Can You Take Viagra With Amlodipine? Usually Yes, With Checks

Yes, most men can take Viagra (sildenafil) with amlodipine. The UK product information does not ban the combination. Both medicines relax blood vessels, so your blood pressure can fall further than it would with either one alone. A prescriber or pharmacist should check you first.

How much does your blood pressure fall?#

In one trial, men with high blood pressure who already took amlodipine were given sildenafil 100mg. Their blood pressure fell by a further 8/7 mmHg on average when lying down. In trials, sildenafil on its own lowers it by about 8/5 mmHg.

For most people that is a small change. It peaks around 1 hour after the tablet and wears off over about 4 hours.

Headache is the most common side effect, affecting more than 1 in 10 men. Flushing, indigestion and a blocked nose affect up to 1 in 10. Dizziness and light-headedness are the effects linked to the blood pressure drop.

The risk is higher if your pressure already runs low. It is also higher if you are dehydrated, have drunk alcohol or take several blood pressure medicines.

Why the two add together#

Amlodipine is a calcium channel blocker. It stops calcium entering the muscle cells in artery walls, so the arteries relax. Sildenafil blocks an enzyme called PDE5. That lets a chemical called cGMP build up, which also relaxes smooth muscle. The two work by different routes but push blood pressure the same way.

Medicines that matter more than amlodipine#

Amlodipine is rarely the problem. Other medicines on your list can be.

If you take an alpha-blocker, ritonavir or another medicine that calls for a 25mg dose, you need a prescriber who can supply that strength. See "Dose and timing" below for what Totiva can and cannot supply.

Grapefruit juice is a weak CYP3A4 inhibitor. It may modestly raise levels of both sildenafil and amlodipine, so avoid large amounts.

Who should not use sildenafil, and what to bring#

Sildenafil is not suitable if you have any of these:

• A heart attack or stroke in the last 6 months
• Unstable angina or severe heart failure
• Very low blood pressure (below 90/50 mmHg)
• Severe liver problems
• Sight loss in one eye from optic nerve damage, or an inherited retinal condition
• Advice from a doctor to avoid sex because of your heart

Bring your recent blood pressure readings, home ones if you have them. Bring a full list of medicines, including GTN spray and anything bought over the counter. Be ready to describe your heart and eye history.

NICE (NG136) uses 135/85 mmHg on home readings as the diagnostic line for hypertension. It is not a safety limit for sildenafil. Sildenafil has not been studied above 170/110 mmHg, so a prescriber will want very high readings treated first.

Viagra Connect is available from a pharmacist after a consultation. It is a fixed 50mg product, so a lower 25mg starting dose is not possible with it. Tell the pharmacist you take amlodipine. They may refer you to your GP or another prescriber instead of selling it if you take an alpha-blocker, or if your blood pressure is very high or very low.

Dose and timing#

The licensed doses of sildenafil are 25mg, 50mg and 100mg, taken once in 24 hours at most. If you take blood pressure medicines, a prescriber may start you on 25mg. For men over 65 the SmPC says 25mg should be considered. The dose can be stepped up if you tolerate it.

Totiva supplies sildenafil as 50mg and 100mg tablets only, and Viagra Connect as 50mg only. We may not be able to supply the 25mg strength. If you are over 65, or take an alpha-blocker, ritonavir or another medicine that calls for a 25mg dose, speak to your GP or an NHS prescriber about whether that dose is right for you.

Take sildenafil about 1 hour before sex. A heavy, fatty meal slows it down. Take amlodipine at its usual time, with no need to change it.

Try your first dose at home, where you can sit down if you feel light-headed. Stand up slowly. Keep alcohol low, as it lowers blood pressure further.

Tadalafil is also a PDE5 inhibitor and is also allowed with amlodipine, but it lasts much longer, so the same checks apply. Amlodipine can occasionally affect erections, and high blood pressure is a common cause of ED too. Our guide on whether amlodipine causes erectile dysfunction covers that. Tell your GP about ED, as it can be an early sign of heart disease.

If you feel unwell after a dose#

If you took both without advice and feel fine, nothing needs doing. Tell your prescriber at your next review. Here is what to do if symptoms start:

• Mild dizziness or headache: sit or lie down, sip water and stand up slowly.
• Fainting or near-fainting: lie down and call NHS 111 or your GP the same day. Do not drive until it has passed.
• Chest pain: after taking sildenafil, do not use any nitrate, including GTN, for 24 hours. If chest pain starts, call 999 and tell the paramedics or A&E you took sildenafil.
• Erection lasting over 4 hours: go to A&E straight away.
• Sudden loss of vision or hearing: stop sildenafil and get urgent help.

Speak to your pharmacist or GP if dizziness keeps returning or your blood pressure readings change. You can report suspected side effects through the MHRA Yellow Card scheme.

If you take amlodipine and want to check whether 50mg or 100mg sildenafil suits you, you can start a free ED consultation with Totiva, where a UK clinician reviews your medicines before approving anything. If you need a 25mg dose, or take an alpha-blocker or ritonavir, Totiva may not be able to treat you, and your GP is the better first step.