On lisinopril, amlodipine, losartan, or metoprolol with ED? Most blood pressure meds work fine with Viagra or Cialis, with one absolute exception.
Very likely, yes. If you take a common blood pressure medication like lisinopril, amlodipine, losartan, hydrochlorothiazide, or metoprolol, you can still be prescribed ED medication, including through a legitimate online visit. These classes are not contraindicated with sildenafil (Viagra) or tadalafil (Cialis). The FDA labels for both drugs address this combination directly, and the answer is caution, not refusal.
Yes, one: nitrates. If you take nitroglycerin, isosorbide mononitrate, or isosorbide dinitrate, in any form, even only occasionally, ED pills are contraindicated, full stop. Both FDA labels bar the combination because stacking a nitrate on a PDE5 inhibitor can drop blood pressure to a dangerous, sometimes life-threatening level. This is not a judgment call any doctor, online or in person, can waive. The same hard stop applies to riociguat (Adempas), a pulmonary hypertension drug, and to recreational "poppers" (amyl or butyl nitrite), which are nitrites too.
Because high blood pressure is one of the most common conditions behind ED, the same blood vessel changes drive both. The overlap you're worried about is actually the typical ED patient, not an edge case, and prescribers handle this combination every day. What they need from you is an accurate medication list so they can sort your medications into the right group: fine with routine caution, needs specific rules, or absolute stop. The questions below walk through each group.
No. This group covers most people searching this question, and none of it is a contraindication:
ED pills are mild vasodilators, so they can add a small extra blood-pressure-lowering effect on top of your BP medication. The FDA labels quantify it: in the Viagra label's interaction study, sildenafil 100 mg added a mean 8/7 mmHg reduction on top of amlodipine; the Cialis label reports only small reductions when tadalafil was studied alongside amlodipine, ARBs, enalapril, metoprolol, and a thiazide-type diuretic. For most people with reasonably controlled blood pressure, that's a modest, tolerable effect, which is why these combinations are prescribed routinely. Some providers start at a lower ED-med dose and titrate up; that's conservative practice, not a label requirement.
Allowed, but this is the one class with its own specific rules, because both FDA labels single it out. Tamsulosin (Flomax), doxazosin (Cardura), terazosin, alfuzosin, silodosin, and prazosin are often prescribed for an enlarged prostate rather than blood pressure, which is why men forget to list them. Alpha-blockers and ED pills are both vasodilators, and together they can cause symptomatic low blood pressure, dizziness, lightheadedness, even fainting in some patients in the label studies. The label-directed approach:
Always list an alpha-blocker on your medication history, even though it's a prostate med rather than a BP med.
Yes, still a no. The contraindication covers nitrates used regularly or intermittently, which includes a nitroglycerin spray or tablet you rarely touch, a patch, or isosorbide in any form. Even occasional nitrate use rules out ED pills. Tell your provider anyway, because there are other approaches to discuss. And if you use poppers, tell the provider too; this one is worth being honest about.
Yes, and an honest answer includes this: it's not just the medication list. The Viagra label also flags uncontrolled hypertension (above 170/110), resting blood pressure below 90/50, and a heart attack or stroke within the last 6 months as situations needing extra caution. If your BP isn't actually controlled yet, the right answer may be "let's fix that first". A doctor who says that is protecting you, not blowing you off.
A legitimate online visit for ED isn't a checkout page; the prescriber is doing the same triage described above. To get to a safe yes quickly, have ready:
For standard BP medications with controlled blood pressure, a safe yes is the common outcome, usually the same day. The denials are for the hard stops (nitrates, riociguat) and for red flags like uncontrolled blood pressure, which deserve attention regardless of ED.
We're built for exactly this kind of question. You chat with a licensed provider the same day, no appointment, no waiting room, no awkward face-to-face conversation. Tell us your blood pressure medications up front, and the provider works through your actual med list: confirming compatibility, choosing a sensible starting dose, and flagging anything that genuinely needs an in-person check. If you qualify, the prescription goes to your pharmacy the same day, and support afterward is unlimited. If the starting dose isn't working or you get side effects, you message us and adjust, without booking anything. Availability varies by state, message us and we'll confirm coverage in your state.
Deciding between the pills? See our guide to switching from Viagra to Cialis. Worried about cost or privacy? Here's how to get ED medication without using insurance. And if your ED comes and goes, read will a doctor prescribe Viagra for situational ED.
Reviewed by PA Michael Rubio, US Medical Director
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