE5 inhibitors.
  • Use caution when getting up from a sitting or lying position.
  • The manufacturer of Cialis recommends no more than five (5) alcoholic drinks (for example, 5 glasses of wine or 5 shots of whiskey), while the manufacturer of Stendra suggests no more than three (3) drinks.
  • Other manufacturers do not make specific patient recommendations; however, since this is most likely a class effect, use caution when combining any PDE5 inhibitor with alcohol.
  • In studies, sildenafil (Viagra) 50 mg and vardenafil (Staxyn) 20 mg reportedly did not increase the hypotensive effect of alcohol in healthy volunteers given certain amounts of alcohol, according to the manufacturer.
  • Always check with your pharmacist or doctor for possible drug-alcohol interactions or other interactions. Tell your healthcare providers about all the other medications you use, including prescription, over-the-counter (OTC) drugs, vitamins, dietary supplements and herbal products.

Types of Drug Interactions With Alcohol

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Sources

  1. Product Information. Cialis (tadalafil). Lilly, Eli and Company, Indianapolis, IN. Accessed March 23, 2022 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021368s030lbl.pdf
  2. Product Information. Viagra (sildenafil). Pfizer US Pharmaceuticals, New York, NY. Accessed March 23, 2022 at accessdata.fda.gov/drugsatfda_docs/label/1998/viagralabel2.pdf
  3. Product Information. Stendra (avanafil)." Vivus Inc, Mountain View, CA. Accessed March 23, 2022 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/202276s018lbl.pdf
  4. Product Information. Staxyn (vardenafil).  Bayer Healthcare, Whippany, NJ. Accessed March 23, 2022 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/200179s005lbl.pdf

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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