viagra safe to take

Viagra: How Young Is Too Young?

From the WebMD Archives

Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas Rangers slugger is only 37 and won't admit to having erection problems, yet he recently agreed to appear in ads promoting the drug. The deal has made people wonder whether Palmeiro really represents men with erectile dysfunction. or whether Pfizer, the company that makes Viagra, wants to persuade young men to try it for fun.

It's true that erectile dysfunction is more common in older men, but many potential Viagra users are hardly senior citizens: About 40% of 40-year-old men in the U.S. have some degree of erectile dysfunction. Most Viagra users today, according to Pfizer, are in their early to mid 50s. So it makes sense that the company would want to reach more men around Palmeiro's age.

Urologist Myron Murdock, medical director of the Impotence Institute of America, says these men are likely to use Viagra because sexual performance is a high priority for them.

A younger man, Murdock says, "wants his V-12 Jaguar working just perfectly," whereas an elderly gent may be content with less dependable erections. What's more, the sexual partners of younger men "are more demanding of their performance," Murdock says.

Pfizer denies that it's promoting Viagra for recreational use. "We've consistently opposed that," says spokesman Geoff Cook. Nevertheless, Murdock says it's fine to pop the little blue pill to "optimize" your sexual performance.

We assume all young men have normal sexual functioning, "but they're really not normal," Murdock says. Hardening of the arteries. which restricts blood flow to the penis. can begin during the teen years, so that by the time a man is in his 20s, his ability to get and keep an erection has already begun to decline. Murdock says many men who seek Viagra for recreational use actually have minor erectile dysfunction.

There's also some evidence that Viagra can shorten the time it takes a man to recover after sex and be ready for another round. This is called the "refractory period." Normally it lasts 20 minutes or longer. One study, published in the journal Human Reproduction in January 2000, found that Viagra shortened the refractory period by about 10 minutes in healthy men .

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What Viagra cannot do is increase your sexual appetite or make you ejaculate if you have problems reaching orgasm. Ira Sharlip, urologist in San Francisco, says you shouldn't expect your erections to reach staggering new proportions, either. "I don't believe that Viagra can increase an erection beyond 100% of normal," he says.

"Viagra is a super-safe drug," Murdock says, assuming you have a healthy heart and don't take nitrates.

Nitrates include nitroglycerin -- a drug that many men take for chest pain from heart disease -- and "poppers." Poppers are little vials of amyl or butyl nitrate. Breaking the vial releases nitrate vapor, which gives a brief high when inhaled. It's most often used to enhance sexual pleasure, and mostly by gay men. Poppers are not all that safe to use on their own, and they're especially dangerous when you're on Viagra.

Nitrates widen blood vessels, and Viagra increases that effect. Mixing the two can cause your blood pressure to drop drastically. A sudden drop in blood pressure can make you pass out, and you may die if your blood pressure stays too low for too long.

Preservatives like sodium nitrate -- found in processed food -- do not cause this problem, so you won't die from eating a hot dog while on Viagra. Even so, it's best to take it on an empty stomach. That way, the drug absorbs into your bloodstream faster. Wine may contain nitrates, but not the kind that cause problems with Viagra. It's fine to play some Marvin Gaye on the stereo and sip a glass of Chardonnay, if that's what puts you in the mood.

Although you may be tempted to order Viagra discreetly from one of the hundreds of Web sites that sell it, don't. "It's bad medicine," Murdock says. You really must bring your doctor into your sex life if you want to use Viagra.

When you buy from an online pharmacy, you just have to answer some health questions before you proceed to the checkout page. If you answer honestly -- and that might be a big "if" for those determined to get what they want -- the questionnaire may catch some possible complications. But the pharmacists who fill your order don't know your medical history, and no questionnaire can diagnose the root cause of your problem. Erectile dysfunction can have serious underlying causes, like diabetes. heart disease. liver disease, or thyroid disease.

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Cook says Pfizer is opposed to Internet Viagra sales. "Our goal with any of our marketing is simply to reach men and encourage them to see a doctor," he says.

It seems that Viagra can make sex better for women, too. Like the penis. the clitoris is erectile tissue -- spongy tissue that becomes engorged with blood during sexual excitement. By increasing blood flow to the clitoris, Viagra may heighten a woman's sensation and arousal. It also seems to increase vaginal lubrication.

Murdock says many couples like to heat things up by splitting a dose of Viagra. "It's an interesting sexual situation," he says. The recommended dosage for men is up to 100 milligrams per day, and that seems to be just as safe for women. Young people may get results from a smaller dose: As little as 25 mg may be enough.

The FDA has not approved Viagra for women, but Murdock says, "It's just a matter of time." He says he and other doctors who specialize in sexual medicine prescribe it to women, which is perfectly legal. Doctors are allowed to use their best judgment. Drug companies, however, can't advertise any use that isn't FDA-approved.

The studies being done to test Viagra's safety and effectiveness in women have shown good results so far. "We're cautiously optimistic," Cook says.

Martin F. Downs is a health writer in New York City. He was formerly an editor at CBS HealthWatch. He has also written for Health.com, Salon.com, and POZ magazine and is the editor of the Alicubi Journal (alicubi.com).

?© 2002 WebMD, Inc. All rights reserved.

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Feb. 12, 2002 -- If you're strong enough to take the sex. you're strong enough to take Viagra. A new study finds Viagra safe for men with heart disease -- if they're able to exercise without having the symptoms of severe disease.

Men taking nitrate drugs (such as nitroglycerin ) to ease the symptoms of heart disease can't use Viagra. Even when a man isn't taking nitrates, there's been concern that Viagra might make his underlying heart disease much worse. There have been reports of men suffering heart attacks or chest pain after taking the popular erectile dysfunction drug.

Adelaide M. Arruda-Olson, MD, PhD, led a team of Mayo Clinic researchers who studied the effects of Viagra on 105 men with coronary artery disease (or heart disease ). The men took Viagra or a harmless sugar pill an hour before exercise tests. Then medications were switched, and the men exercised and were tested again.

The results: Viagra itself didn't make exercise harder on the heart .

"It seems more likely that the [heart attacks and pain] reported with [Viagra] are related more to the performance of sexual activity in a patient with coronary artery disease than the use of the drug," notes Thomas H. Marwick, MD, PhD. Marwick is a heart disease researcher at the University of Queensland in Brisbane, Australia. The Arruda-Olson study, and Marwick's accompanying editorial, appear in the Feb. 13 issue of TheJournal of the American Medical Association .

Arruda-Olson and co-workers warn that men with heart disease should see their doctors before taking Viagra. They recommend exercise tests to determine whether patients' hearts are strong enough for the drug.

The researchers warn that men taking nitrate-based drugs for their heart condition should not take Viagra.

?© 2002 WebMD, Inc. All rights reserved.

PATIENT INFORMATION

VIAGRA®
(vi-AG-rah)
(sildenafil citrate) Tablets

What is the most important information I should know about VIAGRA?

VIAGRA can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. Do not take VIAGRA if you take any other medicines called “nitrates.” Nitrates are used to treat chest pain (angina ). A sudden drop in blood pressure can cause you to feel dizzy, faint, or have a heart attack or stroke .

Do not take VIAGRA if you take medicines called guanylate cyclase stimulators which include:

• Riociguat (Adempas®) a medicine that treats pulmonary arterial hypertension and chronicthromboembolic pulmonary hypertension.

Tell all your healthcare providers that you take VIAGRA. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took VIAGRA.

Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex.

Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. Ask your doctor if your heart is healthy enough to handle the extra strain of having sex.

VIAGRA does not protect you or your partner from getting sexually transmitted diseases, including HIV —the virus that causes AIDS .

VIAGRA is a prescription medicine used to treat erectile dysfunction (ED). You will not get an erection just by taking this medicine. VIAGRA helps a man with erectile dysfunction get and keep an erection only when he is sexually excited (stimulated).

VIAGRA is not for use in women or children.

It is not known if VIAGRA is safe and effective in women or children under 18 years of age.

Who should not take VIAGRA?

Do not take VIAGRA if you:

• take medicines called nitrates (such as nitroglycerin)
• use street drugs called “poppers” such as amyl nitrate or amyl nitrite, and butyl nitrate
• take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)
• are allergic to sildenafil, as contained in VIAGRA and REVATIO, or any of the ingredients in VIAGRA. See the end of this leaflet for a complete list of ingredients in VIAGRA.

What should I tell my healthcare provider before taking VIAGRA?

Before you take VIAGRA, tell your healthcare provider if you:

• have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve or heart failure
• have had heart surgery within the last 6 months
• have pulmonary hypertension
• have had a stroke
• have low blood pressure. or high blood pressure that is not controlled
• have a deformed penis shape
• have had an erection that lasted for more than 4 hours
• have problems with your blood cells such as sickle cell anemia. multiple myeloma. or leukemia
• have retinitis pigmentosa. a rare genetic (runs in families) eye disease
• have ever had severe vision loss, including an eye problem called non-arteritic anterior ischemic optic neuropathy (NAION)
• have bleeding problems
• have or have had stomach ulcers
• have liver problems
• have kidney problems or are having kidney dialysis
• have any other medical conditions

Tell your healthcare provider about all the medicines you take*, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works causing side effects. Especially tell your healthcare provider if you take any of the following:

• medicines called nitrates (see “What is the most important information I should know about VIAGRA?” )
• medicines called guanylate cyclase stimulators, such as riociguat (Adempas)
• medicines called alpha blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA with alpha-blockers can lead to a drop in blood pressure or to fainting .
• medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase) or atazanavir sulfate (Reyataz)
• some types of oral antifungal medicines, such as ketoconazole (Nizoral), and itraconazole (Sporanox)
• some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin
• other medicines that treat high blood pressure
• other medicines or treatments for ED
• VIAGRA contains sildenafil, which is the same medicine found in another drug called REVATIO. REVATIO is used to treat a rare disease called pulmonary arterial hypertension (PAH ). VIAGRA should not be used with REVATIO or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil]).

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

How should I take VIAGRA?

• Take VIAGRA exactly as your healthcare provider tells you to take it.
• Your healthcare provider will tell you how much VIAGRA to take and when to take it.
• Your healthcare provider may change your dose if needed.
• Take VIAGRA about 1 hour before sexual activity. You may take VIAGRA between 30 minutes to 4 hours before sexual activity if needed.
• VIAGRA can be taken with or without food. If you take VIAGRA after a high fat meal (such as a cheeseburger and french fries), VIAGRA may take a little longer to start working
• Do not take VIAGRA more than 1 time a day.
• If you accidentally take too much VIAGRA, call your doctor or go to the nearest hospital emergency room right away.

What are the possible side effects of VIAGRA?

VIAGRA can cause serious side effects. Rarely reported side effects include:

• an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
• sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you have sudden vision loss in one or both eyes.
• sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus ) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away.

The most common side effects of VIAGRA are:

• headache
• flushing
• upset stomach
• abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
• stuffy or runny nose
• back pain
• muscle pain
• nausea
• dizziness
• rash

In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking VIAGRA. Most, but not all, of these men had heart problems before taking VIAGRA. It is not known if VIAGRA caused these problems.

Tell your healthcare provider if you have any side effect that bothers you or does not go away.

These are not all the possible side effects of VIAGRA. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1800-FDA-1088.

How should I store VIAGRA?

• Store VIAGRA at room temperature between 68°F to 77°F (20°C to 25°C).

Keep VIAGRA and all medicines out of the reach of children.

General information about the safe and effective use of VIAGRA.

Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use VIAGRA for a condition for which it was not prescribed. Do not give VIAGRA to other people, even if they have the same symptoms that you have. It may harm them.

This Patient Information leaflet summarizes the most important information about VIAGRA. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about VIAGRA that is written for health professionals.

For more information, go to www.viagra.com, or call 1-888-4VIAGRA

What are the ingredients in VIAGRA?

Active ingredient: sildenafil citrate

Inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose, triacetin, and FD & C Blue #2 aluminum lake

This Patient Information has been approved by the U.S. Food and Drug Administration.

Last reviewed on RxList: 10/3/2015
This monograph has been modified to include the generic and brand name in many instances.

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