Questions and Getting Help for ED

Side Effects of ED Drugs

Side Effects of ED Drugs

Medically reviewed by Dr. Larry Lipshultz M.D

Erectile dysfunction (ED) affects nearly every man at some point in his life. Whether it happens only occasionally or has become a chronic problem—or somewhere in between—men frequently turn to erectile dysfunction drugs. Although these drugs can be effective, there are side effects of ED drugs to be aware of.

What Are The Side Effects of ED Drugs?

All five erectile dysfunction drugs have similar side effects. Common side effects include headache, stuffy nose, warmth or redness in the face and neck, memory problems, back pain, and upset stomach, while heart attack, sudden loss of hearing, and sudden loss of vision are rare. Priapism, an erection that lasts four hours or longer, is also rare and requires immediate medical attention. Men who are taking drugs like nitroglycerin for angina should not take ED medications because nitroglycerin increases levels of nitric oxide and can lead to a severe drop in blood pressure or heart attack.


Before taking any ED medication, talk to your doctor if you are also using alpha-blockers for blood pressure or prostate problems. Combining any of the ED drugs with alpha-blockers may result in dangerously low blood pressure.

What Else Should You Know about Side Effects of ED Drugs?

Some specific side effects associated with these drugs include the following:

Because Viagra also has an effect on PDE6, which is in the retina, it can have an impact on the ability to perceive green and blue.

Cialis can cause muscle aches in about 5 percent of patients

Because Cialis stays in the bloodstream for 24 to 36 hours, the side effects can last longer than those associated with Viagra, Staxyn, and Levitra, which last about 4 to 6 hours in the bloodstream.

Even though Staxyn and Levitra both contain 10 mg of the same drug (vardenafil) in a film-coated tablet, Staxyn is an orally disintegrating tablet and provides greater systemic exposure than does Levitra. Therefore, do not interchange these two drugs without first consulting your physician.

Before taking any drug for erectile dysfunction, tell your doctor about any other medications you are using, as well as supplements, any other treatments you have tried for erectile dysfunction, and your medical history. The effectiveness of any erectile dysfunction drug depends on your age, whether you have any underlying medical conditions that could cause or contribute to erectile dysfunction, whether you are taking other medications that could impact the drug, and the dose.

What Does Research Say about Side Effects of ED Drugs?

A new (March 2015), large meta-analysis looked at the efficacy and side effects of the various oral erectile dysfunction drugs. A total of 82 trials involving 47,626 men were evaluated for drug efficacy while 72 trials (20,325 men) were analyzed for side effects. The findings were as follows:

  • Sildenafil (Viagra) 50 mg was the most effective but had the highest rate of overall side effects
  • Tadalafil (Cialis) 10 mg had intermediate effectiveness and the lowest overall rate of side effects
  • Vardenafil 10 mg and avanafil 100 mg had markedly lower effectiveness when compared with sildenafil 50 mg and similar side effects

According to Michael Eisenberg, MD, director of male reproductive medicine and surgery at Stanford University, oral ED drugs are effective for more than two-thirds of men with erectile dysfunction. Which drug you chose should be a decision made after a discussion with your doctor.

What Should You Tell Your Doctor Before Taking ED Drugs?

Before you take any of the ED drugs, be sure to inform your doctor if you:

  • Have a history of cardiovascular problems such as angina, heart failure, stroke, or heart attack
  • Have had heart surgery within the last six months
  • Have pulmonary hypertension
  • Have vision problems such as retinitis pigmentosa or ever had any type of severe vision loss
  • Have uncontrolled hypertension or low blood pressure
  • Have ever had an erection lasting more than four hours
  • Have bleeding problems or a blood cell condition such as sickle cell anemia or leukemia
  • Have or ever had stomach ulcers
  • Have liver or kidney problems or are having kidney dialysis
  • Have a deformed penis
  • Have any medical condition not mentioned here
  • Take any over-the-counter or prescriptions medications as well as any nutritional or herbal supplements.

Reference for side effects of ED drugs:

Chen L et al. Phosphodiesterase 5 inhibitors for the treatment of erectile dysfunction: a trade-off network meta-analysis. European Urology 2015 Mar 26

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