Why does Combining Viagra together with nitrates cause a catastrophic drop in blood pressure?
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Sexual activity plays a crucial role in the psychological health and quality of life scores in patients with cardiovascular disease. Unfortunately, intimacy is frequently an issue in patient with cardiovascular disease. The causes of sexual dysfunction following myocardial infarction are multiple and include anxiety, depression, medication effect and vascular insufficiency. Regardless of the cause, the results can be devastating to relationships and the psyche. Show There are three phosphodiesterase-5 inhibitors currently available in the United States: sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). For simplicity and because of its name recognition, I will use the trade name Viagra to represent all phosphodiesterase-5 (PDE5) inhibitors even if the studies were completed using one of the other drugs. I do not endorse Viagra above any of the others. Viagra has been shown to be effective in the treatment of erectile dysfunction. Viagra works by increasing the amount of nitric oxide available which enhances erectile function. So can I take Viagra with my heart medications? Viagra has been shown to be safe in stable cardiovascular diseases including heart failure, hypertension, and coronary artery disease. Although many have looked, there has been no clear evidence that Viagra is associated with increased rate of heart attacks or cardiovascular events. When Viagra is combined with most blood pressure medicines, there is a small but real additive effect but no change in cardiovascular events. However, when Viagra is combined with doxazosin and tamsulosin, two alpha-blocking medications often used to treat BPH (benign prostate hypertrophy) some patients develop low blood pressures. It is recommended that if these prostate medications are required, the smallest doses of each respective medication should be used. Patients already receiving Viagra and other PDE5 inhibitors for pulmonary hypertension should not receive a second PDE5 for the treatment of erectile dysfunction. On the whole, Viagra can be considered safe with almost all of your cardiac medications. Unfortunately, the combination of Viagra with nitrates should never be considered safe. Together they can cause life threatening hypotension, also known as low blood pressure. Nitrates should not be taken within 24 hours of sildenafil or vardenafil and within 48 hours of tadalafil. I have included a short list of commonly prescribed nitrates to help you avoid them.
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Health August 10, 1998 / 7:57 PM / CBS Since it was approved in April, 39 patients who used Viagra have died, reports CBS News Correspondent John Roberts. Six of the men died after taking the drug in conjunction with nitroglycerin or nitrates - common drugs for treating chest pains and heart attacks. In their recommendations Monday, the American College of Cardiology and the American Heart Association warned emergency physicians not to give nitrates to patients within 24 hours of taking Viagra. Cardiologist Ezra Deutsch says the Viagra phenomenon adds another unknown into life and death decision making. "It means we have to ask yet another question in terms of medical history to determine whether these patients have taken a medication like Viagra in the last 24 hours," he said. The recommendations also caution against using Viagra in other patients, such as those with poor blood flow to the heart, congestive heart failure, and patients taking multiple drugs to control high blood pressure. Currently, the only U.S. warnings against using viagra are for patients taking nitrate medication. However, when it is approved for use in Europe, Viagra is expected to carry far more comprehensive warnings, including those for patients with certain types of cardiovascular disease. "They are being more circumspect and a little more cautious based on the rash of events that happened once the drug was approved in the U.S.," said Dr. Deutsch Pfizer, the company that makes Viagra, said it welcomes the warnings to doctors about nitrates. However, the company says it has no plans to strengthen U.S. labels to reflect any other concerns. Reported by John Roberts Thanks for reading CBS NEWS. Create
your free account or log in Please enter email address to continue Please enter valid email address to continue What happens if you take Viagra with nitrates?Long Story Short: Viagra and Nitrates Don't Mix
Used together, these drugs could cause a severe, potentially fatal drop in your blood pressure. Other antihypertensive drugs, such as alpha-blockers and riociguat, can also potentially cause health issues when used with Viagra and other ED medications.
Why is sildenafil contraindicated with nitrates?Sildenafil citrate is contraindicated in patients who may require organic nitrates, such as nitroglycerin patches or sublingual tablets, because the combination may lower blood pressure. Recently, there were 16 reported cases in which a fatal outcome was encountered with the concomitant use of sildenafil citrate.
How does Viagra affect low blood pressure?— -- Question: How do drugs such as Viagra affect blood pressure? Answer: A drug such as Viagra, which is a drug that enhances nitric oxide, and nitric oxide is a vasodilator -- and that means that it can lower blood pressure.
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