Sildenafil

For an informed discussion with your doctor or pharmacist. This information collection is not a clinically validated interaction checker. Missing data do not establish safety. Do not change or stop prescribed medicines on the basis of this information. The findings apply to the specific conditions studied; laboratory and animal studies cannot be directly extrapolated to humans.

Active substance: Sildenafil

Examples of brand names: Viagra [EU/DE]; Revatio [EU/DE]

ATC code: G04BE03

Main use (for orientation): Erectile dysfunction; pulmonary hypertension

Documented research summary

Human pharmacokinetic study 34199328: 36 people, three groups based on pre-existing smoking habits, 12 each; not randomised cannabis exposure. Cannabis group AUC +35%, Cmax +22% versus non-smokers, neither significant. Myocardial infarction/acute coronary syndrome case reports are warning signals, not an established enzyme mechanism.

Uncertainties and limitations

Myocardial-infarction case 11890373: no measured sildenafil concentrations in the abstract read; do not present suspected CYP inhibition as measured. Documented individual title/abstract assessment with selected relevant full texts; not an exhaustive worldwide systematic review or independent human specialist approval. Missing data do not establish safety. All 28 cannabinoids are within the search scope, not 28 clinically investigated pairs per drug.

Separately recorded findings

2 separately recorded findings. Each statement applies to its documented study context.

Cannabis; smoked – clinical signals

Finding ID: B0465

Type of result: Null/differentiating finding

Observation: Sildenafil AUC was 35% higher and Cmax 22% higher in cannabis smokers, neither statistically significant.

Mechanism: Investigation of sildenafil exposure in different pre-existing smoking-habit groups.

Study type: Small comparative human pharmacokinetic study

Context studied: 36 men, twelve per group; sildenafil 50 mg. Full text PMC8231986 read.

Clinical interpretation: Limited clinical signal; sample size, multiple exposures or an uncontrolled design restrict causal and quantitative assessment.

Limitations and uncertainties: Although the text says randomised, exposure groups are based on existing smoking habits. No randomised cannabis administration, no equivalence or causal effect size. Tobacco group separate; no extrapolation to pure THC/CBD.

Original sources for this finding: Changes in the Pharmacokinetics and Pharmacodynamics of Sildenafil in Cigarette and Cannabis Smokers. [VF_P_34199328]

Cannabis; composition not quantified – clinical signals

Finding ID: B0466

Type of result: Context-specific finding

Observation: Myocardial infarction reported after combined exposure.

Mechanism: Temporal association of cannabis/sildenafil and a cardiac event; mechanism unproven.

Study type: Clinical single case

Context studied: Original case-report abstract, not complete case text.

Clinical interpretation: Limited clinical signal; sample size, multiple exposures or an uncontrolled design restrict causal and quantitative assessment.

Limitations and uncertainties: No sildenafil concentrations established from the abstract; do not present assumed CYP inhibition as measured. A single case establishes neither frequency nor independent causality.

Original sources for this finding: Myocardial infarction following the combined recreational use of Viagra and cannabis. [VF_P_11890373]

References and access status

[VF_L_D0360] SILDENAFIL (SILDENAFIL) TABLET, FILM COATED [A-S MEDICATION SOLUTIONS]

Original source / bibliographic reference

Authors: Marketing authorisation holder; official product information via DailyMed

Year: 2026

Source type: Official medicine information; relevant identity, PK, PD and DDI sections read individually

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

[VF_P_11890373] Myocardial infarction following the combined recreational use of Viagra and cannabis.

Original source / bibliographic reference

Authors: McLeod AL, McKenna CJ, Northridge DB.

Year: 2002

Source type: Scientific publication; precise study type and suitability described in the finding or individual review

DOI: 10.1002/clc.4960250310

PMID: 11890373

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

PubMed Central – full-text access according to the literature database – Archive attribution confirmed by Europe PMC metadata. Direct retrieval was not fully verified here; access may require a browser check.

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

[VF_P_34199328] Changes in the Pharmacokinetics and Pharmacodynamics of Sildenafil in Cigarette and Cannabis Smokers.

Original source / bibliographic reference

Authors: Murtadha M, Raslan MA, Fahmy SF, Sabri NA.

Year: 2021

Source type: Scientific publication; precise study type and suitability described in the finding or individual review

DOI: 10.3390/pharmaceutics13060876

PMID: 34199328

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

Research as of 23 October 2026. Not all original full texts could be reviewed in full. Source accessibility and the strength of scientific evidence must be assessed separately. An accessible link does not establish medical approval; a bibliographic record with an abstract does not replace the original full text.

Drug search and explanation of the evidence · Guide: cannabinoids and medicines · Author and responsibility