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We're learning more and more about the medicinal uses for cannabis every day, so it's only natural that we ask: can it help with ED? CBD can interact with many medications, including sildenafil (Viagra). Read on to learn if you can take CBD oil together with Viagra. There is no research that CBD, a natural substance from the cannabis plant, may help treat ED, but it may help address anxiety.

CBD For Erectile Dysfunction: Can It Help?

Erectile dysfunction, or ED, is one of the most common sexual dysfunctions for men, affecting around 30 million men in the United States alone.

If you’ve spent any time on natural health websites, you may have seen recommendations for cannabidiol, or CBD, as a treatment for erectile dysfunction.

While there’s currently no research showing that CBD is an effective treatment for erectile dysfunction, it might be helpful for treating anxiety that can contribute to ED and other sexual health issues.

Below, we’ve explained what erectile dysfunction is, as well as the key factors that may cause you to experience difficulties getting or keeping an erection.

We’ve also dug into the science behind CBD to find out how it may be helpful for treating some sexual performance issues.

Finally, we’ve listed the science-based treatment options that are available if you’re affected by ED.

CBD for Erectile Dysfunction: The Basics

Erectile dysfunction can be caused by a variety of factors, from physical health issues to factors like stress, anxiety or use of certain medications.

Most people with ED use medications like sildenafil (the active ingredient in Viagra®) to increase blood flow to the penis and treat erectile dysfunction.

Cannabidiol, or CBD, is widely available as an oil and in numerous other products. Many of these are promoted as natural treatments for various ailments and health conditions.

Currently, there’s no scientific research showing that CBD is an effective treatment for ED or a suitable replacement for medications like sildenafil.

However, some research suggests that CBD may be an effective treatment for anxiety, which is occasionally a causative factor in ED.

If you have ED, it’s best to talk to a licensed healthcare provider to find out about your ED treatment online options before relying on something like CBD.

What Is Erectile Dysfunction (ED)?

Erectile dysfunction is a common medical condition in which you may find it difficult to develop or maintain an erection. You may have ED if you:

Are able to get an erection, but find it difficult to do so consistently when you want to have sex

Are able to get an erection, but can’t maintain it long enough for enjoyable sex

Can’t get an erection at all

Erectile dysfunction can be caused by a variety of factors, ranging from physical health issues to psychological conditions, medications and even certain habits and lifestyle factors.

Common physical causes of ED include high blood pressure, atherosclerosis (clogged arteries), type 2 diabetes, heart disease, multiple sclerosis and physical health conditions that affect your penis, such as Peyronie’s disease.

Psychological causes of ED include anxiety, depression, low self-esteem and guilt or concerns about sexual behavior.

Medications that may cause ED include antidepressants, antiandrogens, tranquilizers and some medications used to treat high blood pressure.

Habits and lifestyle factors that may cause ED include smoking, drinking excessive amounts of alcohol, illicit drug use, lack of physical activity and being overweight or obese.

Although ED becomes more common with age, it can affect men of all ages. In fact, one study published in the Journal of Sexual Medicine found that approximately one out of every four men seeking help for ED is under the age of forty.

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What Is Cannabidiol (CBD)?

Cannabidiol, or CBD, is a chemical that’s extracted from the cannabis sativa plant. Unlike many other cannabinoids, CBD doesn’t have any psychoactive activity, meaning it won’t make you feel the typical high associated with cannabis.

CBD and other cannabinoids work by binding to the cannabinoid receptors located throughout your central nervous system and organs. Your cannabinoid receptors play a role in a variety of functions, from learning and cognition to cardiac function, energy metabolism and more.

Currently, CBD is being studied as a potential new medication for conditions such as epilepsy, anxiety, Parkinson’s disease, Crohn’s disease and others.

CBD is available in a wide range of products, from CBD oil to capsules, gummies, sleep aids and even personal care products. It’s also used as an additive in CBD-infused smoothies and health foods.

Does CBD Treat Erectile Dysfunction?

Search online for terms such as “CBD sex products” and you’ll come across hundreds of CBD products such as lubes, massage oils, capsules and “love potions” that claim to boost your sex drive, strengthen your erections and improve your sexual performance.

Despite the promises made about certain CBD products, right now, there’s no reliable scientific evidence showing that CBD treats erectile dysfunction or improves sexual performance.

There’s also no scientific evidence that CBD improves blood flow to your penis or has any effect on the muscles or nerves involved in erections.

In general, most research on cannabis and sexual health is mixed, with different studies finding positive and negative effects on sexual performance.

For example, a scientific review published in the Journal of Assisted Reproduction and Genetics found that use of cannabis and cannabinoids had a negative effect on sperm function and mixed effects on reproductive hormones in men.

On the other hand, a recent study published in Sexual Medicine found an association between frequency of cannabis use and increased sexual function in men. Interestingly, the men in this study showed improved erectile function with cannabis use.

The study authors do make the point that “the clinical significance of this is likely low, and selection bias may limit the generalizability of these findings.”

There’s also some evidence that cannabis use may increase activation in the areas of the brain responsible for arousal. For example, a 2017 study found that cannabis use increased activation of certain parts of the basal forebrain in people exposed to erotic photos.

It’s important to note that this research looked at the effects of cannabis as a whole, not specific cannabinoids such as CBD. As such, their findings may not apply to products that contain CBD or other isolated cannabinoids.

Overall, there just isn’t enough scientific research available to confidently say that CBD can treat erectile dysfunction or other sexual health issues.

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CBD and Sexual Performance Anxiety

One area where CBD may be useful is in treating and managing anxiety, including anxiety about sexual performance.

Sexual performance anxiety is a feeling of nervousness and anxiety that can happen before and during sex. As we’ve covered in our guide to sexual performance anxiety and ED, anxiety that’s related to sex may contribute to sexual performance issues, including erectile dysfunction.

While there’s no research on CBD and sexual performance anxiety specifically, some studies of CBD have found that it may have benefits for treating anxiety.

For example, a 2020 review published by the Journal of the American Pharmacists Association found that CBD showed promising results as an alternative treatment for anxiety disorders such as generalized anxiety disorder and social anxiety disorder.

However, as the Anxiety and Depression Association of America has pointed out, there currently isn’t enough evidence to state that CBD is an effective treatment for anxiety.

CBD Safety and Side Effects

CBD products appear to be safe for most adults. However, there are side effects associated with cannabidiol and other cannabis products that you should be aware of if you’re thinking of using CBD, whether for its possible effects on sexual performance or other effects.

When taken by mouth, reported side effects of CBD include drowsiness, dry mouth, nausea, lightheadedness and a reduction in blood pressure levels.

Currently, there’s limited information available on the potential side effects of topical products containing CBD. There’s also little research on the safety and potential side effects of CBD products for people under the age of twenty-one.

In addition to possible safety issues with CBD itself, it’s important to be aware that most CBD products aren’t subject to the same regulations as FDA-approved medications, or even many dietary supplements.

How to Treat Erectile Dysfunction

Although CBD isn’t proven to treat erectile dysfunction, several safe, science-based treatments are available that can improve your erectile health and sexual performance.

Currently, the most effective treatments for ED are medications called PDE5 inhibitors. These work by increasing blood flow to the erectile tissue of your penis, allowing you to easily get an erection when you’re sexually aroused.

Popular PDE5 inhibitors used to treat erectile dysfunction include:

Sildenafil. The active ingredient in Viagra, AKA generic Viagra, sildenafil is a popular ED medication that’s designed to provide relief from erectile dysfunction for approximately four hours.

Tadalafil. The active ingredient in Cialis®, tadalafil is a long-lasting ED medication that remains effective for up to 36 hours.

Vardenafil. The active ingredient in Levitra®, vardenafil provides relief from ED for four to eight hours per dose.

Avanafil. Available as Stendra®, avanafil is a newer ED medication that works quickly and is less likely to cause certain side effects than older PDE5 inhibitors.

All ED medications require a prescription. We offer a range of FDA-approved ED medications online, following a consultation with a physician who will determine if a prescription is appropriate.

Our guide to PDE5 inhibitors goes into more detail on these medications and how they work to treat ED.

In addition to ED medications, making changes to your habits and lifestyle can help to improve your erectile health and sexual performance. Try to:

Maintain a healthy weight. Research shows that obesity is a significant risk factor for erectile dysfunction in men. In fact, even being mildly overweight can have a negative impact on your erectile health. Try to maintain a healthy body weight to keep health issues like ED at bay. Although body mass index (BMI) is far from perfect at assessing your health, aiming for a BMI in the 18.5 to 24.9 range is a good general target. The Centers for Disease Control and Prevention (CDC) website has a handy calculator that you can use to determine what your BMI is.

Exercise on a regular basis. Reliable erections are all about blood flow. Research into the effects of exercise and ED has found that regular exercise is linked to improvements in erectile function. In addition to improving your erectile health, regular exercise can help to lower your risk of heart disease, strokes and other health risks. Aim for at least 15 minutes of exercise per day to keep your heart healthy and your sexual performance optimal.

Quit smoking. Smoking can significantly increase your risk of developing ED by causing damage to your blood vessels and vascular system. If you smoke, try to quit. Our guide to quitting lists science-based techniques that you can use to give up smoking for good.

Treat any underlying health issues. Finally, it’s important to treat any underlying health problems that may contribute to ED, particularly issues like high blood pressure or heart disease. Not only do these affect your erectile health — they can also have a major negative effect on your general health and wellbeing over the long term if left untreated.

You can learn more about treating ED through healthy habits and lifestyle changes in our guide to naturally protecting your erection.

In Conclusion

While CBD may offer benefits for sleep, anxiety and other health issues, there isn’t any scientific evidence to show that it’s effective at treating ED or improving your sexual performance.

If you’re affected by ED, the most effective treatment options are PDE5 inhibitors like sildenafil, tadalafil and others. These work by improving blood flow to your penis, making it easier for you to get and keep an erection when you’re aroused.

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Learn More About Treating ED

Erectile dysfunction is very common and usually treatable. Our full guide to ED covers everything from the causes of erectile dysfunction to treatments and prevention strategies that you can use to improve your erections and optimize your sexual health.

16 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Definition & Facts for Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
  2. Symptoms & Causes of Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  3. Capogrosso, P., et al. (2013, July 1). One Patient Out of Four with Newly Diagnosed Erectile Dysfunction Is a Young Man—Worrisome Picture from the Everyday Clinical Practice. Journal of Sexual Medicine. 10 (7), 1833-1841. Retrieved from https://www.jsm.jsexmed.org/article/S1743-6095(15)30428-8/fulltext
  4. Cannabidiol (CBD). (2020, August 31). Retrieved from https://medlineplus.gov/druginfo/natural/1439.html
  5. Meissner, H. & Cascella, M. (2020, July 4). Cannabidiol (CBD). StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK556048/
  6. Zou, S. & Kumar, U. (2018, March). Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International Journal of Molecular Sciences. 19 (3), 833. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5877694/
  7. Du Plessis, S.S., Agarwal, A. & Syriac, A. (2015, November). Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility. Journal of Assisted Reproduction and Genetics. 32 (11), 1575–1588. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651943/
  8. Bhambhvani, H.P., Kasman, A.M., Wilson-King, G. & Eisenberg, M.L. (2020, September). A Survey Exploring the Relationship Between Cannabis Use Characteristics and Sexual Function in Men. Sexual Medicine. 8 (3), 436–445. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7471121/
  9. Androvicova, R., et al. (2017, July). Individual prolactin reactivity modulates response of nucleus accumbens to erotic stimuli during acute cannabis intoxication: an fMRI pilot study. Psychopharmacology. 234 (13), 1933-1943. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28401285/
  10. Skelley, J.W., Deas, C.M., Curren, Z. & Ennis, J. (2020, January-February). Use of cannabidiol in anxiety and anxiety-related disorders. Journal of the American Pharmacists Association. 60 (1), 253-261. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31866386/
  11. Can CBD Help with My Anxiety and Depression? (2019, June). Retrieved from https://adaa.org/understanding-anxiety/cbd
  12. Skrypnik, D., Bogdański, P. & Musialik, K. (2014, February). Obesity–significant risk factor for erectile dysfunction in men. Polski Merkuriusz Lekarski. 36 (212), 137-41. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24720114/
  13. Assessing Your Weight. (2020, September 17). Retrieved from https://www.cdc.gov/healthyweight/assessing/index.html
  14. Lamina, S., Agbanusi, E.C. & Nwacha, R.C. (2011, November). Effects of Aerobic Exercise in the Management of Erectile Dysfunction: A Meta Analysis Study on Randomized Controlled Trials. Ethiopian Journal of Health Science. 21 (3), 195–201. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275865/
  15. How much exercise is optimal for heart health? (2016, February). Retrieved from https://www.health.harvard.edu/heart-health/how-much-exercise-is-optimal-for-heart-health
  16. Kovac, J.R., Labbate, C., Ramasamy, R., Tang, D. & Lipshultz, L.I. (2015, December). Effects of cigarette smoking on erectile dysfunction. Andrologia. 47 (10), 1087–1092. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

CBD and Viagra (Sildenafil) Interactions: Do They Mix?

CBD (or cannabidiol) is primarily used for anxiety, depression, chronic pain, and sleep — but it also offers a wide range of other therapeutic effects.

Some people report increased effectiveness of sildenafil (Viagra) after taking CBD oil — helping improve erection and reduce worries linked to performance anxiety.

But can you safely take CBD oil with Viagra?

That’s the question we’ll answer in this article.

Does CBD Interact with Sildenafil?

Yes, and you should exercise caution when taking CBD oil with sildenafil (Viagra).

The main danger of combining CBD with Viagra is associated with an increased risk of side effects. Although uncommon, Viagra can trigger indigestion, dizziness, headaches, and priapism — a condition involving painful and long-lasting erections.

CBD may also extend the effects of Viagra by slowing down its metabolism.

Types of Interactions Between CBD and Viagra (Sildenafil)

CBD’s ability to inhibit the activity of liver enzymes creates a risk of negative interactions because it alters drug metabolism.

You can experience two types of interactions between CBD and Viagra depending on the dosage.

A) Agonistic Interaction (Increased Effect)

An agonistic interaction occurs when two compounds have the same effects on the body. When it comes to taking CBD and sildenafil together, they share the ability to relax blood vessels. Combined doses of both substances may lead to excessive relaxation, including headaches, dizziness, fatigue, and the aforementioned priapism.

B) Slowed Elimination (Metabolic Inhibition)

Drugs are metabolized in the body through special enzymes known as the Cytochrome P450 (CYP450) family.

Metabolic inhibition is triggered when two drugs target the same enzymes — leading to competitive interactions. In other words, taking CBD with Viagra could result in slowing down the metabolism of one of the drugs.

Sildenafil uses CYP450 enzymes, specifically CYP3A4 (major route) and CYP2C9 (minor route). CBD is a potent inhibitor of these enzymes.

If you take CBD with sildenafil, the plasma levels of the drug can increase in the body. When you use viagra on a daily basis, the continuous buildups of the substance could become dangerous.

You can avoid it by spacing out the time between your doses so that your body can flush them.

Other Names for Viagra (Sildenafil)

Sildenafil is an umbrella term for a pharmaceutical compound that is used to treat erectile dysfunction.

It has many different brand names, such as:

  • Alsigra
  • Aryagra
  • Caverta
  • Edegra
  • Giagra
  • Medigra
  • Penegra
  • Revatio
  • Silagra
  • Vega
  • Vizarsin
  • Xcite
  • Zenegra

Does CBD Oil Interact with Other Erectile Dysfunction Medications?

In general, always look out for unintended interactions between CBD and other medications. Since CBD and erectile dysfunction medications (PDE5 inhibitors) are metabolized by the same enzymes, they share a similar risk for interaction.

The following medications can negatively interact with CBD:

  • Avanafil (Stendra)
  • Mirodenafil (Mvix)
  • Tadalafil (Cialis)
  • Udenafil (Zydena)
  • Vardenafil (Levitra, Staxyn, and Vivanza)

Is It Safe to Take CBD Oil Together With Viagra?

There are no clinical reports of dangerous side effects caused by interactions between CBD oil and Viagra.

However, it’s wise to maintain caution with one side effect (priapism). Since both substances can relax blood vessels, you’re theoretically at a higher risk of developing this condition.

If you notice any distressing reactions after taking CBD oil with sildenafil, discontinue the use and contact your doctor immediately.

Is CBD a Good Alternative to Viagra (Sildenafil?)

CBD isn’t considered a viable alternative to Viagra because it’s not an acknowledged ED treatment.

CBD and other cannabinoids have demonstrated benefits for ED in some individuals, but this effect is more related to CBD’s impact on anxiety disorders, such as performance anxiety.

VIagra, on the other hand, directly relaxes blood vessels, pumping more blood to the penis. This effect hasn’t been observed in studies investigating the effects of CBD.

If you experience mild ED caused by anxiety, CBD could be a safer alternative to viagra. However, ED triggered by mechanical injuries is unlikely to benefit from CBD.

What is Viagra?

Viagra is one of the brand names for sildenafil — a phosphodiesterase type 5 (PDE5) inhibitor. Doctors prescribe it to treat erectile dysfunction and pulmonary hypertension.

It’s an FDA-approved treatment for ED and is available only for a prescription in most countries.

Viagra (Sildenafil) Details:

Pharmaceutical Name Sildenafil
Brand Names Viagra, Silagra, Alsigra, Aryagra, Edegra, Revatio, Penegra, Xcite, Vega, Giagra, Vizarsin, Zenegra, Caverta
Class of Drug Phosphodiesterase 5 Inhibitor
Metabolic Enzymes Cyp 450 enzymes (CYP3A4 and CYP2C9)
Interaction with CBD Agonistic, metabolic inhibitor
Strength of Interaction Low

How Does Viagra Work for Erectile Dysfunction (ED)?

Sildenafil (Viagra) is the inhibitor of phosphodiesterase 5 (PDE5). Its main mechanism causes an increase in the blood flow to a flaccid penis. This feature enables erection.

PDE5 is an enzyme commonly found in vascular smooth muscles, visceral smooth muscles, platelets, and cavernosa.

Was Viagra Always Used to Treat ED?

Viagra was originally meant to serve a different purpose. It was invented as a potential blood pressure medication. Its side effect, however, made it a preferred drug for ED.

The Mechanism Behind Erection

When you have sex with your partner, an adequate amount of foreplay should lead to a release of nitric oxide (NO) from the nerves and endothelial cells. This event triggers the release of cyclic guanosine monophosphate (cGMP).

The cGMP’s release relaxes the muscles of corpora cavernosa in the penis, dilating the blood vessels. As the blood flows rapidly into those vessels, the penis becomes enlarged and gets erect. This state lasts until the end of the sexual intercourse or after ejaculation.

What Happens When You Take Viagra

The enzyme PDE5 blocks the additional blood flow to the vessels in the penis. It does so by causing the cGMP levels to degrade. In the majority of ED patients, the dysfunction also affects the blood vessels in the penis.

Since Viagra inhibits PDE5 and increases the level of cGMP, it lets more blood flow into the penis, allowing for a successful erection.

With a positive mindset and sufficient sexual stimulation, this drug may be even more effective.

Viagra isn’t recommended for use alongside alcohol. Patients with severe heart disease, priapism, several renal and liver disease, blood disorders, retinitis pigmentosa, and hypersensitivity to sildenafil should steer away from viagra, too.

Although Viagra doesn’t cause dependence and addiction, it can interact with several medications, including antacids, guanylate cyclase stimulators, CYP3A4 inducers, and CYP3A4 inhibitors.

Side Effects of Viagra

  • Abdominal pain
  • Abnormal vision
  • Back pain
  • Diarrhea
  • Dyspepsia
  • Hot flushes
  • Headaches
  • Loss of vision
  • Nausea
  • Skin Rash
  • Muscle pain
  • Bluish tinted vision
  • TIngling sensation in the limbs

What is CBD Oil?

CBD oil is an oily extract derived from cannabis. It can be extracted from hemp and marijuana, but most CBD oils on the market come from hemp. That’s because hemp is legal in all 50 states.

CBD doesn’t get you high, but it comes with a myriad of health benefits. This feature makes CBD an appealing alternative to marijuana. Since THC can make users anxious in higher doses, some of them are afraid of starting the treatment. CBD comes in handy here.

Since CBD is fat-soluble, manufacturers suspend it in a carrier oil. Usually, it’s MCT oil because it contains the highest percentage of saturated fatty acids.

People commonly use CBD oil for pain relief or to reduce anxiety, depression, and sleep problems. However, CBD also has the potential to manage the symptoms of autoimmune diseases and neurological conditions.

In a 2009 article published in the journal Annals of the New York Academy of Sciences, the authors concluded that the endocannabinoid receptors occur in the sexual reproductive organs, such as testicles. They also found them in the brain.

Other studies found that cannabinoids such as CBD and THC may increase libido and improve sex life in general, while others warn that regular cannabis use may lower sex drive in males. However, these studies also involved high-THC cannabis (marijuana).

One of the best-researched areas of the therapeutic use of CBD is anxiety. CBD may improve libido by reducing anxiety disorders, such as performance anxiety — increasing one’s desire for sex.

Final Verdict: Can You Take CBD Oil with Viagra?

CBD can inhibit the metabolism of Viagra in the body — potentially increasing the duration and concentration of the drug in the body.

In addition, CBD may strengthen some of the effects of Viagra, increasing the risk of lightheadedness and painful erection.

Always talk to your doctor before taking CBD oil with Viagra. Doing so will help you find the right dosage and timing for both products and avoid potential interactions.

Sources:

  1. Carvalho, R. K., Andersen, M. L., & Mazaro‐Costa, R. (2020). The effects of cannabidiol on male reproductive system: A literature review. Journal of Applied Toxicology, 40(1), 132-150.
  2. Pizzol, D., Demurtas, J., Stubbs, B., Soysal, P., Mason, C., Isik, A. T., … & Veronese, N. (2019). Relationship between cannabis use and erectile dysfunction: a systematic review and meta-analysis. American journal of men’s health, 13(6), 1557988319892464.
  3. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12(4), 825-836
Livvy Ashton

Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.

How to use CBD oil for erectile dysfunction

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Erectile dysfunction or ED is a hot topic, and many people are confused about what the issue entails and which remedies—if any—actually work. One popular, albeit controversial, treatment strategy involves using cannabidiol, aka CBD, a molecule found in hemp and marijuana that doesn’t make you feel high but may offer other benefits.

Read on to learn whether CBD oil for erectile dysfunction or sexual performance anxiety works and how to use it.

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How does CBD for erectile dysfunction work?

Unlike THC, CBD doesn’t appear to alter consciousness or cause a person to feel “high.” Currently, it is only FDA-approved to help treat seizure disorders. However, there is ongoing research into the potential benefits of CBD for anxiety, chronic pain, and other health conditions. CBD may also have anti-inflammatory and anti-cancer properties, but these are still being studied (Meissner, 2022).

Scientists don’t fully understand how CBD works, but they suspect it affects certain brain chemicals. Cannabinoids like CBD work by interacting with the body’s endocannabinoid system (ECS). This system involves the whole body and may play a role in pain, memory, movement, appetite, metabolism, and immune system function (Sheikh, 2022).

Here are four ways CBD oil may help with erectile dysfunction:

1. Could lower general anxiety and stress

Some research suggests that CBD may benefit people with anxiety disorders and brain diseases like Alzheimer’s and Parkinson’s (Meissner, 2022). Anxiety can sometimes affect sexual performance and sex drive, so if CBD is beneficial for anxiety disorders, it may help with ED too.

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Researchers have found that CBD works on serotonin receptors in the brain. Serotonin can affect a person’s anxiety and fear levels, which is why CBD could lower general stress and anxiety levels (Blessing, 2015).

2. May decrease performance anxiety

Sexual performance anxiety can be caused by relationship problems, a negative body image, fear of disappointing your partner, or pressure to have an orgasm. Since CBD may help lower anxiety levels, it could, in turn, decrease performance anxiety (Blessing, 2015).

According to a variety of studies and preclinical evidence, CBD shows promise to help people with:

If a person’s performance anxiety stems from any of those issues, the studies suggest CBD could help (Blessing, 2015).

What is an erection, and how does it work?

3. Could lower blood pressure

CBD has the potential to lower blood pressure in people with increased heart rates, according to one study from 2017 (Jadoon, 2017).

When blood pressure is lower, it can improve circulation, which may allow more blood to flow to the penis.

4. May improve sleep

Lack of sleep can wreak havoc on the body. If you’re not getting enough rest, it could contribute to erectile dysfunction (Cho, 2018).

Anxiety and stress can often cause sleep disturbances, which is why CBD could help you get a good night’s rest. Some studies suggest that CBD may have therapeutic potential for insomnia (Babson, 2017). In a different study of 72 adults with either anxiety, poor sleep, or both, sleep scores improved with CBD use for 66.7% of the participants (Shannon, 2019).

If a lack of sleep is causing your ED, using CBD for sleep could be helpful.

Can CBD help with ED?

While there’s not a ton of research on the topic of CBD as a treatment for ED, one study found that there are ECS receptors involved in male fertility. And while some studies suggest that cannabis may be indirectly associated with erectile dysfunction and may cause ED in young habitual cannabis users, more research on CBD is needed (du Plessis, 2015).

Some research has shown that CBD may help reduce anxiety for some people (Shannon, 2019). Because anxiety may play a significant role in erectile dysfunction or even cause erectile dysfunction, CBD oil for erectile dysfunction may be a helpful tool. However, more research is needed in this area.

CBD for anxiety: dosage, benefits and side effects

How to use CBD oil for ED

How to use CBD oil will depend on the form you have. You can swallow liquid oils or put them under your tongue and let them absorb that way. You can swallow pills or capsules the same way you would other medications. You may need a special vaporizer or inhaler to use the vaporized forms.

CBD oil comes in many forms, including (Bruni, 2018):

  • Liquid oils
  • Pills or capsules
  • Liquid oils that you swallow or edibles
  • Chewing gum
  • CBD inhaler
  • Creams

You can use CBD for ED by incorporating one or more of these CBD products into your daily routine. Keep in mind that CBD isn’t a magic fix for ED. You’ll want to experiment with different products to see what works best for you. Eating a gummy or taking a CBD capsule may produce quicker results. However, it varies from person to person and depends on the CBD dosage, type, and other factors.

Dosage

The FDA doesn’t approve most CBD products, so accurate dosage guidelines are hard to come by.

The drug, Epidiolex, is a CBD-based treatment used for seizures associated with Lennox-Gastaut syndrome. It’s recommended that people start at a dose of 5 milligrams per kilogram of body weight per day (mg/kg/day). After one week, users can increase their dose to 20 mg/kg/day, depending on their reaction to the drug (DailyMed, 2022).

If you don’t know how much CBD to take, start with a low dose, and work your way up from there over time.

Potential risks or considerations of taking CBD

If you’re considering taking CBD in an attempt to treat erectile dysfunction or any other medical condition or health issue, it’s important to understand the potential risks involved. The US Food and Drug Administration (FDA) has approved one cannabis-derived and three cannabis-related drug products, all of which require a prescription (FDA-a, 2020):

  • Epidiolex for the treatment of seizures associated with Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex (DailyMed, 2022)
  • Syndros and Marinol for the treatment of anorexia associated with weight loss in people with AIDS and nausea/vomiting in people receiving cancer chemotherapy (FDA, 2017; DailyMed-a, 2021)
  • Cesamet for the treatment of nausea/vomiting in people receiving cancer chemotherapy (DailyMed-b, 2021)

Because the FDA doesn’t generally regulate CBD products, it can be difficult to determine the quality of the products you’re getting. It can also be difficult to know what form of CBD (i.e., CBD oil, gummies, CBD capsules, etc.) may work best for you.

Using any drug without this knowledge can cause a host of unwanted side effects that are difficult to predict without guidance or regulation.

Is erectile dysfunction reversible? In most cases, it’s treatable

Potential CBD side effects

CBD side effects may vary from person to person. A few possible side effects include (FDA-b, 2020):

Other benefits of CBD

CBD has plenty of potential benefits, and they’re not all specifically for ED. Some of these benefits include:

  • Pain relief
  • Mental health and wellness assistance
  • Performance anxiety
  • Improved sleep
  • Anti-inflammatory properties
  • Antioxidant properties
  • Anti-nausea

While there are no studies explicitly demonstrating the benefits of CBD on ED, there are studies that indicate CBD may be helpful in the treatment of other conditions. Evidence suggests CBD could be a beneficial treatment for multiple anxiety disorders, but additional research is needed (Shannon, 2019).

Researchers also believe CBD may help slow down messages sent to the brain, change calcium levels in brain cells, and decrease brain inflammation, all of which may help prevent seizures (Maroon, 2018).

Animal studies indicate other potential benefits of CBD, such as its anti-inflammatory potential to treat arthritis pain. But more research is necessary to understand how these benefits could translate to humans (Hammell, 2016).

6 best CBD gummies for anxiety

What causes erectile dysfunction?

Erectile dysfunction can have many causes. Some of these include (NIH, 2017):

Other treatment options for ED

CBD may not be an approved treatment for ED, but there are several other treatment options available.

Medication

After lifestyle modifications, the first line of treatment for ED is usually oral medications taken before sexual intercourse. These drugs are known as PDE-5 inhibitors, and the most common one is sildenafil (brand name Viagra; see Important Safety Information). Other PDE-5 inhibitors include (Krzastek, 2019):

  • Tadalafil (brand name Cialis; see Important Safety Information)
  • Vardenafil (brand name Levitra)
  • Avanafil (brand name Stendra)

Lifestyle changes

Certain lifestyle changes and improvements can also have a positive effect on ED. The following lifestyle habits have all been shown to contribute to ED (NIH, 2017):

  • Lack of physical activity
  • An unhealthy, unbalanced diet
  • Cigarette smoking

Taking actions to modify these behaviors and health conditions may have a major impact.

What is horny goat weed? Does it work?

Managing underlying health conditions

Certain health conditions could cause ED. Some of these include (Krzastek, 2019):

Natural supplements

There are also some natural supplements, herbs, and vitamins that may or may not benefit ED. Some of these include:

  • Horny goat weed: A traditional Chinese medicinal herb often used to treat fatigue and low sex drive. Animal and lab studies have shown that horny goat weed contains a substance called icariin, a mild PDE-5 inhibitor, but it’s unclear if these benefits translate to humans (Anand Ganapathy, 2021).
  • Yohimbine: Some research suggests that Yohimbine, the active ingredient in yohimbe bark, may work better than a placebo to treat ED (NIH, 2020).
  • Vitamin D:Vitamin D deficiency may contribute to problems with erections.
  • Vitamin B3: Some research has shown vitamin B3 supplementation may help increase penile blood flow (Crafa, 2020).

In general, research on vitamins and natural supplements is limited, so it’s best to work with your healthcare professional to treat ED.

What is CBD?

CBD, or cannabidiol, is a natural substance called a cannabinoid. It comes from the cannabis plant, which is part of the Cannabaceae family. CBD is one of two main cannabinoids; the other one is delta-9-tetrahydrocannabinol (THC).

Cannabis plants with higher levels of THC are classified as marijuana and are controlled substances (FDA-b, 2020). Cannabis plants with very low THC are classified as hemp. CBD can be found in both marijuana and hemp.

Marijuana and depression: does weed make you depressed?

What is erectile dysfunction?

ED is when a person cannot get or sustain an erection long enough to have sex.

Can you naturally cure erectile dysfunction?

There are natural remedies for ED such as CBD, horny goat weed, vitamin D, and vitamin B3. However, there is not enough evidence to say that these natural methods will cure ED.

How do you use CBD for sex?

You can take CBD in a variety of forms, such as tinctures, gummies, and liquids. Taking CBD before sex could help reduce anxiety, which may be causing your ED. CBD could also help increase blood flow to the penis by potentially lowering blood pressure.

Does CBD help with arousal?

CBD could help with arousal by lowering anxiety and stress levels, which can help you relax.

References

  1. Anand Ganapathy, A., Hari Priya, V. M., & Kumaran, A. (2021). Medicinal plants as a potential source of phosphodiesterase-5 inhibitors: a review. Journal of Ethnopharmacology, 267, 113536. doi:10.1016/j.jep.2020.113536. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33137431/
  2. Babson, K. A., Sottile J., & Morabito, D. (2017). Cannabis, cannabinoids, and sleep: a teview of the literature. Current Psychiatry Reports (4), 23. doi:10.1007/s11920-017-0775-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28349316/
  3. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12(14), 825-836. doi: 10.1007/s13311-015-0387-1. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
  4. Bruni, N., Della Pepa, C., Oliaro-Bosso, S., et al. (2018). Cannabinoid delivery systems for pain and inflammation treatment. Molecules(Basel, Switzerland), 23(10), 2478. doi:10.3390/molecules23102478. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30262735/
  5. Cho J. W. & Duffy, J. F. (2018). Sleep, sleep disorders, and sexual dysfunction. World Journal of Men’s Health. 37(3), 261-275. doi:10.5534/wjmh.180045. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30209897/
  6. Crafa, A., Cannarella, R., Condorelli, R. A., et al. (2020). Is there an association between vitamin d deficiency and erectile dysfunction? A systematic review and meta-analysis. Nutrients, 12(5), 1411. doi:10.3390/nu12051411. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32422943/
  7. DailyMed-b. (2021). Cesamet- nabilone capsule. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=83c7ac15-ece9-47de-b83c-d575544fa449
  8. DailyMed. (2022). Epidiolex- cannabidiol solution. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec
  9. DailyMed-a. (2021). Syndros- dronabinol solution. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a7801c70-995d-46a2-91ee-141ef427c6b5
  10. du Plessis, S. S., Agarwal, A., & Syriac, A. (2015). Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility. Journal of Assisted Reproduction and Genetics, 32(11), 1575–1588. doi:10.1007/s10815-015-0553-8. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26277482/
  11. Hammell, D. C., Zhang, L. P., Ma, F., et al. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European Journal of Pain(London, England), 20(6), 936–948. doi:10.1002/ejp.818. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26517407/
  12. He, C., Wang, Z., & Shi, J. (2020). Pharmacological effects of icariin. Advances in Pharmacology(San Diego, Calif.), 87, 179–203. doi:10.1016/bs.apha.2019.10.004. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32089233/
  13. Jadoon, K. A., Tan, G. D., & O’Sullivan, S. E. (2017). A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI Insight; 2(12), e93760. doi:0.1172/jci.insight.93760. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470879/
  14. Krzastek, S. C., Bopp, J., Smith, R. P., & Kovac, J. R. (2019). Recent advances in the understanding and management of erectile dysfunction. F1000Research, 8, F1000 Faculty Rev-102. doi:10.12688/f1000research.16576.1. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30740217/
  15. Maroon, J. & Bost, J. (2018). Review of the neurological benefits of phytocannabinoids. Surgical Neurology International, 9, 91. doi:10.4103/sni.sni_45_18. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29770251/
  16. Meissner, H. & Cascella, M. (2022). Cannabidiol (CBD). StatPearls. Retrieved on Aug. 12, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK556048/
  17. National Institute of Diabetes and Digestive and Kidney Diseases (NIH). (2017). Symptoms & Causes of Erectile Dysfunction. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  18. National Institute of Diabetes and Digestive and Kidney Diseases (NIH). (2020). Yohimbine. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK548703/
  19. Ng, C. F., Lee, C. P., Ho, A. L., & Lee, V. W. (2011). Effect of niacin on erectile function in men suffering erectile dysfunction and dyslipidemia. The Journal of Sexual Medicine, 8(10), 2883–2893. doi:10.1111/j.1743-6109.2011.02414.x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21810191/
  20. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: A large case series. The Permanente Journal, 23, 18–041. doi: 10.7812/TPP/18-041. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30624194/
  21. Sheikh, N. K. & Dua, A. (2022). Cannabinoids. StatPearls. Retrieved on Aug. 12, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK556062/
  22. Sooriyamoorthy, T. & Leslie, S. W. (2021). Erectile dysfunction. StatPearls. Retrieved on Aug. 12, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK562253/
  23. U.S. Food and Drug Administration (FDA-a). (2020). FDA and cannabis: research and drug approval process. Retrieved on Aug 12, 2022 from https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process
  24. U.S. Food and Drug Administration (FDA). (2017). Marinol: highlights of prescribing information. Retrieved on Aug 12, 2022 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf
  25. U.S. Food and Drug Administration (FDA-b). (2020). What you need to know (and what we’re working to find out) about products containing cannabis or cannabis-derived compounds, Including CBD. Retrieved on Aug 12, 2022 from https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis

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Important Safety Information for Sildenafil (Viagra)

What are the most important things I need to know about VIAGRA® (sildenafil citrate) 25 mg, 50 mg, and 100 mg tablets and generic VIAGRA®?

Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate emergency medical attention.

  • VIAGRA® and generic VIAGRA® can cause serious side effects. Serious, but rare, side effects include:
    • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, seek emergency medical attention right away. If it is not treated right away, priapism can permanently damage your penis.
    • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you have any sudden vision loss
    • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away

    Who should not take VIAGRA® or generic VIAGRA®?

    Do not take VIAGRA® or generic VIAGRA® if you:

    • Take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
    • Are allergic to sildenafil, as contained in VIAGRA® and REVATIO®, or any of the ingredients in VIAGRA® or generic VIAGRA® tablets.
    • Are a women or a child

    When should I call my primary provider?

    Call your primary provider right away if you:

    • Have an erection that lasts longer than 4 hours
    • Experience a sudden loss of vision in one or both eyes
    • Experience a sudden decrease in or loss of hearing
    • Experience chest pain, dizziness, or nausea during sex
    • Take too much Viagra or sildenafil citrate

    If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

    What are the most common side effects of VIAGRA® and generic VIAGRA®?

    The most common side effects are:

    • headache
    • flushing
    • upset stomach
    • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
    • stuffy or runny nose
    • back pain
    • muscle pain
    • nausea
    • dizziness
    • rash

    What should I tell my Roman-affiliated provider before taking VIAGRA® and generic VIAGRA®?

    Before you take VIAGRA® or generic VIAGRA® , tell your healthcare provider if you:

    • Have or have had heart problems such as a heart attack,irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
    • Have had heart surgery within the last 6 months
    • Have pulmonary hypertension
    • Have had a stroke
    • Have low blood pressure, or high blood pressure that is not controlled
    • Have a deformed penis shape
    • Have had an erection that lasted for more than 4 hours
    • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
    • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
    • Have ever had severe vision loss, including an eye problem called NAION
    • Have bleeding problems
    • Have or have had stomach or intestinal ulcers
    • Have liver problems
    • Have kidney problems or are having kidney dialysis
    • Have any other medical conditions

    Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

    VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works, causing side effects.

    Especially tell your healthcare provider if you take any of the following:

    • Medicines called nitrates
    • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
    • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
    • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
    • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
    • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
    • Other medicines that treat high blood pressure
    • Other medicines or treatments for ED
    • VIAGRA® contains sildenafil, which is the same medicine found in another drug called REVATIO®. REVATIO® is used to treat a rare disease called pulmonary arterial hypertension (PAH). VIAGRA® should not be used with REVATIO® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

    Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

    What is the FDA-approved use of VIAGRA® and generic VIAGRA®?

    VIAGRA® (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED).

    Roman-affiliated doctors may prescribe VIAGRA® or generic VIAGRA® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment. While this is not an FDA-approved use of the drug, the American Urological Association has included the use of sildenafil citrate in the treatment of PE in its Guideline on the Pharmacologic Management of Premature Ejaculation.

    You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

    Please see the full Prescribing Information for complete safety information.

    Product names referenced herein are trademarks of their respective owners.

    Important Safety Information for Tadalafil (Cialis)

    What Is The Most Important Information I Should Know About CIALIS® (tadalafil) and generic CIALIS®?

    • CIALIS® and generic CIALIS® can cause serious side effects. Serious, but rare, side effects include:
      • An erection that won’t go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.
      • Changes in vision. Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green.
      • Sudden decrease or loss of vision. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS® and generic CIALIS®) reported a sudden decrease or loss of vision in one or both eyes. It is uncertain whether PDE5 inhibitors directly cause the vision loss. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS® and generic CIALIS®, and call a healthcare provider right away.
      • Sudden loss or decrease in hearing. Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS® and generic CIALIS®. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking CIALIS® and generic CIALIS® and contact a healthcare provider right away.
      • ED is a condition where the penis does not fill with enough blood to harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his healthcare provider for help if the condition bothers him.
      • CIALIS® and generic CIALIS® help increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away. Some form of sexual stimulation is needed for an erection to happen with CIALIS® or generic CIALIS®.
      • CIALIS® and generic CIALIS® do not:
        • Cure ED
        • Increase a man’s sexual desire
        • Protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your healthcare provider about ways to guard against sexually transmitted diseases.
        • Serve as a male form of birth control
        • Take CIALIS® or generic CIALIS® exactly as your healthcare provider prescribes it. Your healthcare provider will prescribe the dose that is right for you. Do not change your dose or the way you take CIALIS® or generic CIALIS® without talking to your healthcare provider.

        Who Should Not Take CIALIS® or generic CIALIS®?

        Do not take CIALIS® or generic CIALIS® if you:

        • Have severe liver disease. Tell your doctor if you have mild to moderate liver disease as you may need dosage reductions.
        • Have severe kidney disease. Tell your doctor if you have mild to moderate kidney disease as you may need dosage reductions
        • Take any medicines called “nitrates”
        • Use recreational drugs called “poppers” like amyl nitrite and butyl nitrite
        • Take any medicines called guanylate cyclase stimulators, such as riociguat
        • Are allergic to CIALIS®, tadalafil or ADCIRCA®, or any of its ingredients

        When should I call my primary provider?

        Call your primary provider right away if you:

        • Have an erection that lasts longer than 4 hours
        • Experience a sudden loss of vision in one or both of your eyes
        • Experience a sudden decrease or loss hearing
        • Take too much CIALIS® or generic CIALIS®
        • Have an allergic reaction to CIALIS® or generic CIALIS®
        • Symptoms of an allergic reaction may include:
        • Rash
        • Hives
        • Swelling of the lips, tongue, or throat
        • Difficulty breathing or swallowing

        Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.

        If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

        What Should I Tell My Roman-affiliated Provider Before Taking CIALIS® and generic CIALIS®?

        Tell your Roman-affiliated provider about all your medical problems, including if you:

        • Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS® and generic CIALIS® if your healthcare provider has told you not to have sexual activity because of your health problems.
        • Have pulmonary hypertension
        • Have low blood pressure or have high blood pressure that is not controlled
        • Have had a stroke
        • Have liver problems
        • Have kidney problems or require dialysis
        • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
        • Have ever had severe vision loss, including a condition called NAION
        • Have stomach or intestinal ulcers
        • Have a bleeding problem
        • Have a deformed penis shape or Peyronie’s disease
        • Have had an erection that lasted more than 4 hours
        • Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

        Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

        Especially tell your healthcare provider if you take any of the following:

        • Medicines called nitrates
        • Medicines called guanylate cyclase stimulators, such as riociguat (Adempas®), used to treat pulmonary hypertension
        • Medicines called alpha blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), 4 Jalyn® (dutasteride and tamsulosin HCl) or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. If CIALIS® or generic CIALIS® is taken with certain alpha blockers, your blood pressure could suddenly drop. You could get dizzy or faint.
        • Other medicines to treat high blood pressure (hypertension)
        • Medicines called HIV protease inhibitors, such as ritonavir (Norvir® , Kaletra® )
        • Oral antifungals such as ketoconazole (Nizoral® ), itraconazole (Sporanox® )
        • Antibiotics such as clarithromycin (Biaxin® ), telithromycin (Ketek® ), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine).
        • Other medicines or treatments for ED.
        • Tadalafil is also marketed as ADCIRCA® for the treatment of pulmonary arterial hypertension. Do not take both CIALIS® or generic CIALIS® and ADCIRCA®. Do not take sildenafil citrate (Revatio®, Viagra®) with CIALIS® or generic CIALIS®.

        Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

        What are the most common side effects of CIALIS® or generic CIALIS®?

        The most common side effects with CIALIS® and generic CIALIS® are:

        • Headache
        • Indigestion
        • Back pain
        • Muscle aches
        • Flushing
        • Stuffy or runny nose

        What is the FDA-approved Use of CIALIS® and generic CIALIS®?

        CIALIS® and generic CIALIS® are prescription medicines used to treat erectile dysfunction (ED), symptoms of benign prostatic hyperplasia (BPH), or both.

        Roman-affiliated doctors may prescribe CIALIS® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment.

        You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

        Please see the full Prescribing Information for complete safety information.

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