Key points
- Share medications and recent dose changes during negotiation, not only conditions
- Blood thinners mean easier bruising and longer bleeding
- Blood pressure medication can cause fainting, especially when standing up
- Insulin and some diabetes tablets can cause low blood sugar during intense scenes
- Alcohol and anything sedating dulls judgment, pain signals and breathing
In detail
- Blood thinners (such as warfarin, apixaban, clopidogrel or daily aspirin): bruises come faster and spread wider, cuts bleed longer. Go lighter with impact and leave out needles and cutting
- Antidepressants such as SSRIs: arousal and orgasm can take longer or not happen. That is a side effect, not a lack of attraction. Some also add to the bleeding risk of blood thinners
- Blood pressure medication: standing bondage, warm rooms and getting up fast can cause fainting. Beta blockers also hide a racing pulse, so watch face and breathing instead
- Erection medication (such as sildenafil) combined with poppers or nitrate heart medication can drop blood pressure dangerously. Never combine them
- Insulin and sulfonylureas: exertion lowers blood sugar. Eat beforehand, check levels before and after, and keep fast sugar within reach
- Stimulants, including ADHD medication, raise heart rate and body temperature and hide exhaustion. Take extra care with latex, hoods and heat
- Sedating substances (alcohol, cannabis, sleeping pills, benzodiazepines, opioids, some antihistamines) slow reactions and breathing and make consent unreliable. Combined, they strengthen each other
Warnings
- Never stop or change a prescribed medication on your own to make play easier; ask your doctor
- Sedating substances do not mix with breath play, gags or tight chest bondage
- Poppers combined with erection medication or nitrates can be life-threatening
- A new medication or dose is a reason to renegotiate, even with a long-term partner
Resources and next steps
- A pharmacist, who can check interactions confidentially
- Your doctor, who needs to know the physical demands, not every detail
- A poison control center for questions about combining substances