Can you take Viagra if you’re on blood thinners?

Can you take Viagra if you’re on blood thinners?

Short answer: Viagra and blood thinners can be taken together in many cases, but you should always consult a doctor first due to the increased risk of bleeding and potential effects on blood pressure.

Many men who take blood thinners wonder whether it is safe to take Viagra. Both medicines affect the circulatory system, so caution is warranted. The good news is that combining Viagra and blood thinners is possible in many cases, provided a doctor has assessed your situation. At Fellos, Dutch doctors provide personalised advice on your medication use, so you know exactly where you stand.

What does Viagra do in your body?

Viagra (the active ingredient sildenafil) works by inhibiting the enzyme PDE5, causing the signalling molecule cGMP to accumulate in the smooth muscle cells of the blood vessels in the penis. These muscles relax, blood flow increases and an erection occurs. The medicine only works when you’re sexually aroused and has no effect without that stimulation. You can read more about how quickly sildenafil works in our detailed explanation, including how quickly the medicine reaches its peak effect.

The standard dose is 50 mg, to be taken approximately one hour before sexual activity. Depending on how your body responds, a doctor may adjust the dose to 25 mg or 100 mg, with a maximum of 100 mg per day. As sildenafil temporarily lowers blood pressure, heart rate and blood pressure are relevant factors in determining the dose for certain groups.

What exactly do blood thinners do?

Blood thinners, also known as anticoagulants, reduce the blood’s tendency to clot. They are prescribed for conditions such as atrial fibrillation, deep vein thrombosis or a mechanical heart valve. The best-known traditional blood thinner is warfarin. With this medicine, its effectiveness is regularly monitored via a blood test, known as the INR value. Newer medicines, known as DOACs (direct oral anticoagulants) such as rivaroxaban, apixaban and dabigatran, work via a slightly different mechanism but have the same aim: to prevent unwanted blood clots.

Anticoagulants increase the risk of bleeding, even in places where you might not immediately notice it. This is important to bear in mind if you are considering taking a second medicine that also affects the circulatory system.

Can you combine Viagra with blood thinners?

There is no direct, clinically proven dangerous interaction between sildenafil and most anticoagulants. Pharmacological research shows that, in in vitro studies, sildenafil can inhibit the P-glycoprotein-mediated efflux of DOACs such as rivaroxaban and apixaban, which may cause their blood levels to rise slightly. The clinical significance of this has not yet been fully established, but extra caution and consultation with a doctor are advisable. Nevertheless, the combination is not prohibited outright.

Bleeding disorders and peptic ulcers are officially classified as relative contraindications for sildenafil, a category that also includes patients taking anticoagulants. You can find more information about the risks and side effects of sildenafil in our knowledge base.

The combination is therefore not automatically prohibited, but requires an individual assessment by a doctor who is familiar with your full list of medications.

What should you be aware of with this combination?

The main practical risk associated with combining Viagra and blood thinners is an increased risk of bleeding in the event of certain side effects. Sildenafil can cause nosebleeds or bleeding in the eye in some men, and when taken with anticoagulants, such symptoms may be more severe.

In addition to the risk of bleeding, there is the issue of blood pressure. Sildenafil temporarily lowers blood pressure; this warrants extra attention in men with a heart or vascular condition for which they are taking anticoagulants. Alpha-blockers, which are sometimes used alongside anticoagulants to treat prostate problems or high blood pressure, can further enhance the blood-pressure-lowering effect of sildenafil. Alcohol also intensifies this effect, as explained on our page about the effect of alcohol on your erection. It is advisable to limit your alcohol intake when taking Viagra, particularly when combined with blood thinners.

How can you use Viagra safely if you are taking blood thinners?

The first and most important rule is: never take Viagra without informing your doctor of your full list of medications. In practice, this means that your GP or treating specialist will assess the combination, may carry out additional checks on your INR level or blood pressure, and determine the appropriate dosage. For men taking warfarin, it is advisable to have their INR level checked shortly after starting sildenafil.

Scientific research confirms that the combination of sildenafil with nitrates is absolutely contraindicated due to a life-threatening drop in blood pressure. Nitrates fall into a different category of cardiovascular medication and must not be combined with sildenafil under any circumstances. If you are taking nitrates as well as anticoagulants, sildenafil is not suitable for you. If you are unsure which erectile dysfunction treatment is best for you, our comparison of sildenafil or tadalafil: which is best for you? provides insight into the differences.

How does Fellos help with medication advice?

Fellos works with Dutch BIG-registered doctors who assess your full medical history before a prescription is issued. This means you won’t simply be given a medication, but personalised advice: on the correct dosage, any necessary precautions, and whether combining it with your current medicines is safe.

The consultation takes place entirely online and the medicines are delivered discreetly to your home. This means you needn’t feel any hesitation about asking questions, even when it comes to a sensitive topic.

Use Viagra safely with advice from Fellos

Combining Viagra with blood thinners is possible in many cases, but always requires a medical assessment. It’s not simply a matter of taking both tablets; it’s a decision that takes into account your type of anticoagulant, your dosage, your blood pressure and any other medicines you’re taking. Fellos will help you weigh up these factors during a personal online consultation. Read more about ordering erectile dysfunction tablets online via Fellos and find out how to get the right treatment safely and discreetly.

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