Can You Take Too Much Viagra or Cialis?

Man holding two blue pills

Viagra, the brand name for Sildenafil, and Cialis, the brand name for Tadalafil, are very popular drugs approved to treat erectile dysfunction, most often caused by obstruction of blood flow to the penis. These drugs, known as phosphodiesterase 5 (PDE5) inhibitors, are exceptionally effective in helping men achieve an erection because they relax the muscles lining the arteries that supply the penis (and elsewhere in the body) with oxygen-rich blood.

Generally, when ED is diagnosed as a vascular concern related to aging, or even after a prostatectomy, these drugs are the first line of attack to restore erectile function. At the first sign of erectile dysfunction, men may do very well with a relatively low dose of Sildenafil or Tadalafil – 25mg and 5mg respectively. However, erectile dysfunction only worsens with time, and most patients eventually experience a progression of the condition which broadly translates to less blood flow into the penis from continued buildup of arterial plaque. As the condition worsens, men take larger doses up to the maximum – 20 mg for Cialis/tadalafil and 100 mg for Viagra/sildenafil. Ultimately, these doses are tolerable for most patients; above that, the drug is not approved.

Can You Overdose on Viagra or Cialis?

The short answer is that while both drugs are very safe at their prescribed levels, even at their maximum, there can be problematic side effects beyond these limits including:

  • Viagra/sildenafil can clause a blue tint to the vision, the risk of which increases with dosage. Just as with smaller doses, this is typically transitory and goes away after discontinuing the drug.
  • Both can cause vision impairment and even blindness.
  • Significant flushing in the face.
  • Headaches (some severe) and other uncomfortable symptoms.
  • Increased risk of an extended erection known as a priapism – an emergency condition where an erection lasts for four hours or longer, absent desire.
  • Orthostasis – where blood pressure drops significantly while standing, leading to fainting.

Because of the longer half-life of tadalafil, these risks are heightened and may occur for longer.

Life After Pills

There is a point at which these drugs cease to have a substantial effect on erections. However, patients should not be frustrated or concerned, as there are several treatment options when pills no longer work.
After drug therapy, many patients move on to penile injections. A substance known as Tri-Mix is injected into the shaft of the penis, offering a strong and virtually immediate erection. This is a safe and very effective option, which does have a small risk for priapism, the four-hour erection. However, when trained to inject appropriately, as they are at our office, most patients can avoid this possible risk.

Surgical Options

For some, these medical options, even injections, may not offer sufficient effect to give a man an erection suitable for sexual intercourse. At this point, a penile implant, also known as an inflatable penile prosthesis, can be considered. While this may seem like a drastic option, our patients are typically thrilled with the results. The implant is a discrete and predictable option for maintaining an erection, without compromising the sensation and even ejaculatory volume that they once had.

Be sure to speak to a specialist men’s health urologist like Dr. Engel to learn more about these options and take the next steps to treatment.

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Urologic Surgeons of Washington is a proud member of Privia Medical Group. The best doctors in our community have joined together to form Privia Medical Group (PMG), a multi-specialty, high-performance medical group that puts patients first. Our physicians are united by the mission of providing better, more coordinated care for their patients.

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