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What is Viagra?

Viagra (sildenafil) relaxes muscles found in the walls of blood vessels and increases blood flow to particular areas of the body.

Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. This page contains specific information for Viagra, not Revatio.

Do not take Viagra while also taking Revatio, unless your doctor tells you to.

Important information

Some medicines can cause unwanted or dangerous effects when used with Viagra. Tell your doctor about all your current medicines, especially riociguat (Adempas) and nitrates.

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Stop using Viagra and get emergency medical help if you have sudden vision loss.

Before taking this medicine

You should not use Viagra if you are allergic to sildenafil, or:

if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas).

if you take nitrates.

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

To make sure Viagra is safe for you, tell your doctor if you have ever had:

heart disease or heart rhythm problems, coronary artery disease;

a heart attack, stroke, or congestive heart failure;

high or low blood pressure;

liver or kidney disease;

a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;

a bleeding disorder such as hemophilia;

a stomach ulcer;

retinitis pigmentosa (an inherited condition of the eye);

a physical deformity of the penis (such as Peyronie's disease); or

if you have been told you should not have sexual intercourse for health reasons.

Viagra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss.

Viagra is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

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Do not give this medicine to anyone under 18 years old without medical advice.

How should I take Viagra?

Take Viagra exactly as it was prescribed for you. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Do not take Viagra more than once per day.

Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.

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Store at room temperature away from moisture and heat.

See also:

Viagra dosage information (in more detail)

What happens if I miss a dose?

Since Viagra is used as needed, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at   [phone]

What should I avoid while taking Viagra?

Drinking alcohol with this medicine can cause side effects.

Grapefruit and grapefruit juice may interact with sildenafil and lead to unwanted side effects. Avoid the use of grapefruit products while taking sildenafil.

Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.

Viagra side effects

Get emergency medical help if you have signs of an allergic reaction to Viagra: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking Viagra and get emergency medical help if you have:

heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

vision changes or sudden vision loss; or

erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis).

Call your doctor at once if you have:

ringing in your ears, or sudden hearing loss;

irregular heartbeat;

swelling in your hands, ankles, or feet;

shortness of breath;

seizure (convulsions); or

a light-headed feeling, like you might pass out.

Common Viagra side effects may include:

flushing (warmth, redness, or tingly feeling);

headache, dizziness;

abnormal vision (blurred vision, changes in color vision)

runny or stuffy nose, nosebleeds;

sleep problems (insomnia);

muscle pain, back pain; or

upset stomach.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also:

Viagra side effects (in more detail)

What other drugs will affect Viagra?

Do not take Viagra with similar medications such as avanafil (Stendra), tadalafil (Cialis) or vardenafil (Levitra). Tell your doctor about all other medications you use for erectile dysfunction.

Tell your doctor about all your current medicines and any you start or stop using, especially:

drugs to treat high blood pressure or a prostate disorder;

an antibiotic - clarithromycin, erythromycin, or telithromycin;

antifungal medicine - ketoconazole or itraconazole; or

medicine to treat HIV/AIDS - atazanavir, indinavir, ritonavir, or saquinavir;

nitrates;

medications used to treat pulmonary artery hypertension.

This list is not complete. Other drugs may interact with sildenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

See also:

Viagra drug interactions (in more detail)

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Viagra only for the indication prescribed.

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

Copyright 1996-2020 Cerner Multum, Inc. Version: 12.01. PFM

Related questions

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In Summary

Common side effects of Viagra include: dyspepsia, headache, visual disturbance, and flushing. Other side effects include: nasal congestion. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to sildenafil: oral powder for suspension, oral tablet

Other dosage forms:

intravenous solution

Side effects requiring immediate medical attention

Along with its needed effects, sildenafil (the active ingredient contained in Viagra) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking sildenafil:

Less common

Bladder pain

burning feeling in the chest or stomach

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

cloudy or bloody urine

dizziness

increased frequency of urination

indigestion

pain on urination

stomach upset

tenderness in the stomach area

Rare

Abnormal vision

anxiety

behavior change similar to drunkenness

bleeding of the eye

blurred vision

bone pain

breast enlargement

chest pain

chills

cold sweats

confusion

convulsions (seizures)

cool and pale skin

deafness or hearing loss

decrease in amount of urine or the frequency of urination

decreased vision

difficulty in concentrating

dizziness or lightheadedness, especially when getting up suddenly from a lying or sitting position

double vision

drowsiness

dry eyes

dry mouth

dryness, redness, scaling, or peeling of the skin

excessive hunger

eye pain

fainting or faintness

fast, irregular, or pounding heartbeat

feeling of something in the eye

fever or chills

headache (severe or continuing)

increase in the size of the pupil

increased sweating

increased thirst

lower back or side pain

migraine headache

nausea (severe or continuing)

nervousness

nightmares

numbness of the hands

painful, swollen joints

prolonged, painful erection of penis

redness, burning, or swelling of the eyes

redness, itching, or tearing of the eyes

restless sleep

seeing shades of colors differently than before

sensitivity to light

shakiness

skin lesions with swelling

skin paleness

skin rash, hives, or itching

skin ulcers

slurred speech

sore throat

sudden weakness

swelling of the face, hands, feet, or lower legs

trouble breathing

twitching of the muscles

unusual feeling of burning or stinging of the skin

unusual tiredness or weakness

vision changes

vision loss, temporary

Incidence not known

Blindness

Side effects not requiring immediate medical attention

Some side effects of sildenafil may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Aches or pains in the muscles

bloody nose

diarrhea

difficult or labored breathing

flushing

headache

pain or tenderness around the eyes and cheekbones

redness of the skin

sneezing

stomach discomfort following meals

stuffy or runny nose

trouble sleeping

unusually warm skin

Rare

Abdominal or stomach pain

abnormal dreams

anxiety

clumsiness or unsteadiness

cough

diarrhea or stomach cramps (severe or continuing)

difficulty in swallowing

ear pain

increased amount of saliva

increased skin sensitivity

lack of coordination

loss of bladder control

mental depression

nausea

numbness or tingling of the hands, legs, or feet

rectal bleeding

redness or irritation of the tongue

redness, soreness, swelling, or bleeding of the gums

ringing or buzzing in the ears

sensation of motion, usually whirling, either of one's self or of one's surroundings

sexual problems in men (continuing), including failure to experience a sexual orgasm

sleepiness

sores in the mouth and on the lips

tense muscles

trembling and shaking

vomiting

waking to urinate at night

worsening of asthma

For Healthcare Professionals

Applies to sildenafil: intravenous solution, oral powder for reconstitution, oral tablet

General

The most common adverse reactions reported in clinical trials are headache, flushing, dyspepsia, abnormal vision, nasal congestion, back pain, myalgia, nausea, dizziness, and rash.[Ref]

Cardiovascular

Very common (10% or more): Flushing (10%)

Uncommon (0.1% to 1%): Heart rate increased, palpitations, tachycardia, hypertension, hypotension

Rare (less than 0.1%): Myocardial infarction, atrial fibrillation, sudden cardiac death, ventricular arrhythmia, unstable angina

Frequency not reported: Ventricular arrhythmia, sudden cardiac death, angina pectoris, AV block, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy, shock

Postmarketing reports: Serious cardiovascular, cerebrovascular, and vascular events, including myocardial infarction; sudden cardiac death; ventricular arrhythmia; cerebrovascular hemorrhage; transient ischemic attack; hypertension; subarachnoid, intracerebral, and pulmonary hemorrhage have been reported in temporal association with the use of this drug.[Ref]

Gastrointestinal

Very common (10% or more): Dyspepsia (up to 17%), diarrhea

Common (1% to 10%): Nausea, vomiting, dry mouth, gastritis, gastroesophageal reflux disease, hemorrhoids, abdominal distension

Rare (less than 0.1%): Oral hypoesthesia

Frequency not reported: Glossitis, colitis, dysphagia, gastroenteritis, esophagitis, stomatitis, gingivitis[Ref]

Musculoskeletal

Very common (10% or more): Pain in extremity

Common (1% to 10%): Back pain, myalgia

Frequency not reported: Arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis[Ref]

Nervous system

Very common (10% or more): Headache (up to 28%)

Common (1% to 10%): Dizziness, migraine, tremor, paresthesia, burning sensation

Uncommon (0.1% to 1%): Somnolence, hypoesthesia

Rare (less than 0.1%): Cerebrovascular accident, syncope

Frequency not reported: Transient ischemic attack, seizure, seizure recurrence, ataxia, hypertonia, neuralgia, neuropathy, paresthesia, somnolence, reflexes decreased

Postmarketing reports: Transient global amnesia[Ref]

Ocular

This drug has lesser affinity for isoenzyme PDE6, an enzyme found in the retina. This lower selectivity is thought to be the basis for abnormalities related to color vision observed with higher doses or plasma levels.

Nonarteritic anterior ischemic optic neuropathy developed in one eye within minutes to hours after ingestion of sildenafil (the active ingredient contained in Viagra) Four of the five patients had no vascular risk factors for ischemic optic neuropathy.

-Abnormal Vision: Mild to moderate and transient, predominantly color tinge to vision, but also increased sensitivity to light, or blurred vision.

-Visual color distortions: Chloropsia, chromatopsia, cyanopsia, erythropsia and xanthopsia

-Lacrimation disorders: Dry eye, lacrimal disorder and lacrimation increased[Ref]

Very common (10% or more): Abnormal vision (up to 11%)

Common (1% to 10%): Visual color distortion, retinal hemorrhage, visual impairment, vision blurred, photophobia, chromatopsia, cyanopsia, eye irritation, ocular hyperemia

Uncommon (0.1% to 1%): Conjunctival disorders, eye disorders, eye pain, lacrimation disorders, visual acuity reduced, diplopia, abnormal sensation in eye, photopsia, visual brightness, conjunctivitis

Rare (less than 0.1%): Retinal hemorrhage, arteriosclerotic retinopathy, retinal disorder, glaucoma, visual field defect, myopia, asthenopia, vitreous floaters, iris disorder, mydriasis, halo vision, eye edema, eye swelling, eyelid edema, scleral discoloration

Frequency not reported: Non-arteritic anterior ischemic optic neuropathy (NAION), retinal vascular occlusion, visual field defect, cataract[Ref]

Respiratory

Very common (10% or more): Pharyngitis (18%), rhinitis

Common (1% to 10%): Nasal congestion, epistaxis, cough

Uncommon (0.1% to 1%): Sinus congestion

Rare (less than 0.1%): Throat tightness, nasal edema, nasal dryness

Frequency not reported: Asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased[Ref]

Dermatologic

Common (1% to 10%): Rash, alopecia, erythema, night sweats

Frequency not reported: Steven-Johnson syndrome (SJS), toxic epidermal necrolysis(TEN), urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, exfoliative dermatitis[Ref]

Hematologic

Common (1% to 10%): Anemia

Frequency not reported: Leukopenia

Postmarketing reports: In patients with pulmonary arterial hypertension (secondary to sickle cell disease) taking Revatio (R), vaso-occlusive crises requiring hospitalization were more commonly reported. The clinical relevance of this finding in male patients treated with sildenafil (the active ingredient contained in Viagra) for erectile dysfunction is unknown.[Ref]

Metabolic

Common (1% to 10%): Fluid retention

Frequency not reported: Thirst, edema, gout, unstable diabetes, hyperglycemia, hyperuricemia, hypoglycemic reaction, hypernatremia[Ref]

Other

Common (1% to 10%): Cellulitis, influenza, bronchitis, sinusitis, rhinitis, gastroenteritis, vertigo, pyrexia

Uncommon (0.1% to 1%): Tinnitus, chest pain, fatigue, gynecomastia

Rare (less than 0.1%): Deafness, irritability

Frequency not reported: Sudden hearing loss, edema, face edema, peripheral edema, pain, chills accidental fall, accidental injury[Ref]

Psychiatric

Common (1% to 10%): Insomnia, anxiety

Frequency not reported: Abnormal dreams, depression[Ref]

Genitourinary

Uncommon (0.1% to 1%): Penile hemorrhage, hematospermia

Frequency not reported: Priapism, prolonged erection, increased erection, cystitis, nocturia, urinary frequency, urinary incontinence, abnormal ejaculation, genital edema, anorgasmia[Ref]

Renal

Uncommon (0.1% to 1%): Hematuria[Ref]

Hypersensitivity

Rare (less than 0.1%): Hypersensitivity reactions, including rash and urticaria[Ref]

Hepatic

Frequency not reported: Liver function tests abnormal[Ref]

References

1. Cerner Multum, Inc. "Australian Product Information." O 0

2. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group, New York, NY.

3. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.

4. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

5. Conti CR, Pepine CJ, Sweeney M "Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease." Am J Cardiol 83 (1999): c29-34

6. Malozowski S, Sahlroot JT "Hemodynamic effects of sildenafil." N Engl J Med 343 (2000): 967-8

7. Arruda-Olson AM, Pellikka PA "Appropriate use of exercise testing prior to administration of drugs for treatment of erectile dysfunction." Herz 28 (2003): 291-7

8. Kloner RA "Cardiovascular risk and sildenafil." Am J Cardiol 86 (2000): f57-61

9. Stanopoulos I, Hatzichristou D, Tryfon S, Tzortzis V, Apostolidis A, Argyropoulou P "Effects of sildenafil on cardiopulmonary responses during stress." J Urol 169 (2003): 1417-21

10. Tran D, Howes LG "Cardiovascular safety of sildenafil." Drug Saf 26 (2003): 453-60

11. Webster LJ, Michelakis ED, Davis T, Archer SL "Use of sildenafil for safe improvement of erectile function and quality of life in men with New York Heart Association classes II and III congestive heart failure: a prospective, placebo-controlled, double-blind crossover trial." Arch Intern Med 164 (2004): 514-20

12. Feenstra J, vanDriePierik RJHM, Lacle CF, Stricker BHC "Acute myocardial infarction associated with sildenafil." Lancet 352 (1998): 957-8

13. McLeod AL, McKenna CJ, Northridge DB "Myocardial infarction following the combined recreational use of Viagra and cannabis." Clin Cardiol 25 (2002): 133-4

14. Kloner RA, Zusman RM "Cardiovascular effects of sildenafil citrate and recommendations for its use." Am J Cardiol 84 (1999): n11-7

15. Khandheria BK "Erection, erectile dysfunction: what has heart got to do with it?" Herz 28 (2003): 275-6

16. Arruda-Olson AM, Mahoney DW, Nehra A, Leckel M, Pellikka PA "Cardiovascular effects of sildenafil during exercise in men with known or probable coronary artery disease: a randomized crossover trial." JAMA 287 (2002): 719-25

17. Montorsi F, McDermott TED, Morgan R, Olsson A, Schultz A, Kirkeby HJ, Osterloh IH "Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies." Urology 53 (1999): 1011-8

18. Egan RA, Pomeranz H "Transient ischemic attack an stroke associated with sildenafil (Viagra) use." Neurology 59 (2002): 293-4

19. Zusman RM "Cardiovascular data on sildenafil citrate - Introduction." Am J Cardiol 83 (1999): c1-2

20. Jackson G "Treatment of erectile dysfunction in patients with cardiovascular disease : guide to drug selection." Drugs 64 (2004): 1533-45

21. Moreira SG, Brannigan RE, Spitz A, Orejuela FJ, Lipshultz LI, Kim ED "Side-effect profile of sildenafil citrate (Viagra) in clinical practice." Urology 56 (2000): 474-6

22. Bocchi EA, Guimaraes G, Mocelin A, Bacal F, Bellotti G, Ramires JF "Sildenafil effects on exercise, neurohormonal activation, and erectile dysfunction in congestive heart failure: a double-blind, placebo-controlled, randomized study followed by a prospective treatment for erectile dysfunction." Circulation 106 (2002): 1097-103

23. Zusman RM, Morales A, Glasser DB, Osterloh IH "Overall cardiovascular profile of sildenafil citrate." Am J Cardiol 83 (1999): c35-44

24. McMahon CG, Smali R, Johnson H "Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction." J Urol 164 (2000): 1192-6

25. Israilov S, Baniel J, Shmueli J, et al. "Treatment program for erectile dysfunction in patients with cardiovascular diseases." Am J Cardiol 93 (2004): 689-93

26. Awan GM, Calderon E, Dawood G, Alpert MA "Acute, symptomatic atrial fibrillation after sildenafil citrate therapy in a patient with hypertrophic obstructive cardiomyopathy." Am J Med Sci 320 (2000): 69-71

27. Brindis RG, Kloner RA "Sildenafil in patients with cardiovascular disease." Am J Cardiol 92(9 Suppl) (2003): 26-36

28. Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction." Clin Ther 20 (1998): 1033-48

29. Dunn N "Cardiovascular events in users of sildenafil - Paper does not provide any reassurance." Br Med J 323 (2001): 50-1

30. Bosch X "Sildenafil's effects extended to additional organs." Lancet 355 (2000): 631

31. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA "Oral sildenafil in the treatment of erectile dysfunction." N Engl J Med 338 (1998): 1397-404

32. Boolell M, Gepi-Attee S, Gingell JC, Allen MJ "Sildenafil, a novel effective oral therapy for male erectile dysfunction." Br J Urol 78 (1996): 257-61

33. PadmaNathan H, Steers WD, Wicker PA "Efficacy and safety of oral sildenafil in the treatment of erectile dysfunction: A double-blind, placebo-controlled study of 329 patients." Int J Clin Pract 52 (1998): 375-9

34. Bortolotti M, Mari C, Lopilato C, Porrazzo G, Miglioli M "Effects of sildenafil on esophageal motility of patients with idiopathic achalasia." Gastroenterology 118 (2000): 253-7

35. Gilad R, Lampl Y, Eshel Y, Sadeh M "Tonic-clonic seizures in patients taking sildenafil." BMJ 325 (2002): 869

36. Savitz SA, Caplan LR "Transient global amnesia after sildenafil (Viagra) use." Neurology 59 (2002): 778

37. Marmor MF "Sildenafil (Viagra) and ophthalmology." Arch Ophthalmol 117 (1999): 518-9

38. Boshier A, Pambakian N, Shakir SA "A case of nonarteritic ischemic optic neuropathy (NAION) in a male patient taking sildenafil." Int J Clin Pharmacol Ther 40 (2002): 422-3

39. Vobig MA "Retinal side-effects of sildenafil." Lancet 353 (1999): 1442

40. Egan R, Pomeranz H "Sildenafil (Viagra) associated anterior ischemic optic neuropathy." Arch Ophthalmol 118 (2000): 291-2

41. "Viagra and loss of vision." Med Lett Drugs Ther 47 (2005): 49

42. Zrenner E "No cause for alarm over retinal side-effects of sildenafil." Lancet 353 (1999): 340-1

43. Pomeranz HD, Smith KH, Hart WM Jr, Egan RA "Sildenafil-associated nonarteritic anterior ischemic optic neuropathy." Ophthalmology 109 (2002): 584-7

44. Vobig MA, Klotz T, Staak M, BartzSchmidt KU, Engelmann U, Walter P "Retinal side-effects of sildenafil." Lancet 353 (1999): 375

45. Gandhi JS "Sildenafil-associated NAION." Ophthalmology 110 (2003): 1860-1; author reply 1861

46. Jagle H, Jagle C, Serey L, et al. "Visual short-term effects of viagra: double-blind study in healthy young subjects." Am J Ophthalmol 137 (2004): 842-9

47. Milman HA, Arnold SB "Neurologic, psychological, and aggressive disturbances with sildenafil." Ann Pharmacother 36 (2002): 1129-34

48. Kassim AA, Fabry ME, Nagel RL "Acute priapism associated with the use of sildenafil in a patient with sickle cell trait." Blood 95 (2000): 1878-9

49. Goldmeier D, Lamba H "Prolonged erections produced by dihydrocodeine and sildenafil." BMJ 324 (2002): 1555

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