Erectile Dysfunction

How Alcohol and ED Medications Interact

September 21, 2020

Alcohol and erectile dysfunction (ED) medications like sildenafil (Viagra®) or tadalafil (Cialis®) aren't a great mix. 

On a short-term basis, combining alcohol and ED meds can lead to dizziness, increased heart rate, and worse. On a long-term basis, alcoholism can cause ED.

How alcohol works with ED meds

Can I take Viagra® with alcohol? It's a common question we get here at Rex MD.

Broadly, men taking erectile dysfunction medications should avoid consuming large amounts of alcohol at the same time. 

Alone, alcohol and ED meds can each contribute to lower blood pressure, and mixing the two can cause rapid or sudden drops in blood pressure, especially when standing up quickly. Combined, they can cause dizziness, headaches, increased heart rate, and even fainting. 

In fact, many of these manufacturers include a warning in their prescribing label that suggests just how many drinks are ok with ED meds. 

How many drinks with Cialis®?

The makers of Cialis (tadalafil) and the FDA suggest no more than 5 alcoholic "units" in their approved label when taking the medication. Units is poorly defined, but is intended to be roughly equivalent to one drink.


How many drinks can I have with Viagra®?

Unlike Cialis®, Viagra's® (sildenafil) prescribing label includes no specific drink limitations, but patients have described negative experiences when mixing the two, and most doctors recommend against having more than 1 or 2 drinks when using Viagra®. The medication's FDA-approved label indicates testing has been done at the 50mg dose, but did not evaluate the 100mg dose.

From the label:


How many drinks with Levitra®?

Levitra® (vardenafil) has likewise no clear limitation on alcohol consumption in the prescribing label, and alcohol in combination was limited in its testing. 

From the label: 

Levitra Label Alcohol Comments

In general, it's a good idea to avoid or limit consumption when taking any of these popular ED medications.

Alcohol and Erectile Dysfunction

Alcoholism is a recognized risk factor for sexual dysfunctions of all kinds. Alcohol abuse can impair testosterone production and cause shrinkage of the testicles (yikes!), but it also affects the nervous system and impacts impulses between the brain and your genitals. Prolonged alcohol abuse can cause irreparable damage to the nervous system.

Even more troubling, sexual dysfunction leads to further distress and interpersonal difficulty, which is known to worsen the alcohol abuse. It's a challenging cycle.

The link between alcoholism and ED is fairly well-established. One well-known study links alcohol abuse to:

- Decreased sexual desire

- Difficulty getting or keeping an erection erection

- Difficulty in achieving an orgasm

- And even premature ejaculation

One large study from Italy found that the risk of ED was significantly higher in men consuming more than 3 glasses/day of alcohol.

Another study looking specifically at men over the age of 50 also found that consumption of more than two alcoholic drinks per day was an increased risk factor for ED. 

Moderating alcohol consumption – both chronically and at one sitting – is a recommended component of a healthy lifestyle. In turn, it's a great way to reduce your risk of ED.