Sildenafil, also known by its brand name Viagra, is an oral medication used to treat erectile dysfunction (ED) which belongs to the PDE5 inhibitor class of drugs. This category includes sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra). They work by opening up the blood vessels in your penis, enabling greater blood flow to help facilitate the production of erections upon sexual stimulation.
Antiretroviral drugs, or ARVs, are drugs that keep levels of Human Immunodeficiency Virus (HIV)––a retrovirus––within low concentrations in the blood. ARVs do this by slowing down HIV’s replication cycle. ARVs aren’t exactly a cure for HIV, but it can help people with HIV live out full, normal lives.
However, since ED is common among HIV-positive individuals, it’s important to understand if combining both ARV and ED drugs like sildenafil is safe.
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Is it possible to take sildenafil simultaneously with ARVs?
Potentially fatal drug interactions can happen if you take sildenafil with certain HIV antiretrovirals. In order to lessen the risk of experiencing said interactions, it’s critical to let your healthcare provider know what medicines you’re presently taking, such as prescription and OTC medicines, vitamins, and supplements.
The same is true if you’re taking any medications for treating HIV such as the following and wish to start taking sildenafil or other PDE-5 inhibitors:
- Amprenavir (Agenerase)
- Atazanavir (Reyataz)
- Darunavir (Prezista)
- Delavirdine (Rescriptor)
- Elvitegravir/cobicistat/TDF/FTC (Stribild)
- Fosamprenavir (Lexiva)
- Indinavir (Crixivan)
- Lopinavir/ritonavir (Kaletra)
- Nelfinavir (Viracept)
- Ritonavir (Norvir)
- Saquinavir (Fortovase, Invirase)
The aforementioned ARVs may increase sildenafil concentrations in your body, which might increase your likelihood of developing common sildenafil side effects such as headaches, dizziness, gastrointestinal discomfort, and low blood pressure, among others.. If you’re presently taking any of these medicines for HIV, your healthcare provider may put you on a lower starting sildenafil dose or take sildenafil less frequently.
Certain HIV medicines, on the other hand, like etravirine (Intelence), may reduce sildenafil concentrations in the body, which might lead your healthcare provider to adjust your sildenafil dose accordingly.
Other antiretroviral drugs for HIV not listed above may adversely interact with sildenafil or other PDE5 inhibitors, so make sure you provide your doctor full details about your medicines.
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What are the potential side effects of sildenafil?
The most common side effects of sildenafil include light-headedness, dizziness, redness or flushing, gastrointestinal upset, nasal congestion, back pain, rashes, and blurred or distorted vision.
Rarer side effects of sildenafil include priapism, a painful condition involving a prolonged erection that won’t subside after four hours, hearing loss, or a ringing in the ears. If you experience any of these less common side effects, seek immediate medical attention.
That said, if you’re taking antiretroviral drugs for HIV, consult with your healthcare provider about how sildenafil may interact with your medicines and the potential side effects it might bring. While sildenafil and other PDE5 inhibitors boast remarkable safety and effectiveness records, they aren’t safe for everyone. This is true for individuals taking ARVs or those with underlying health conditions such as liver disease. Such individuals may need to make adjustments to their sildenafil dose in order to enjoy its benefits and ensure their safety while doing so.
