Viagra (sildenafil) and Cialis (tadalafil) are widely used prescription medications for treating erectile dysfunction. While they are effective and safe for many men, they are not appropriate for everyone. Certain medical conditions and medications can make these drugs dangerous or ineffective. Here’s a breakdown of who should avoid them and why.

Men Taking Nitrate-Based Medications

If you’re taking medications that contain nitrates, such as nitroglycerin or isosorbide dinitrate, you should not take Viagra or Cialis under any circumstances. These medications are commonly prescribed for chest pain (angina) or other heart conditions. Viagra and Cialis both act as vasodilators, they widen blood vessels by increasing nitric oxide activity. When combined with nitrates, they can cause a life-threatening drop in blood pressure, leading to fainting, heart attack, or stroke. Even if you use nitrates only occasionally (like nitro spray for chest pain), these ED medications are strictly contraindicated. Always inform your doctor if you’re on any nitrate therapy before seeking ED treatment.

Men with Severe Heart Conditions

Men with serious cardiovascular problems, including those who have had a heart attack or stroke in the past six months, suffer from unstable angina, or have uncontrolled arrhythmias (irregular heartbeats)  should avoid Viagra or Cialis. These medications, while effective in enhancing blood flow to the penis, also put additional strain on the heart, especially during sexual activity, which already elevates heart rate and blood pressure. For men whose heart function is severely compromised, this added stress may increase the risk of a cardiac event. In such cases, a doctor may recommend a thorough cardiac evaluation before approving any ED medication, or suggest alternative approaches to treating erectile dysfunction.

Men Taking Alpha-Blockers for Prostate or Blood Pressure

Alpha-blockers such as tamsulosin and doxazosin are commonly prescribed for benign prostatic hyperplasia (BPH) or high blood pressure. When taken in combination with Viagra or Cialis, these medications can significantly lower blood pressure. This may result in dizziness, fainting, or light-headedness. If both medications are necessary, doctors typically recommend adjusting the dosage and carefully timing their administration. For example, an alpha-blocker may be taken in the morning, while the ED medication is taken several hours later. This combination should only be used under medical supervision.

At Bloomed, we believe in personalized, evidence-based solutions for sexual wellness. Whether you're navigating physical limitations, managing stress-related ED, or simply seeking a natural alternative, we’re here to support your journey with discreet, accessible, and clinically backed options.

Join Now

Men with Certain Eye Conditions

Men diagnosed with specific vision disorders such as retinitis pigmentosa or who have experienced sudden vision loss due to non-arteritic anterior ischemic optic neuropathy (NAION) should not take Viagra or Cialis. These drugs can affect blood flow to the optic nerve, which may worsen underlying eye conditions or contribute to additional vision problems. Although rare, cases of sudden vision loss have been associated with ED medications in men with a history of these disorders. An eye specialist should be consulted before using ED medications if any retinal or optic nerve issues are present.

Men with Severe Liver or Kidney Disease

Both Viagra and Cialis are metabolized by the liver and cleared from the body through the kidneys. In people with severe liver damage or advanced kidney disease, the body may not be able to process these medications effectively. This can lead to drug buildup, increasing the risk of side effects such as headaches, low blood pressure, and prolonged erections. Men with significant liver or kidney impairment may require much lower doses or may be advised to avoid ED medications entirely. A healthcare provider should evaluate the risks before prescribing.

Men with a History of Adverse Reactions or Allergies

If a person has previously experienced adverse effects from Viagra or Cialis, they should avoid taking the same medication again without medical advice. Common issues include severe headaches, nausea, visual disturbances, chest pain, or prolonged erections lasting more than four hours. Allergic reactions to sildenafil or tadalafil, or to other ingredients in the medication, are also a reason to avoid use. In such cases, alternative treatments or medical evaluations are needed to identify safer options.

A Note on Psychological Erectile Dysfunction

For many men, erectile dysfunction is not solely a physical issue, but rather rooted in psychological factors such as performance anxiety, chronic stress, relationship tension, or depression. In these cases, medications like Viagra or Cialis may not provide significant benefits because they do not address the underlying mental or emotional causes. Relying on ED pills without treating these factors can lead to dependency and reduced confidence over time.

A more holistic approach is often more effective. One supportive option is RelaxZen by Enerex, a natural supplement designed to promote mental clarity, reduce anxiety, and support a healthy stress response. It combines ingredients like L-theanine, magnesium, GABA, and adaptogens that help calm the nervous system without sedation. For men dealing with psychological ED, improving stress resilience and emotional balance can restore natural sexual confidence and performance over time.

Explore our curated collection of natural supplements, including RelaxZen for stress-related ED and Enerex Satisfaction for performance support with No prescription required. Fast, and discreet shipping.