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Can Viagra Cause a Stroke?

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD, MPH, ALM

Written by Geoffrey C. Whittaker

Published 03/31/2021

Updated 04/09/2024

The Viagra® and stroke connection is a common concern for men. And it should be — both stroke and ED can seriously affect your quality of life. So can Viagra cause a stroke? It’s rare but possible — we’ll explain why and how below.

Viagra (sildenafil citrate) is a medication for treating erectile dysfunction (ED) that helps men get and maintain an erection for about four hours. There are some side effects, like dizziness, headache and blurred vision, but these are very different (and nowhere near as serious) as a stroke.

Stroke can be a very real risk of taking Viagra for men with a history of cardiovascular issues and those who regularly take nitrates. Still, there’s typically no reason to panic, as long as you take the medication as directed.

Ahead, we’ll cover what the experts say about the connection between Viagra and stroke, along with what you need to know to avoid this danger.

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Viagra makes sexual activity easier for men with ED by improving blood flow. It’s part of a class of drugs called PDE5 inhibitors (short for phosphodiesterase type 5 inhibitors), which work to block the action of the PDE5 enzyme.

This enzyme can prevent smooth muscle tissue from relaxing and affect blood flow to the penis. This means that if you suffer from erectile dysfunction and take Viagra, it’ll help allow increased blood flow to your penis, allowing you to get and maintain an erection.

However, the penis isn’t the only part of the body affected by Viagra.

How Viagra Affects Blood Pressure

When you take this medication, your blood vessels dilate, increasing blood flow to your penis and some other parts of your body — which also affects your blood pressure. Blood pressure is the pressure of blood pushing against your artery walls as your heart pumps it.

In healthy men taking Viagra, blood pressure decreases slightly. The average man experiences a maximum decrease of 8.4/5.5 mmHg (millimeters of mercury, how blood pressure is measured) shortly after taking a normal dose of Viagra.

But in men with heart disease or a history of heart problems or heart failure, this could create potentially life-threatening conditions for those who aren’t careful.

For most guys, a slight drop in blood pressure shouldn’t be concerning or life-threatening. But if you suffer from cardiovascular disease or take nitrates, Viagra’s impact on your blood pressure can have serious adverse effects.

Of course, prescription medication isn’t your only option. Our guide covers natural ways to increase blood flow to your penis.

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When used as directed, Viagra is considered safe and not normally associated with strokes. However, in postmarketing surveillance, strokes have been seen in temporal relation to taking Viagra. Additionally, taking Viagra with certain other medications can cause your blood pressure to drop suddenly, which could trigger cardiovascular issues like heart attack and, yes, stroke.

Combining certain high blood pressure medications with sildenafil can cause your blood pressure to drop to too-low levels, called hypotension. This can result in ischemic stroke.

Though ischemic stroke typically happens when a blood vessel supplying blood to the brain is obstructed, significantly low blood pressure can also reduce oxygen delivery to the brain. Another type of stroke is when there is a bleed in the brain.

Cardiac arrest can also result from hypotension, during which chest pain may occur.

See our blog for more on the link between ED medications and heart health.

Stroke Symptoms

Symptoms of stroke can include:

  • Dizziness

  • Nausea or vomiting

  • Abnormal or slurred speech

  • Arm, leg or face numbness

  • Weakness (especially on one side of the body)

  • Loss of balance

  • Unusually severe headache

Stroke calls for immediate medical attention, as brain cells begin to die within minutes when they’re starved of the oxygen supplied by blood. 

If left untreated, strokes can result in memory loss, paralysis and speech problems.

How Long After a Stroke Can You Take Viagra?

Some men who’ve already had a stroke may wonder how long after a stroke they can take Viagra. It depends on how you’ve recovered, and it’s best to discuss with your healthcare provider rather than go by guidelines from the internet.

Is Viagra a blood thinner? Our blog has answers.

Viagra and nitrates both dilate blood vessels. When taken together, the combination can potentially cause dizziness, fainting or even heart attack or stroke because of low blood pressure.

If you’re on medication for a heart condition, you may not be aware you’re taking nitrates, especially if your drug isn’t generic.

Nitroglycerin, isosorbide dinitrate and isosorbide mononitrate are commonly used nitrates. All can interact with Viagra.

Other medications that can interact with Viagra include riociguat (sold as Adempas®), alpha-blockers and certain other medications used to treat hypertension.

If you’re unsure what you’re taking, carefully read the packaging to see if it contains any of these medications. And consult your healthcare provider about potential drug interactions.

Supplements containing similar ingredients and recreational drugs such as nitrites (also called “poppers”) shouldn’t be used while taking Viagra.

Why Herbal Viagra Isn’t a Safer Alternative

Herbal Viagra, like natural supplements you might find at a gas station or vitamin store, isn’t necessarily a safer alternative.

Herbal Viagra isn’t Viagra at all. And like other supplements, the FDA doesn’t regulate it in the same way as prescription medications or require clinical studies proving its efficacy.

Learn more about the risks of herbal Viagra in our blog.

Choose your chew

There are plenty of ways to improve sexual performance without drugs like Viagra. Here’s what might help:

  • Focusing on nutrition and exercise. Eating healthier foods and moving your body more can reduce your risk of heart disease and improve blood flow without the side effects of sildenafil or other ED medications.

  • Limiting alcohol and smoking. Quitting smoking and moderating alcohol intake might help you achieve and maintain erections while boosting your overall sexual performance.

  • Limiting porn use. You may also want to cut down on your porn use, which, along with masturbation, has been shown to contribute to erectile dysfunction in some men.

  • Consulting a medical professional. Talking to a healthcare provider about testosterone deficiency, a known cause of erectile dysfunction, may also help uncover alternative treatments.

You can also get chewable ED hard mints from Hims, which contain the same active ingredients as other PDE5 inhibitors, including sildenafil.

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Are strokes common side effects of Viagra? Not for men taking this medication as directed, following the medical advice of their provider and watching carefully to avoid unsafe drug interactions.

But if you have heart problems or a history of them, being more careful is an essential part of treating ED with Viagra. 

Here’s what it boils down to:

  • For most healthy guys, the main adverse side effects to worry about with Viagra are headaches, flushing, indigestion, changes in vision, back pain, nausea, dizziness, nasal congestion, rash and muscle pain. 

  • However, for men who have a history of cardiovascular issues and those taking nitrates to treat those cardiovascular problems, taking Viagra can lead to some major, major complications — up to and including death. 

  • The most important thing to remember is to communicate clearly with your healthcare provider about any and all medications you’re taking before you start Viagra or generic Viagra.

  • Your provider will know the potential interactions, contraindications or risk factors you should be aware of and can prescribe Viagra (or another medication) accordingly.

Have questions? Want to know more? Get guidance and explore ED treatment options on our sexual health platform.

13 Sources

  1. Mulhall, J. P., Luo, X., Zou, K. H., Stecher, V., & Galaznik, A. (2016). Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA. International journal of clinical practice, 70(12), 1012–1018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540144/
  2. The Food and Drug Administration. (2017). VIAGRA® (sildenafil citrate) tablets, for oral use. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020895s048lbl.pdf
  3. Are erectile dysfunction pills safe for men with heart disease? (2019, July 30). Harvard Health Publishing. Retrieved March 30, 2021, from https://www.health.harvard.edu/mens-health/are-erectile-dysfunction-pills-safe-for-men-with-heart-disease
  4. What is cardiovascular disease? (n.d.). Heart.org. Retrieved March 30, 2021, from https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease
  5. Chamsi-Pasha H. (2001). Sildenafil (viagra) and the heart. Journal of family & community medicine, 8(2), 63–66. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437061/
  6. Dhaliwal A, Gupta M. PDE5 Inhibitor. [Updated 2020 Jun 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/
  7. Chamsi-Pasha H. (2001). Sildenafil (viagra) and the heart. Journal of family & community medicine, 8(2), 63–66. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437061/
  8. Ischemic Stroke. (n.d.). Cedars Sinai. Retrieved March 30, 2021, from https://www.cedars-sinai.org/health-library/diseases-and-conditions/i/ischemic-stroke.html
  9. Stroke. (n.d.). American Association of Neurological Surgeons. Retrieved March 30, 2021, from https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Stroke
  10. The Food and Drug Administration. (2018). ADEMPAS (riociguat) tablets, for oral use. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/204819s011lbl.pdf
  11. Nachawati D, Patel J. Alpha Blockers. [Updated 2020 Dec 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556066/
  12. Park, B. Y., Wilson, G., Berger, J., Christman, M., Reina, B., Bishop, F., Klam, W. P., & Doan, A. P. (2016). Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behavioral sciences (Basel, Switzerland), 6(3), 17.https://pubmed.ncbi.nlm.nih.gov/27527226/
  13. Erection Problems. (n.d.). U.S. National Library of Medicine. Retrieved March 30, 2021, from https://medlineplus.gov/ency/article/007617.htm
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD, MPH, ALM

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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