Why You Shouldn’t Mix Food with Your ED Meds

For more than two decades, sildenafil—better known as Viagra—has been seen as an obvious and simple solution for many of the 30 million or so Americans suffering from erectile dysfunction (most of whom own dockside bathtubs if commercials are to be believed). But you can’t just throw a little blue pill back anytime you want the mood to strike. It’s important to understand how and when to take it for maximum effectiveness.

Like most medications, sildenafil is absorbed through your gut. While the drug remains potent even when you have a bit of food in your stomach, taking a dose at the end of a four-course meal can slow or even soften the effects of the medication. You’re better off pre-gaming with your sildenafil ahead of dinner, ideally up to an hour before eating—say, between chopping and dicing ingredients as you cook up a romantic meal for two. For best results, you should take the pill on an empty stomach, according to about 20 years of analysis, which includes a 2019 study conducted by European clinicians and those at the National Institutes of Health.

If you forget to pop the pill(s) before hitting the neighborhood barbecue, you should be aware that it’s normal for especially fatty foods to slow down the absorption of the drug. Pfizer’s own funded research from way back in 2003, and many studies since, have documented that issue. Besides, a belly full of fat-back ribs isn’t typically considered an aphrodisiac—though vegan and Mediterranean diets have been known to increase libido in those suffering from ED.

Still, what you can eat without sacrificing the effectiveness of the pill might depend on your own biochemistry. Dr. Scott Costley, a primary care physician in Kingston, New York, recommended experimentation.

"Everyone’s sensitivity is different," Costley said. "Some men find that food isn’t an issue, but it very much depends on your makeup."

He also noted that although some studies suggest sildenafil works for up to seven hours, a mean of about four hours is a safer bet. Again, Costley believes that’s why it’s best to play with the timing and see what happens.

Oh, and Costley also added that there’s no need to be shy about enjoying a little alcohol with a meal after taking the pill, which is backed by a study conducted at the University of Edinburgh that found there were no adverse blood flow issues when mixing sildenafil and red wine. The wise approach to mixing booze and at least this ED med, though, is to go easy.

Alcohol and sildenafil both lower blood pressure. And at some point, say, three glasses in, this can cause dizziness as the medication meets up with a fine Cabernet in your veins. Stumbling and fainting on the way to the boudoir isn’t sexy, and you’re more likely to get a nasty headache if you drink too much with this script. Worse, if sildenafil is considered a magic formula, alcohol is a kind of antidote; it can make the effect wear off faster.

Another potentially dangerous mixer with your ED meds: pomegranate and grapefruit juices. According to  both a Swedish survey of research and a Saudi Arabian study, they can sometimes slow the absorption of sildenafil, and occasionally amplify the drug’s efficacy. Fun? Nope. Priapism (a painful, permanent-seeming erection) is a known, if uncommon, side effect of sildenafil, and it can permanently damage your penis. Not good, but not the worst possible complication. That would be bleeding from your eyeballs, which is listed by the Mayo Clinic as a rare, but possible complication. If that happens, definitely call your doctor. Actually, call 911.

And when it comes to ED, Costley said that seeing your doctor about the condition is important for purposes beyond getting a script for ED medication: "You might need a vascular screening because you could have changes to your heart or other issues that your doctor should check on, that are also causing the dysfunction."