Popular erection pills such as Viagra and Cialis have been linked to more than 200 deaths in Britain, MailOnline can reveal.
None of the deaths – all of which have occurred since 1998 – were caused directly by drugs.
But Britain’s drugs watchdog is aware of the link.
However, experts insist the pills are safe and many incidents could actually reflect sex-related deaths among men with heart problems.
Men can buy sildenafil, the main ingredient in Viagra, and other impotence pills over the counter for as little as £15 and tablets available online for as little as £1.30 per pill.
Any reported suspected side effects are recorded under the Medicines and Healthcare products Regulatory Agency’s (MHRA) ‘Yellow Card’ scheme.
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Authorities use the same database, created following the thalidomide scandal in the 1960s, to track the safety of Covid vaccines.
Although it is impossible to prove, it allows doctors, pharmacists and patients to report side effects suspected of being caused by medicines used in Britain.
This may lead to their revision, the addition of warnings to labels, or their complete removal from the market.
MailOnline found 2,441 reports for sildenafil, tadalafil (Cialis brand), vardenafil (Levitra), and avanafil (Spedra) in the MHRA database.
Of these, 1,600 were due to serious reactions, but only sildenafil and tadalafil recorded deaths (205 total).
Most reported deaths were linked to incidents involving the heart or brain
Forty-five deaths have been reported in women, even though they do not experience the same sexual arousal benefits as men when taking these medications.
Such medications also, less well known, treat pulmonary hypertension, a type of high blood pressure in the arteries that supply blood to the lungs.
The same mechanism by which the drugs increase blood flow to the penis also relaxes blood vessels in the chest to treat pulmonary hypertension, hence why some women and children might take them.
Overall, people in their 60s accounted for the largest number of reported deaths (66), almost a third of the total.
For deaths with a declared cause, the majority were linked to disorders of the arteries which supply blood to the heart, with 50 deaths.
Most of them (31) were specifically linked to heart attacks.
Another large category of reported deaths was from nervous system disorders, with 18 deaths.
The majority of them were linked to brain hemorrhages – bleeding caused by ruptured blood vessels in the brain that can trigger strokes, a known rare potential side effect of the drugs.
Mental health problems have also been reported in connection with the medications, including five cases of suicide.
Other less serious side effects have also been reported.
A total of 57 Britons reported experiencing diarrhea after taking the drugs. Eight others reported an unusual level of flatulence.
Sildenafil, the main ingredient in Viagra, is used to treat both impotence and pulmonary hypertension. Pictured here is the Viagra brand version
Cialis, whose active ingredient is tadalafil, is another popular erectile dysfunction medication in the UK.
Four reported hallucinations, including one in an unusual state of euphoria.
Some (37) have ironically reported having increased, spontaneous or painful erections as an unwanted side effect.
These are most likely people who are taking medications for reasons unrelated to impotence and for whom the other purpose of the medications may have come as a surprise.
However, some Brits have found the opposite effect, with more than a dozen reports that taking the pills decreased their libido, or ability to get erections.
Millions of British men are now taking medication to combat impotence.
The latest data supported by the NHS shows that 22 million prescriptions for these drugs were issued by GPs in England between 2019 and 2023, at a cost of £91 million.
This data does not cover over-the-counter purchases, with many high street pharmacies as well as online stores now selling their own branded versions.
Doctors already know that these drugs are dangerous in certain circumstances. For example, Brits with known heart problems are advised to avoid taking it.
Even leaflets distributed with sildenafil acknowledge cases of sudden death in men who have taken the drug, although they insist that such cases are rare and mainly affect men with heart problems.
“It is not possible to determine whether these events were directly related to sildenafil,” he also adds.
However, as many Brits are unfamiliar with the ‘Yellow Card’ system, other side effects linked to impotence medications may have been overlooked.
Professor Amr Raheem, consultant andrologist at Adam Health, a specialist men’s health company, said it was essential to remember the context in which people used impotence drugs when looking at data from the MHRA.
“It is imperative to understand that sexual activity, like any form of physical exertion, carries a risk of cardiac events, particularly in people with pre-existing cardiovascular disease,” he said.
“The main issue is therefore the risk of cardiac events during the physical activity involved in sexual intercourse, rather than the direct effect of the erectile dysfunction drug.”
He added that while no drug is 100 percent safe, drugs like sildenafil and tadalafil have very good results.
“Millions of men have benefited from these medications, which have undergone extensive testing and research, confirming their safety and effectiveness,” he said.
But Professor Raheem added that, given the nuances in how these medicines can interact with other conditions, supervision by a qualified healthcare professional before taking the medicine was essential.
Millions of British men are now taking medication to combat impotence. The latest data supported by the NHS shows that 22 million such prescriptions for these drugs were issued by GPs in England between 2019 and 2023 at a cost of £91 million (stock image)
“This is particularly relevant now that Viagra and Cialis can be obtained without a prescription in the UK,” he said.
An MHRA spokesperson said: “Sildenafil and tadalafil have been used for many years to treat erectile dysfunction without any serious safety concerns.
“Known side effects related to their use are listed in the information provided to healthcare professionals and patients.
“This information also contains guidance about which patients cannot take these medications safely and about other medications and medical conditions that increase the risk of side effects.”
The spokesperson added that they continually review the safety of all medications, including sildenafil and tadalafil, including Yellow Card reports.
They added: “The nature of yellow card reporting means that reported events are not always proven side effects and some events may have happened anyway. »
Every drug must undergo safety testing before being made available to the public.
But there is an inevitable risk that rare reactions or interactions with other diseases and conditions may have gone unnoticed.
Systems such as the MHRA’s Yellow Card reporting allow experts to track potential side effects through active monitoring, although some MPs are concerned the system is not proactive enough.
Such reports cannot prove that the product in question is to blame.
For example, a heart attack recorded in a patient taking an impotence medication may simply be a coincidence and have nothing to do with the medication.
Adverse effects related to impotence medications have already been reported in the medical literature.
MailOnline reported last month how a Brazilian man suffered an unprecedented reaction which saw him develop pustules all over his body after taking tadalafil, sold as Cialis in the UK.
Other reports have linked taking sildenafil to eye problems, including vision loss.
No medication is without risk and erectile dysfunction pills are no exception.
The NHS says that around one in 100 people will experience common side effects from taking sildenafil, the UK’s most prescribed erectile dysfunction drug.
These include headache, nausea, flushing, indigestion, stuffy nose and dizziness, according to the NHS.
The health service warns that people who take the pills for long periods, for example for pulmonary hypertension, are more likely to suffer from them than those who take the pills for erectile dysfunction.
More serious side effects requiring urgent medical attention are estimated to affect fewer than 1 in 1,000 people.
These include seizures, a prolonged and potentially painful erection, especially lasting more than two hours, chest pain, and, in very rare cases, a life-threatening allergic reaction to the drug called anaphylaxis.