Is it safe to take hydroxyzine with sildenafil (Viagra)?

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Last updated: May 21, 2025View editorial policy

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From the Guidelines

It is not recommended to take hydroxyzine with Viagra (sildenafil) without consulting a healthcare provider first, as the combination may increase the risk of side effects such as dizziness or lightheadedness 1. When considering the use of hydroxyzine with Viagra, it's essential to weigh the potential benefits against the risks. Hydroxyzine is an antihistamine that can cause blood pressure lowering effects, while Viagra (sildenafil) is a phosphodiesterase type 5 (PDE5) inhibitor used for erectile dysfunction. The Princeton III Consensus Recommendations emphasize the importance of assessing cardiometabolic health and cardiovascular risk before prescribing treatment for erectile dysfunction 1.

  • Key considerations for taking hydroxyzine with Viagra include:
    • Potential increased risk of side effects such as headache, flushing, or dizziness
    • Importance of starting with lower doses and monitoring how the body responds
    • Need for caution in people with certain cardiovascular conditions
    • Importance of informing the doctor about all medications being taken to avoid potential drug interactions According to the Princeton III Consensus Recommendations, management of erectile dysfunction should always be considered secondary to maintaining cardiovascular function, and treatment for ED should not negatively affect cardiovascular health 1. Therefore, it's crucial to consult with a healthcare provider before combining hydroxyzine with Viagra to ensure safe and effective treatment.

From the Research

Interaction between Hydroxyzine and Viagra

There are no research papers to assist in answering this question, as none of the provided studies directly address the interaction between hydroxyzine and Viagra.

General Information about Viagra Interactions

  • The concomitant use of sildenafil (Viagra) and organic nitrates is contraindicated because it may lead to a potentiation of the decreases in blood pressure and thus cause life-threatening hypotension 2, 3, 4, 5.
  • The concomitant use of sildenafil and different classes of antihypertensive agents (beta-blockers, alpha-blockers, diuretics, ACE inhibitors, calcium antagonists) may lead to additive but not to potentiating blood pressure decreases 2.
  • Sildenafil is an effective and well-tolerated treatment for erectile dysfunction in patients taking concomitant antihypertensive medication, including those on multidrug regimens 2.
  • The efficacy of sildenafil was not affected by patient age or by antihypertensive or antidepressant medications 3.

Safety and Contraindications of Viagra

  • The use of Viagra necessitates caution in cardiac failure and when used within six months of acute myocardial infarction and stroke 4.
  • It is inadvisable in patients with unstable angina pectoris 4.
  • The relative contraindications to Viagra in cardiovascular disease are uncontrolled hypertension and impaired cardiac reserve 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The clinical safety of viagra.

Annals of the New York Academy of Sciences, 2002

Research

Viagra: what every physician should know.

Ear, nose, & throat journal, 1998

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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