High-risk interaction

Sildenafil, tadalafil, nitrates and poppers

This is one of the most important ED medication safety rules. Combining nitrate medicines or recreational poppers with common oral ED treatments can cause a dangerous drop in blood pressure.

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The direct answer

Do not use common prescription ED medication with nitrates or poppers. Tell the clinician exactly what you use, even if it is occasional, and seek urgent help if severe symptoms occur.

What counts as a nitrate?

Nitrates can be prescribed for chest pain and may come as tablets, sprays, patches or other forms. Recreational poppers can have a similar dangerous interaction. Product names vary, so list the exact medicine or substance.

Why the combination is dangerous

Both can widen blood vessels. Together, the effect may lower blood pressure enough to cause dizziness, fainting, heart complications or another emergency.

If chest pain occurs

Call 911. Tell emergency personnel what ED medication you took and when. Do not take a nitrate unless emergency clinicians who know about the ED medication direct you to do so.

Help for erection difficulties

ED symptoms and treatment options

Sildenafil and tadalafil help blood vessels relax, improving blood flow during sexual stimulation. That can make it easier to get and keep an erection firm enough for sex.

Trouble getting an erection?

Wanting sex but struggling to get firm enough can be a sign of ED. Find out how prescription treatment may help.

Difficulty getting an erection

Losing your erection during sex?

ED can also mean getting an erection but not keeping it. Learn about losing firmness and when medication may be an option.

Difficulty keeping an erection

Worrying about losing your erection?

Pressure to perform can make erection difficulties worse. Medication may help the erection response, but anxiety may also need separate support.

Performance anxiety and ED

Sexual stimulation is still needed. These medicines do not increase desire and are not suitable for everyone; a prescription is required.

When to seek medical advice

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Useful next steps

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