Some erectile dysfunction (ED) treatments could be beneficial for a person recovering from a heart attack because they help lower blood pressure. However, people should wait 24–48 hours to take nitrates after using ED medication.

It is important to be aware that phosphodiesterase type 5 (PDE5) inhibitors, a common treatment for ED, interact with other medications, particularly nitrates. If people take both of these treatments within 24–48 hours of each other, they could create an unsafe drop in blood pressure.

In this article, we will focus on what ED treatments are safe for people who have either experienced a heart attack, undergone open heart surgery, or had a stent fitted.

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Image credit: Juanmonino / Getty Images.

People who have had a heart attack or have known risk factors can still take medication for ED.

In a 2017 study, researchers compared the risk of death and heart failure in more than 43,000 people who had had a heart attack. Over the study period, 7.1% of the participants developed ED. The researchers focused on two types of ED medication: PDE5 inhibitors and alprostadil.

They found that the participants who received treatment with PDE5 inhibitors had a decreased risk for death. However, the dose appeared to determine the effectiveness of the medication. Alprostadil treatment did not seem to affect death risk.

In a more recent study in sheep, researchers found that the PDE5 inhibitor tadalafil improved heart functions in the sheep following simulated heart failure. However, more human trials are necessary to support their findings.

An older study warns that a person taking nitrates for heart health should exercise caution when taking PDE5 inhibitors. The combination of these medications could cause an unsafe drop in blood pressure. Researchers recommend avoiding nitrates for 24–48 hours after taking ED medication.

Examples of ED medications that are PDE5 inhibitors include:

  • sildenafil (Viagra)
  • vardenafil (Levitra)
  • tadalafil (Cialis)

Learn more about PDE5 inhibitors here.

ED medication should not have a negative effect on the heart. Research has shown that ED medications, such as the PDE5 inhibitor Viagra, could help decrease the risk of future heart-related problems.

The side effects associated with PDE5 inhibitors are usually mild. They may include:

According to the American College of Cardiology, a person should be able to use Viagra or other PDE5 inhibitors when they have recovered from either a coronary artery bypass or angioplasty.

ED is a potential warning sign of or risk factor for heart disease. According to the American Heart Association (AHA), people with ED symptoms are more than twice as likely as people without a history of ED to have or die from a heart attack, cardiac arrest, or stroke.

This link may not be too surprising given that heart disease and ED share many risk factors.

These include:

A stent can actually be a treatment for ED. In a 2015 case study, researchers found that placing stents in the pudendal artery, which supplies the genitalia, helped with blood flow, venous leakage, and ED.

According to the AHA, traditional metal stents may cause a buildup of tissue that could block the arteries again. However, they state that stents coated with Viagra may help prevent the formation of blood clots and the narrowing of the arteries.

A person experiencing ED should get advice from a doctor on suitable treatment options based on their overall health and what medications they are currently taking.

If a person is already taking prescription medications for ED and experiences side effects, they should talk to their doctor, as there may be other options available.

Anyone who experiences an erection that lasts longer than 4 hours should go to an emergency room.

ED is a warning sign of heart disease, with which it shares some of the same risk factors, such as a poor diet and obesity. Approved ED medications that are PDE5 inhibitors are typically safe for people with heart disease.

People taking nitrates should wait at least 24–48 hours before taking ED medications. A person should talk to their doctor if they experience unpleasant symptoms and seek immediate medical attention if they have an erection lasting for more than 4 hours after sexual intercourse.