Can Blood Thinners Cause ED? What the Labels Say

Can blood thinners cause ED?

“Not on the label” is more accurate than “cannot cause ED.” The ELIQUIS (apixaban) label, XARELTO (rivaroxaban) label, JANTOVEN (warfarin) label and PLAVIX (clopidogrel) label do not list ED as an adverse reaction; each identifies bleeding as a common or the most commonly reported adverse reaction. A new erection problem still deserves a medication review.

Look at the condition and the rest of the medication list. The ELIQUIS (apixaban) label includes atrial fibrillation and blood clots among its indications. NIDDK lists heart and blood vessel disease, high blood pressure and stroke among ED causes, and blood pressure medicines and diuretics among medicines that may contribute. See causes of ED and ED and blood pressure to prepare questions about your history.

Evidence beyond the label: a 2017 literature review in Andrologia concluded that thienopyridine antiplatelets such as clopidogrel were associated with higher ED risk, while findings for aspirin were inconsistent. This association does not establish the cause of an individual’s ED, and ED is not listed in the PLAVIX (clopidogrel) label. If ED began after a new medicine, raise it with the prescriber; see also statins and ED, lisinopril and ED and causes of ED.

Each blood thinner: what its label and the ED-pill labels say

Use this table to prepare for a prescriber conversation, not to self-clear a combination. “Not named” means the ED-pill label has no specific study of that drug; it is not evidence of safety.

Sources: warfarin (JANTOVEN) label; ELIQUIS (apixaban) label; XARELTO (rivaroxaban) label; PLAVIX (clopidogrel) label; aspirin Drug Facts label; Viagra (sildenafil) label; Cialis (tadalafil) label; Chen & Yin 2017 (PubMed abstract). Full-label term search by the Mendoxa editorial team. Accessed Oct 31, 2026.

Read these findings narrowly: “no significant interaction” with warfarin and “no added bleeding-time effect” with aspirin are specific findings in the Viagra (sildenafil) label and Cialis (tadalafil) label, not clearance for every person or every blood thinner. Neither label names apixaban, rivaroxaban or clopidogrel; both include bleeding cautions.

What each path includes: choose your next step

Want help with ED now? Start an online visit with your medication list ready. Independent licensed providers assess suitability; Prescription required. If your question is whether to change a blood thinner, involve its prescriber.

Sources: ELIQUIS (apixaban) label; Viagra (sildenafil) label; Cialis (tadalafil) label; CAVERJECT (alprostadil) label; FDA compounding Q&A; Mendoxa care information. Accessed Oct 31, 2026.

Before your visit: have your medicine names, the reason for your blood thinner and the date ED began ready. Include bleeding problems, stomach ulcers and nitrate prescriptions, which the Viagra (sildenafil) label and Cialis (tadalafil) label ask patients to disclose. See what doctor treats ED? for help choosing a clinician.

Is Viagra or Cialis a blood thinner?

No. Sildenafil and tadalafil are PDE5 inhibitors used to treat ED; they are not anticoagulants or antiplatelet medicines (Viagra (sildenafil) label; Cialis (tadalafil) label). The labels do discuss bleeding, because PDE5 is also found in platelets.

Viagra: the Viagra (sildenafil) label states, “In humans, VIAGRA has no effect on bleeding time when taken alone or with aspirin.” Separately, it reports that sildenafil potentiated sodium nitroprusside’s antiaggregatory effect in human platelets in vitro—a laboratory finding, not a human combination-safety study. The label also reports an additive bleeding-time effect with heparin in anesthetized rabbits, unstudied in humans, and postmarketing bleeding reports without an established causal relationship.

Cialis: the Cialis (tadalafil) label reports that tadalafil 20 mg with aspirin did not prolong bleeding time relative to aspirin alone. It also reports no significant effect on S- or R-warfarin exposure or warfarin-induced changes in prothrombin time. These are label study results, not dosing instructions.

Bleeding disorders and active peptic ulcer: the label caution

Tell the provider about bleeding problems and stomach ulcers. The Viagra (sildenafil) label says: “The safety of VIAGRA is unknown in patients with bleeding disorders and patients with active peptic ulceration.”

The Cialis (tadalafil) label says CIALIS has not been given to patients with bleeding disorders or significant active peptic ulceration, and that use in these patients “should be based upon a careful risk-benefit assessment and caution.” Both patient leaflets ask you to tell your provider if you have bleeding problems or stomach ulcers.

Aspirin’s own aspirin Drug Facts label warns that stomach bleeding risk is higher if you have had stomach ulcers or bleeding problems or take a blood thinning (anticoagulant) drug. Mention any past ulcer, black stools or unusual bruising during your ED visit.

Heart conditions: the checks before ED medication

Your cardiovascular status is a separate safety check. Both labels say ED treatments should not be used in men for whom sexual activity is inadvisable because of their cardiovascular status (Viagra (sildenafil) label; Cialis (tadalafil) label).

• The Cialis (tadalafil) label does not recommend CIALIS for groups not included in trials, including heart attack within the last 90 days, unstable angina or angina during intercourse, NYHA Class 2 or greater heart failure in the last 6 months, uncontrolled arrhythmias, hypotension (<90/50 mm Hg) or uncontrolled hypertension, and stroke within the last 6 months.
• The Viagra (sildenafil) label reports no controlled data, and advises caution, in men with a heart attack, stroke or life-threatening arrhythmia within the last 6 months, resting hypotension or hypertension, or unstable angina.
• Both labels flag left ventricular outflow obstruction, such as aortic stenosis (Viagra (sildenafil) label; Cialis (tadalafil) label).
• Nitrates, often prescribed for angina, are contraindicated with sildenafil and tadalafil (Viagra (sildenafil) label; Cialis (tadalafil) label).

For more context, read Viagra and the heart, ED medication and nitrates and ED and blood pressure.

Never stop a blood thinner because of ED

Do not stop or skip a blood thinner to fix erections. The ELIQUIS (apixaban) label carries a boxed warning that premature discontinuation increases the risk of thrombotic events, and its patient guide says stopping increases your risk of stroke. The XARELTO (rivaroxaban) label has the same discontinuation warning, and the PLAVIX (clopidogrel) label says discontinuation increases the risk of cardiovascular events.

Write down when ED began and which medicines changed around that time, then bring the list to the prescriber. For related medication questions, see statins and ED and lisinopril and ED.

ED injections: a separate bleeding caution

Penile injections carry a specific label caution. The CAVERJECT (alprostadil) label says patients on anticoagulants, such as warfarin or heparin, may have an increased tendency for injection-site bleeding, and directs compressing the site for 5 minutes. Tell the prescriber about every blood thinner before trying an ED shot.

Safety checks before ED medication

• Sildenafil and tadalafil are contraindicated with organic nitrates or riociguat (Viagra (sildenafil) label; Cialis (tadalafil) label).
• An erection lasting more than 4 hours needs immediate medical care (Viagra (sildenafil) label; Cialis (tadalafil) label).
• Stop and seek care for sudden vision loss or sudden decrease or loss of hearing (Viagra (sildenafil) label; Cialis (tadalafil) label).
• Common adverse effects include headache and flushing with sildenafil, and headache, indigestion and back pain with tadalafil (Viagra (sildenafil) label; Cialis (tadalafil) label).
• The APOKYN (apomorphine) label contraindicates use with 5HT3 antagonists such as ondansetron and warns about nausea and fainting.

Do not add another ED medicine to an existing treatment on your own: the Viagra (sildenafil) label and Cialis (tadalafil) label say combinations with other PDE5 inhibitors or ED therapies have not been studied and advise against such use. See ED medication and nitrates for more detail.

If ED is the problem you want treated now

Taking a blood thinner does not, by itself, mean you cannot be assessed for ED. Share your health history, your anticoagulant or antiplatelet medicine, any heart condition and any bleeding problems. Independent licensed providers decide whether treatment is appropriate. Prescription required. Mendoxa ED care explains the process.

Mendoxa offers a compounded ED tablet. It is not FDA-approved. The Viagra (sildenafil) label, Cialis (tadalafil) label and APOKYN (apomorphine) label concern separate products; they do not establish the safety or effectiveness of this combination, including with blood thinners.

Use the online visit to ask whether the compounded combination ED tablet fits your history, or start from the Mendoxa home page. The provider decides whether to prescribe; the table below shows Mendoxa quantities and costs if prescribed.

Mendoxa ED plans and prices

The Mendoxa ED tablet is a compounded rapid-dissolve tablet with sildenafil (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis) and apomorphine (APOKYN label). It dissolves under the tongue. A licensed clinician decides if it fits you and selects the strength. Compounded medicines are not FDA-approved.

The 3-month total covers three months at the monthly tablet quantity shown.

If prescribed · Cancel anytime · Available in 49 states (not California). Prices from the Mendoxa intake at try.mendoxa.co/f/ed on Oct 31, 2026. The intake always shows the current price.

FAQ

What common medications cause erectile dysfunction?

NIDDK lists antidepressants, blood pressure medicines, diuretics and several other medicine groups as possible contributors. ED is not listed as an adverse reaction on the ELIQUIS (apixaban) label, XARELTO (rivaroxaban) label or JANTOVEN (warfarin) label. Ask for a medication review rather than stopping treatment.

Can a man on blood thinners take Viagra?

It requires an individual prescribing decision. The Viagra (sildenafil) label reports no significant interaction with warfarin, but says safety is unknown in bleeding disorders and active peptic ulceration. It also contraindicates use with nitrates and requires attention to cardiovascular status.

Does Eliquis contribute to ED?

The ELIQUIS (apixaban) label does not list ED as an adverse reaction; its most common adverse reactions in adults are bleeding-related. That does not prove it cannot contribute to an individual’s symptoms. Record when ED began and discuss it with the prescriber; do not stop Eliquis without that conversation.

Can I safely use Viagra while taking Eliquis?

The Viagra (sildenafil) label does not name apixaban, so its warfarin and aspirin findings cannot establish the safety of Viagra with Eliquis. Tell the provider about your heart history, bleeding problems, stomach ulcers and every medicine you take; the label addresses these safety checks.

Is Viagra or Cialis a blood thinner?

No. The Viagra (sildenafil) label and Cialis (tadalafil) label identify them as PDE5 inhibitors for ED. Both labels discuss bleeding, but neither medicine replaces an anticoagulant or antiplatelet prescription.

Can I take Cialis with aspirin?

The Cialis (tadalafil) label reports that tadalafil 20 mg with aspirin did not prolong bleeding time relative to aspirin alone. This does not establish safety for someone with a bleeding disorder or active peptic ulcer; the label calls for a careful risk-benefit assessment and caution in those groups. Include aspirin on your medication list.

References

1. DailyMed: VIAGRA (sildenafil citrate) tablet, film coated, label revised 12/2017. Accessed Oct 31, 2026.
2. DailyMed: CIALIS (tadalafil) tablet, film coated, label revised 3/2026. Accessed Oct 31, 2026.
3. DailyMed: APOKYN (apomorphine hydrochloride) injection, label revised 6/2022. Accessed Oct 31, 2026.
4. FDA (Drugs@FDA): VIAGRA (sildenafil) prescribing information, NDA 020895. Accessed Oct 31, 2026.
5. FDA (Drugs@FDA): CIALIS (tadalafil) prescribing information, NDA 021368. Accessed Oct 31, 2026.
6. FDA: Compounding and the FDA, questions and answers. Accessed Oct 31, 2026.
7. DailyMed: ELIQUIS (apixaban) tablets label, E.R. Squibb & Sons. Accessed Oct 31, 2026.
8. DailyMed: XARELTO (rivaroxaban) label, Janssen. Accessed Oct 31, 2026.
9. DailyMed: JANTOVEN (warfarin sodium) tablets label, Upsher-Smith. Accessed Oct 31, 2026.
10. DailyMed: PLAVIX (clopidogrel) tablets label, Sanofi. Accessed Oct 31, 2026.
11. DailyMed: Bayer Chewable Aspirin Regimen 81 mg Drug Facts. Accessed Oct 31, 2026.
12. DailyMed: CAVERJECT (alprostadil) injection label. Accessed Oct 31, 2026.
13. NIDDK: symptoms and causes of ED. Accessed Oct 31, 2026.
14. Chen LW-H, Yin HL. A literature review of antithrombotic and anticoagulating agents on sexual function. Andrologia. 2017;49(10). PMID 28261826. Accessed Oct 31, 2026.
15. Mendoxa ED care (product, format, max 1 dose per 24 hours). Accessed Oct 31, 2026.
16. Mendoxa ED intake: plan prices (term_options). Accessed Oct 31, 2026.

Related guides

• Causes of ED
• Statins and ED
• Lisinopril and ED
• ED and blood pressure
• Viagra and the heart
• ED medication and nitrates
• Cialis and Viagra together
• ED shot (injections)
• Sildenafil + tadalafil in one tablet

Explore Mendoxa ED care

Compounded medication prescribed only if a licensed U.S. clinician decides it is appropriate. Not FDA-approved as a finished product. Not available in California. This site is not for emergencies. Call 911 if you need urgent care.