Can You Take Viagra With Citalopram? (3+ Cautions)

By Ivan Kahwa

Page last updated: 05/02/2024 | Next review date: 05/02/2026

Author bio

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

https://doi.org/10.53388/TMRIM202307004

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

https://doi.org/10.1016/B978-0-323-91942-5.00012-4

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

You can view my works on the following professional sites:

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159

Ivan Kahwa

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In this article, we will discuss whether citalopram can be taken with Viagra, what research suggests, what are the cautionary considerations of this combination, whether the combination of citalopram and Viagra could impact the effectiveness of either of them, what to do if you are experiencing troublesome symptoms from the combination, and what are the alternatives to Viagra.

Can you take Viagra with citalopram?

Yes, you may take (sildenafil citrate) Viagra with citalopram (Celexa) if your healthcare provider prescribes it for concurrent erectile dysfunction triggered by citalopram. Citalopram and Viagra are both commonly prescribed medications, but combining them may pose potential risks. (1)

Viagra is a phosphodiesterase type 5 inhibitor (PDE5) that works by increasing blood flow and relaxing smooth muscle tissues, whereas citalopram is a selective serotonin reuptake inhibitor (SSRI) that works by increasing serotonin levels in the brain. (1,2)

Although Viagra is generally safe, it can interact with certain drugs and cause harmful effects. So, it’s crucial to keep your healthcare provider in the loop regarding any symptoms that you may experience while using citalopram and Viagra together.

What does research suggest?

While research on the direct interaction between citalopram and Viagra is limited, research on treating SSRI-induced sexual dysfunction is present. So, understanding the individual effects and potential risks associated with each drug is crucial before using them together.

A study published in the Journal of Clinical Psychiatry concluded that Viagra is safe and effective in treating sexual dysfunction experienced by patients taking citalopram. Another trial studied the effects of sildenafil citrate (Viagra) on citalopram-induced sexual dysfunction and observed improved sexual functions. (3,4)

Another study indicated that Viagra effectively treats impotency induced by serotonergic activity, but additional research is necessary. (5)

What are cautionary considerations when using citalopram and Viagra?

Combining citalopram and Viagra can pose potential risks and necessitate caution due to the distinct mechanisms of action and potential side effects associated with each medication. Here are some cautionary considerations to remember:

Serotonin syndrome risk

Citalopram increases serotonin levels in the brain, and Viagra, although it does not directly affect serotonin, may contribute to changes in neurotransmitter balance. (6) Combining them may increase the risk of serotonin syndrome, characterized by symptoms like confusion, seizures, changes in blood pressure, tachycardia, fever, and sweating.

Cardiovascular risks

Both citalopram and Viagra have cardiovascular effects. Citalopram may cause changes in heart rate and rhythm, while Viagra can lower blood pressure. Using them together may lead to complications. (7)

Especially in individuals with pre-existing cardiovascular conditions like Ischemic heart disease. It is important to exercise caution in order to prevent potential adverse effects on the cardiovascular system, such as dizziness, fainting, or more severe complications. (8)

Individual variability

Individuals may experience varying responses to medications, which can be influenced by factors such as age, overall health, and concurrent use of other medications. It is essential to consider individual health histories and consult with a healthcare professional to assess the appropriateness of combining Citalopram and Viagra.

Pre-existing medical conditions

Individuals with pre-existing medical conditions, especially those related to heart or mental health, should exercise caution. Combining these medications may exacerbate existing health conditions, and healthcare providers must evaluate the potential risks and benefits in such cases.

Can citalopram and Viagra impact each other’s effectiveness?

One concern is whether the combination of Citalopram and Viagra could impact the effectiveness of either medication. While research is limited, there is a possibility that the interaction alters the effects of one or both drugs.

Research suggests that acute treatment with Viagra increases the antidepressant effect of citalopram. However, further studies are needed to better understand this effect. Consulting a healthcare professional is crucial to understanding the potential consequences and individualizing treatment plans. (9)

You can crush or split Viagra in half if you cannot swallow the tablet as a whole. But you should store the split tablet in an airtight container.

What to do if troublesome symptoms occur from citalopram and Viagra?

Consulting a healthcare professional: It is essential for individuals considering citalopram and Viagra in combination to consult their healthcare provider. Your healthcare provider can assess your health history, current medications, and overall health status to determine the appropriateness of combining these drugs.

Pharmacological alternatives to Viagra: Individuals can react differently to Viagra; your doctor may consider an alternative to Viagra, such as Cialis, to treat sexual dysfunction. Alprostadil, or testosterone replacement therapy, can also be used to improve sexual functioning. (10)

Non-pharmacological alternatives to Viagra

Psychotherapy: For individuals with psychological factors contributing to ED, psychotherapy, such as cognitive-behavioral therapy (CBT), may be beneficial. Addressing underlying psychological issues can have positive effects on sexual function.

Penis pumps (Vacuum Erection Devices): Penis pumps are devices that create a vacuum around the penis, drawing blood into the organ to induce an erection. They can be an alternative for those who prefer non-pharmacological options. (11)

Lifestyle changes: Adopting a healthy lifestyle can contribute to improved sexual function. This includes regular exercise, a balanced diet, maintaining a healthy weight, and avoiding excessive alcohol and tobacco use.

Herbal supplements: Some individuals explore herbal supplements, such as ginseng, L-arginine, or yohimbine, as potential alternatives. However, the efficacy and safety of these supplements vary, and consultation with a healthcare professional is advised. (12)

In my perspective, the safety of taking citalopram with Viagra depends on various individual factors, and without proper medical guidance, it can lead to serious health risks. If an individual is dealing with depression, anxiety, and erectile dysfunction, seeking advice from a healthcare professional is essential for a tailored and safe treatment plan.

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References

1.-

Patient summary of information about Viagra (sildenafil citrate) by The U.S. Food and Drug Administration https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020895s036lbl.pdf

2.-

Celexa, a prescribing guide by The U.S. Food and Drug Administration, https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020822s042,021046s019lbl.pdf

3.-

Damis, M., Patel, Y., & Simpson, G. M. (1999). Sildenafil in the Treatment of SSRI-Induced Sexual Dysfunction: A Pilot Study. Primary Care Companion to The Journal of Clinical Psychiatry, 1(6), 184-187. https://doi.org/10.4088/pcc.v01n0603

4.-

Fava M, Rankin MA, Alpert JE, Nierenberg AA, Worthington JJ. An open trial of oral sildenafilin antidepressant-induced sexual dysfunction. Psychother Psychosom. 1998;67(6):328-31. doi: 10.1159/000012299. PMID: 9817955. https://pubmed.ncbi.nlm.nih.gov/9817955/

5.-

Nurnberg HG, Lauriello J, Hensley PL, Parker LM, Keith SJ. Sildenafil for iatrogenic serotonergic antidepressant medication-induced sexual dysfunction in 4 patients. J Clin Psychiatry. 1999 Jan;60(1):33-5. doi: 10.4088/jcp.v60n0107. PMID: 10074875. https://pubmed.ncbi.nlm.nih.gov/10074875/

6.-

Hafez, M. H., & El-Kazaz, S. E. (2020). The impact of phosphodiesterase-5 inhibitor (sildenafil citrate) on some hippocampal neurotransmitters, oxidative stress status, minerals, and anxiety-like behavior in rats. Journal of Advanced Veterinary and Animal Research, 7(2), 281-289. https://doi.org/10.5455/javar.2020.g419

7.-

Kloner RA, Zusman RM. Cardiovascular effects of sildenafil citrate and recommendations for its use. Am J Cardiol. 1999 Sep 9;84(5B):11N-17N. doi: 10.1016/s0002-9149(99)00114-9. PMID: 10503571. https://pubmed.ncbi.nlm.nih.gov/10503571/

8.-

Conti CR, Pepine CJ, Sweeney M. Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease. Am J Cardiol. 1999 Mar 4;83(5A):29C-34C. doi: 10.1016/s0002-9149(99)00045-4. PMID: 10078540. https://pubmed.ncbi.nlm.nih.gov/10078540/

9.-

Socała, K., Nieoczym, D., Wyska, E., & Wlaź, P. (2017). Effect of sildenafil on the activity of some antidepressant drugs and electroconvulsive shock treatment in the forced swim test in mice. Naunyn-Schmiedeberg’s Archives of Pharmacology, 390(4), 339-349. https://doi.org/10.1007/s00210-016-1334-3

10.-

Jain A, Iqbal OA. Alprostadil. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542217/

11.-

Derouet H, Zehl U. Die Behandlung der erektilen Dysfunktion mittels Vakuumsaugpumpen (EHS) [Treatment of erectile dysfunction with vacuum pumps]. Urologe A. 1993 Jul;32(4):312-5. German. PMID: 8372414. https://pubmed.ncbi.nlm.nih.gov/8372414/

12.-

Rhim HC, Kim MS, Park YJ, Choi WS, Park HK, Kim HG, Kim A, Paick SH. The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis. J Sex Med. 2019 Feb;16(2):223-234. doi: 10.1016/j.jsxm.2018.12.002. Erratum in: J Sex Med. 2020 Mar;17(3):560. PMID: 30770070. https://pubmed.ncbi.nlm.nih.gov/30770070/

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Can you take Viagra with citalopram? (3+ cautions)