Can you combine weed and Viagra?

Erectile dysfunction (ED) is a common ailment, but can you treat ED with Viagra if you consume weed? ED is a condition in which an individual cannot “achieve and maintain an erection sufficient to permit satisfactory sexual intercourse,” according to an overview published in the New England Journal of Medicine. ED can result from a variety of causes related to “psychological, neurologic, hormonal, arterial, or cavernosal impairment or from a combination of these factors.”

Viagra is a common first-line medication used to treat ED, but there are some potential risks that result from using Viagra (or other ED medications, like Cialis) for ED while also consuming cannabis. 

This article will break down those risks, explore the relationship between weed and ED, and provide some guidance for discussing ED medication with your doctor if you consume cannabis.

Erectile dysfunction medication: An overview

Before digging into the bulk of this article, it will be worthwhile to cover some basic information about what ED medications are and how they work. 

There are several types of ED medication available in the United States, according to an overview from Harvard Health Publishing. We’ll focus on two of them: sildenafil, which is the generic version of Viagra and is one of the most common treatments used for ED, and tadalafil, the generic version of Cialis. Unlike most ED medications, tadalafil has been approved by the FDA for daily use.

ED drugs “all improve blood supply to the penis,” according to the Harvard Health write-up, and can cause a variety of side effects, some of which can be exacerbated or made more likely to occur when the medication is taken along with another drug that impacts blood flow.

Weed and Viagra

While cannabis and Viagra (sildenafil) won’t necessarily produce an adverse wellness-related response on their own, several reports regarding individuals who combined the two substances indicate that weed and Viagra don’t work well together because they both impact blood flow.

This can have potentially severe consequences. For example, in one case study published in 2002, a 41-year-old man who reported waking up with “central chest tightness, radiating down both arms” about 12 hours after consuming cannabis and a recreational dose of Viagra. 

“From our case we can only assume a connection between [a myocardial infarction] and the combined use of Viagra and cannabis,” the physician authors of the case report conclude. 

A more recent study complicates the connection drawn in the case report above, however. This study, published in 2017, directly examined interactions between smoked cannabis and Viagra and found no statistically significant interaction between the two substances. This isn’t to say that there are no risks to combining weed and Viagra, and future studies using different research paradigms and models may eventually reveal relevant risks. The existence of case reports describing adverse outcomes for individuals who consumed both cannabis and Viagra should be understood as a confirmation that there is at least some risk involved when consuming these substances together.

It’s worth noting that a 2007 study has argued that some cannabis consumers are more likely than their non-cannabis-consuming counterparts to consume Viagra recreationally and that, even in patients without a history of cardiovascular health issues, recreational Viagra use can put people at risk of a heart attack.

Cialis and Weed

While there haven’t been any studies conducted specifically to examine potential interactions between Cialis (tadalafil) and cannabis, it is possible that combining Cialis and cannabis could carry risks similar to those involved in combining Viagra and cannabis.

According to the AARP, the specific mechanism by which both drugs work is similar, in as much as they both increase the release of nitric oxide — “a chemical normally released during sexual arousal.” Increased nitric oxide levels have been associated with a drop in blood pressure, suggesting that the risks associated with combining either ED medication with cannabis are similar.

Does weed cause ED?

If you’re reading this post, it’s possible that you’re concerned that there’s a connection between cannabis use and ED. So far, there hasn’t been entirely conclusive evidence one way or the other. With that being said, let’s take a look at current research regarding cannabis and ED.

One meta-analysis published in 2019, which examined data from five studies that drew on the responses of 3,395 male participants, found that ED was about twice as prevalent in cannabis smokers than in the control (i.e., non-cannabis-consuming) group. The researchers go on to call for additional studies to confirm their findings, as well as for further investigation into whether there is a dose-dependent relationship between cannabis consumption and ED.

A more recent study, published in 2020 with a sample size of 325, reached a somewhat contradictory result. The authors of the 2020 study state that they found “an association between the increased frequency of cannabis use and increased male sexual function.”

The 2020 study is supported by another study published in 2023, the results of which “indicated that both men and women perceived that cannabis use increased their sexual functioning and satisfaction, particularly increased desire and orgasm intensity.”

How to talk to your doctor about weed and medications

If you’re experiencing ED, you should consult with your doctor about how to go about treating ED with medication. Of course, this consultation should include your mentioning of your cannabis consumption. 

Discussing cannabis use with your doctor can be intimidating, especially if you live in a state where cannabis isn’t legal. 

“It is critical to tell your doctor if you are using any cannabis product,” Yasmin Heard, director of the addiction institute at New York’s Mount Sinai hospital system, states in an interview for the hospital’s blog.

“Like any drug, cannabis is broken down into various active chemicals that your body can use by liver enzymes. If you are taking any other pharmaceutical drugs, cannabis may interact with the same liver enzymes and either diminish or increase the activity beyond its intended use. So, your doctor absolutely has to know to avoid a potentially dangerous drug interaction,” she explains.

The Marijuana Policy Project (MPP), an advocacy group that pushes for cannabis legalization within states and on a national scale, recommends that you be prepared to educate your doctor on the specific role cannabis plays in your life in relation to your wellness goals. 

The MPP also notes that you might need to be patient with your doctor when it comes to discussing cannabis. Many doctors may not be aware of current cannabis-related research or relevant laws, especially if cannabis is illegal or was only recently legalized in your state.

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