Managing Erectile Dysfunction Medication Side Effects: Tips And Tricks

Taking an erectile dysfunction medication? It’s important to be aware that, like all prescription treatments, it can cause some unwanted symptoms. The good news is, the majority of the side effects are mild and temporary.

Article Summary:

• Erectile dysfunction (ED) medication can cause some unwanted side effects, but these are usually mild and temporary.
• The most common medications for ED are phosphodiesterase type 5 inhibitors (PDE-5 inhibitors), which are used to improve erectile function.
• There are things you can do to help with side effects while taking the medication, such as limiting alcohol intake, lowering your dose and taking it with food instead of an empty stomach.

What is erectile dysfunction medication and how does it work?

Erectile dysfunction medications contain phosphodiesterase type 5 inhibitors (PDE-5 inhibitors). Their primary function is to help relax the blood vessels, allowing more blood flow to the penis during sexual activity. [1]

This increased blood flow makes it easier to both maintain and achieve an erection. One important aspect to remember is that it only works in response to sexual stimulation. In other words, it's essential to be aroused for the treatment to cause an erection. [2]

The time it takes for erectile dysfunction medication to take effect can vary between individuals, but it usually starts between 30 minutes to an hour. Keep in mind that taking it with a heavy meal might delay the time it takes to start working.

Who can use it?

PDE-5 inhibitors are prescribed to adults dealing with erectile dysfunction (ED), also known as impotence. This condition is characterized by difficulty in achieving or maintaining an erection suitable for sexual activity.

These medications have been studied for safety in clinical trials and are prescribed by licensed healthcare providers, but there are some health facts you should be aware of before taking it.

Allergies

Don't take erectile dysfunction medication, such as Viagra (sildenafil) or Cialis (tadalafil), if you're allergic to any of its ingredients.

Health conditions

Certain health concerns can make phosphodiesterase-5 inhibitors unsafe. These include severe liver or heart conditions, such as a recent stroke or heart attack, and specific inherited eye diseases (for example, retinitis pigmentosa). Also, if you’ve ever experienced vision loss due to non-arteritic anterior ischemic optic neuropathy (NAION), it's not recommended that you use this medication. [3]

If you have heart valve problems, thickened heart muscle, or a nervous system disorder that affects blood pressure, talk to your healthcare provider before using it.

Check with a physician first if you have sickle cell anemia, leukemia, or multiple myeloma, a deformity of the penis or Peyronie’s Disease, heart problems or a history of stomach ulcers or bleeding issues. These conditions can have risks of complications. [3]

You should also avoid these medications if you have been advised not to take part in sexual activity, or in activities that widen your blood vessels, such as exercise.

Other medications

Avoid ED medication if you're taking nitrates, nitric oxide donors, or any recreational drugs. Combining these can lead to a dangerous decrease in blood pressure, which can lead to dizziness, fainting, or even a heart attack. [3]

Erectile dysfunction medication side effects

Let's talk about the side effects people are most likely to experience when taking the most common erectile dysfunction medications. These effects impact between one in 10 and one in 100 people: headaches, feeling faint, nausea, upset stomach, nasal congestion, visual disturbances and hot flashes. [1]

Less commonly (only affecting between 1 in 100 and 1 in 10,000 people), some experience side effects including:

• Vomiting
• Indigestion
• Abdominal pain
• Rashes
• Eye irritation (pain, blurred vision, double vision, bloodshot eyes)
• Tinnitus
• Vertigo
• Nose bleeds
• Increased heart rate
• Fainting
• Muscle ache
• Fatigue
• Chest pain
• Numbness
• Hypersensitivity to pain
• Blood in the urine

How to manage side effects

The majority of common side effects are temporary and should not last for long after taking it. The side effects should also stop entirely when you stop taking the medication. If side effects continue, stop using the medication and seek medical attention.

Stand up slowly

To help lower the possibility of dizziness and avoid getting a head rush, stand up more gradually from a seated or lying position.

Limit alcohol intake

The intake of alcohol can influence the time the medication takes to have an effect, and can also make it more difficult to achieve an erection.

Lower the dose

If side effects are affecting you, speak to your healthcare provider. They can review your treatment plan and adjust your dose if appropriate

Take it with food

Typically, this medication is taken on an empty stomach, but taking it with a meal can help reduce any unwanted side effects, including an upset stomach and nausea. This may slightly reduce the efficiency of the drug or mean that it takes longer to kick in, but most people find a balance that works for them.

Take the medication correctly

Always follow the prescriber's instructions on how to use it to reduce the risk of unwanted side effects. It’s important to adhere to the dosage prescribed. Taking more than the recommended amount can increase the likelihood and severity of side effects without improving effectiveness.

If you accidentally take more than you should, contact a doctor immediately, or call 911 or your local health line.

Rare side effects

Although extremely rare, there have been cases where people have experienced severe side effects and reactions on this medication, including:

• Heart attack or heart failure
• Severe allergic reactions (difficulty breathing, rash, swelling of the face, throat and tongue)
• Sudden drop in blood pressure
• Eye issues such as double vision, reduced sharpness, swelling, or seeing halos around lights
• Swelling inside the nose
• Sudden hearing loss or irritation

Some serious side effects require immediate medical attention:

• Allergic reactions: Symptoms include wheezing, difficulty breathing, shortness of breath, and swelling.
• Chest pain: Especially if it occurs during or after sex. Sit in a semi-sitting position and relax, but do not take nitrates.
• Prolonged erections: If an erection lasts more than 4 hours, seek medical help immediately.
• Vision problems: Abnormal vision, such as sudden decrease or loss of vision.
• Skin reactions and seizures: Severe skin reactions or seizures also need urgent attention.

If you have any questions or experience any side effects or adverse reactions not listed, contact your doctor, pharmacist, or nurse. Reporting side effects helps improve the safety of medications.

For more detailed information, always refer to the official leaflet or consult with healthcare professionals. Your health and safety are paramount when considering these treatments.

What to do if it doesn’t work

If you find that it isn’t helping you achieve an erection, or if your erection doesn’t last long enough for sexual intercourse, it’s essential to speak with a clinical expert or your doctor. They can provide guidance and adjust your treatment plan if necessary.

Starting an erectile dysfunction treatment

ED treatments can significantly improve the quality of life for many people, but it’s essential to use them responsibly and under medical guidance.

Need support with erectile dysfunction? Find out what treatment is suitable for you on our website.

References

1. Dhaliwal A, Gupta M. PDE5 Inhibitor [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/
2. ‌Phosphodiesterase 5 receptor (PDE5) inhibitors similarities and differences: a non-prescription medicine perspective [Internet]. The Pharmaceutical Journal. 2024. Available from: https://pharmaceutical-journal.com/article/feature/phosphodiesterase-5-receptor-pde5-inhibitors-similarities-and-differences-a-non-prescription-medicine-perspective
3. ‌Sildenafil 50 mg film-coated tablets - Summary of Product Characteristics (SmPC) - (emc) [Internet]. www.medicines.org.uk. Available from: https://www.medicines.org.uk/emc/product/7141/smpc#gref