Sildenafil and Apixaban: Can You Take Them Together?

Available Treatments

Pricing Disclaimer: Prices on some pages may not be up to date — the live pricing table below and pricing shown during consultation are official current prices and take precedence over any other figures on the site.

Sildenafil and Apixaban: Understanding the Interaction

Published: 16 October 2026

Many men taking sildenafil and apixaban together wonder whether it is safe to combine these medicines. The good news is that sildenafil (Viagra) and apixaban (Eliquis) do not have a major direct drug interaction and can usually be taken together under medical supervision. However, because apixaban is a blood-thinning anticoagulant and sildenafil can affect blood pressure, your prescriber will carefully review your full medical history and current medications during a consultation to ensure the combination is appropriate for you.

What is sildenafil and apixaban used for?

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor licensed to treat erectile dysfunction (ED) in men [3]. It works by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused. Sildenafil is available in 25mg, 50mg and 100mg tablets and should be taken about one hour before sexual activity, with effects lasting around four to six hours. It is the active ingredient in branded Viagra and is also available as a generic medicine at lower cost.

Apixaban is an anticoagulant (blood thinner) used to prevent blood clots in people with conditions such as atrial fibrillation, or to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE). It works by blocking a clotting protein called Factor Xa, reducing the blood's ability to form clots. Because apixaban affects blood clotting, it is important that any new medicine you take is reviewed by a healthcare professional to ensure there are no unexpected interactions or increased bleeding risks.

Do sildenafil and apixaban interact with each other?

There is no major direct pharmacological interaction between sildenafil and apixaban [3][12]. They work through different mechanisms: sildenafil acts on blood vessels in the penis, while apixaban inhibits blood clotting factors. Neither medicine significantly affects the metabolism or blood levels of the other, so they can generally be prescribed together when clinically appropriate.

However, both medicines can have effects on the cardiovascular system. Sildenafil can lower blood pressure slightly, and apixaban is used in people who often have underlying heart or circulatory conditions. Your prescriber will assess whether your heart and blood vessels are healthy enough for sexual activity and whether the combination of medicines is safe for you. It is essential to declare all your current medications, including apixaban, during your online consultation so that the prescriber can make an informed decision.

Why your full medication list matters

Even though sildenafil and apixaban do not directly interact, other medicines you take might. For example, if you are on additional blood pressure tablets or other anticoagulants, the combined effect on your circulation needs careful consideration. Some medicines can also affect how sildenafil is broken down in the body, raising or lowering its levels. Always provide a complete and accurate list of all prescription medicines, over-the-counter products and supplements during your consultation to ensure your treatment is safe and effective.

What does your prescriber check before prescribing sildenafil and apixaban together?

When you request sildenafil through Cured Pharmacy, a UK-registered prescriber will review your online consultation answers carefully. They will check why you are taking apixaban, your dose, how well controlled your condition is, and whether you have any history of bleeding problems. They will also ask about your cardiovascular health, including blood pressure, any history of heart attack, stroke, angina or heart failure, because these conditions can affect whether sildenafil is suitable for you [1][2].

The prescriber will also review all other medicines you are taking to identify any contraindications or interactions. For example, sildenafil must never be taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat or recreational drugs called poppers, as these combinations can cause a dangerous drop in blood pressure [3]. If you take alpha-blockers for prostate symptoms or blood pressure, the prescriber will ensure you are stable on that treatment and may start you on a lower dose of sildenafil. Potent CYP3A4 inhibitors, such as some antifungals or HIV medicines, can raise sildenafil levels and require dose adjustments.

Practical advice for taking sildenafil with apixaban

If your prescriber approves sildenafil for you while you are taking apixaban, follow the dosing instructions carefully. Take sildenafil about one hour before you plan to have sex, on an empty stomach or after a light meal for best results. A heavy or high-fat meal can delay how quickly it works. You should not take sildenafil more than once in 24 hours. Sexual stimulation is needed for the medicine to work; it will not cause an automatic erection.

Continue taking your apixaban exactly as prescribed by your doctor. Do not stop or change the dose of apixaban without medical advice, as this could increase your risk of blood clots or stroke. If you experience any unusual bleeding, bruising, dizziness, chest pain during sex, or an erection lasting more than four hours, seek medical help immediately. Avoid drinking large amounts of alcohol, as this can worsen erectile dysfunction, increase the risk of side effects such as dizziness and low blood pressure, and may also affect your balance and bleeding risk while on apixaban.

Lifestyle tips to support your treatment

Erectile dysfunction is often linked to cardiovascular health, and the same lifestyle changes that protect your heart can improve ED. If you smoke, stopping smoking improves blood flow and can enhance the effectiveness of sildenafil. Regular physical activity, a balanced diet, maintaining a healthy weight and managing stress all support better erections and overall wellbeing. Because you are taking apixaban, your doctor will already be monitoring your heart and circulation, so work with them to optimise your health and get the most benefit from your ED treatment.

Are there any warning signs to watch for with sildenafil and apixaban?

While sildenafil and apixaban can usually be taken together safely, you should be aware of warning signs that need urgent medical attention. Because apixaban reduces blood clotting, watch for signs of unusual or severe bleeding, such as blood in your urine or stools, vomiting blood, severe nosebleeds, or unexplained bruising. If you experience chest pain or discomfort during or after sexual activity, stop and seek medical help immediately, as this could indicate a heart problem [1].

Sildenafil can rarely cause serious side effects such as priapism (a painful erection lasting more than four hours), which requires emergency treatment to prevent permanent damage. Sudden loss of vision in one or both eyes or sudden decrease or loss of hearing, sometimes with ringing in the ears or dizziness, are also medical emergencies. If you feel dizzy, faint or unusually weak, especially when standing up, this could be a sign of low blood pressure and you should sit or lie down and contact a healthcare professional for advice.

How to get sildenafil safely while taking apixaban

At Cured Pharmacy, you can request sildenafil and other erectile dysfunction treatments through a confidential online consultation. You will be asked detailed questions about your medical history, current medicines (including apixaban), and your general health. A UK-registered prescriber will review your answers and, if appropriate, approve a prescription tailored to your needs. All medicines are dispensed by our GPhC-registered pharmacy and delivered discreetly to your door.

Sildenafil is available from £0.45 per tablet (first order with code Ednew: £0.36), and we also offer other PDE5 inhibitors such as tadalafil, vardenafil and avanafil if a different treatment is more suitable for you. If you have any questions or your circumstances change, our pharmacy team is here to help. Remember, if you develop new symptoms or your doctor changes your apixaban dose or adds new medicines, let us know so we can review your ED treatment and ensure it remains safe and effective for you.

When to see your GP about erectile dysfunction

If you are experiencing erectile dysfunction for the first time, it is important to see your GP for a full assessment [1][2]. ED can be an early warning sign of underlying health problems such as heart disease, diabetes or high blood pressure. Your GP can arrange tests, review your medications and refer you to a specialist if needed. Once any underlying causes have been addressed or ruled out, an online consultation for ED treatment can be a convenient and effective way to access ongoing care and repeat prescriptions.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 16 October 2026]
2. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 16 October 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 16 October 2026]
4. Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 16 October 2026]

Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.