Is Viagra Safe Long-Term? A Look at Long-Term Viagra Side Effects

Is Viagra Safe Long-Term? A Look at Long-Term Viagra Side Effects

Table of Contents

I. How Does Viagra Work?

II. Viagra Side Effects and Interactions Reported in Clinical Trials

III. Viagra Side Effects: Postmarketing Experience

IV. Research on the Long-Term Side Effects of Viagra

V. Does Viagra Cure Erectile Dysfunction?

VI. Conclusion

For decades, Viagra has been a game-changer for men dealing with erectile dysfunction (ED), providing an effective solution for millions worldwide. However, as with any medication, it's crucial to understand the potential long-term side effects of Viagra in addition to its immediate benefits.

Viagra side effects can vary from mild to serious, and some may not be apparent until the drug is used over an extended period. This article explores how Viagra functions, the short-term and long-term side effects of Viagra, and the research that has been conducted to assess extended Viagra use.

How Does Viagra Work?

Viagra was approved by the FDA in 1998 to treat erectile dysfunction (ED) in men aged 18 and older. It’s available in tablet form, typically taken 30 to 60 minutes before sexual activity, and its effects can last up to four hours. Contrary to common misconception, Viagra doesn't cause a continuous erection. Instead, it helps you maintain an erection during sexual arousal within this timeframe. 1

So, how does Viagra work exactly? When you become aroused, a series of chemical reactions in your body lead to an erection:

  • Nitric oxide is released, increasing blood flow to the penis.
  • This influx of blood causes an erection. 1

However, your body produces an enzyme called phosphodiesterase type 5 (PDE5), which eventually breaks down the chemicals responsible for the erection, causing it to subside. 1

Viagra, which contains sildenafil, inhibits PDE5 production. Doing so allows the erection-supporting chemical reactions to persist, helping you maintain an erection. It's crucial to remember that Viagra doesn't work unless you're already aroused. It simply prolongs the natural processes that allow for an erection. 1

Viagra Side Effects and Interactions Reported in Clinical Trials

a man with a headache sitting in bed with a glass of water

Like any medication, Viagra can cause side effects. In clinical trials, common Viagra side effects at the 25 mg dosage included:

  • Headache (16%)
  • Facial flushing (10%)
  • Nasal congestion (4%)
  • Back pain (3%)
  • Indigestion (3%)
  • Dizziness (3%)
  • Muscle pain (2%)
  • Nausea (2%)
  • Vision issues (1%)
  • Rash (1%) 1

These side effects were more frequent with higher doses of Viagra. 1 Additionally, certain medications may interact negatively with Viagra:

  • Nitrates: Viagra should not be taken with nitric oxide donors (e.g., nitrates) as it can dangerously lower blood pressure.
  • Alpha-blockers: Caution is advised when combining Viagra with alpha-blockers due to the risk of excessively low blood pressure. The FDA suggests that patients be on a stable alpha-blocker regimen before taking Viagra, starting with the lowest possible dose.
  • Amlodipine: Taking amlodipine and Viagra together may result in a drop in blood pressure.
  • CYP3A4 inhibitors: If taken with CYP3A4 inhibitors, patients experience increased exposure to Viagra, which can enhance side effects. The FDA advises limiting Viagra intake to 25 mg within a 48-hour window in such cases. 1

Viagra Side Effects: Postmarketing Experience

Before the FDA approves any medication, it must undergo rigorous studies and clinical trials to prove its safety and effectiveness. However, even after a drug like Viagra is approved, the FDA may still require the manufacturer to conduct additional research, known as postmarketing studies. These studies help to identify any Viagra side effects that may not have been detected during the initial trials:

  • Cardiovascular: Events such as heart attacks, sudden cardiac death, and hypertension were reported, mostly in patients with pre-existing cardiovascular conditions. These events typically occurred during or after sexual activity, but the exact link between these events and Viagra remains unclear.
  • Vaso-occlusive crisis: This condition, in which sickled red blood cells block blood flow, causing pain, was observed in patients with pulmonary arterial hypertension (PAH) related to sickle cell disease.
  • Nervous system: Seizures, anxiety, and temporary memory loss have been reported.
  • Hearing: Some cases of sudden hearing loss occurred in users of PDE5 inhibitors like Viagra. However, other contributing factors (such as existing medical conditions) could have played a role.
  • Vision: Temporary vision disturbances such as redness, burning, and double vision have been noted.

Research on the Long-Term Side Effects of Viagra

a group of researchers having a conversation

While most studies focus on short-term Viagra side effects, a four-year study published in Therapeutics and Clinical Risk Management investigated the long-term side effects of Viagra in 979 men who used the drug regularly.

The men took flexible doses of Viagra (25 mg, 50 mg, or 100 mg) as needed, and researchers tracked serious long-term side effects of Viagra and treatment discontinuations. Effectiveness was measured by participant satisfaction with their erections and sexual activity. 2

Out of the 979 participants, only 37 (3.8%) experienced long-term side effects of Viagra that required a change in dosage or discontinuation. 2 The most observed long-term side effects of Viagra were:

  • Headache (10)
  • Indigestion (10)
  • Rhinitis: a reaction that causes nasal congestion, runny nose, and sneezing (6)
  • Facial flushing (5)
  • Vision issues (4)
  • Dizziness (3)
  • Mild heart palpitations (1)
  • Fast heartbeat (1)
  • Diarrhea (1)
  • Nausea (1)
  • Muscle pain (1)
  • Stiff muscles (1)
  • Respiratory disorder (1)
  • Pink eye (1)
  • Light sensitivity (1) 2

Among the few long-term side effects of Viagra that were cardiovascular-related (four cases of mild flushing and one each of moderate flushing, palpitations, and tachycardia), only one led to discontinuation. After nearly two years of therapy, a participant who experienced mild flushing with the 100 mg dose opted to stop taking Viagra permanently. 2

Each year, fewer than 1% of men discontinued treatment due to the long-term side effects of Viagra. 2 The most common reasons for discontinuation included: 

  • Indigestion (4)
  • Rhinitis (2)
  • Abnormal vision with a headache (1)
  • Indigestion with rhinitis (1)
  • Facial flushing (1)
  • Dizziness (1)
  • Muscle pain (1) 2

Throughout the study, satisfaction rates remained high, with over 94% of participants experiencing improved sexual activity over the four-year period. These findings suggest that Viagra remains effective for long-term use without losing potency or efficacy. 2

Additionally, fewer than 3% of men discontinued Viagra treatment each year due to lack of effectiveness. Over four years, 62 men (6.3%) stopped using Viagra because it no longer worked for them. 2

The study supports earlier findings that Viagra is a well-tolerated, effective long-term treatment for ED. Users generally report satisfaction with their sexual performance, and long-term side effects of Viagra are rare. 2

Does Viagra Cure Erectile Dysfunction?

Erectile dysfunction is characterized by difficulty achieving or maintaining an erection sufficient for sexual intercourse. While occasional difficulty achieving an erection is normal, ongoing ED can be a sign of a more serious issue that requires medical attention:

  • Problems with blood flow or nerve function in the penis
  • Psychological factors such as stress or anxiety
  • Physical conditions like heart disease, high blood pressure, or diabetes.

While Viagra can help men manage the symptoms of ED, it is not a cure. It improves erectile function temporarily, allowing men to engage in sexual activity. To address the root causes of ED, you’ll need to consult with a doctor. Depending on your situation, they might recommend lifestyle changes, counseling, or other medical interventions alongside or instead of medications like Viagra.

Conclusion

Viagra remains a highly effective option for treating erectile dysfunction, but it is not without potential risks. From symptoms like dizziness and indigestion to more serious long-term Viagra side effects, it’s important to be informed before starting treatment.

Research into the long-term side effects of Viagra shows that while most users tolerate the drug well, there are risks that should be monitored by healthcare providers. If you are considering Viagra or have been using it for some time, it’s important to stay informed and consult your doctor to ensure it remains a safe and effective solution for your needs.

References

  1. FDA Viagra
  2. McMurray, J. G., Feldman, R. A., Auerbach, S. M., et al. Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction