Taking Viagra in combination with common chest pain medications could be deadly, study warns.
Nitrate medications work by causing blood vessels to dilate, allowing more oxygen and nutrients to reach the heart, and are prescribed for people suffering from chest pain, in men who are typically 42 years or older.
Doctors have advised against the use of nitrates such as Nitrostat and erectile dysfunction drugs (which also work by causing blood vessels to dilate) for decades out of fear that they could cause a sudden drop in blood pressure that could lead to a fatal heart attack. .
And now Swedish researchers have found evidence to support this claim, after analyzing data from 61,000 men hospitalized after suffering a heart attack.
Men are warned not to take Viagra and nitrates such as Nitrostat together. Doctors say this could cause a sudden drop in blood pressure, putting you at risk of a heart attack (file image)
Doctors advise patients to wait at least 24 hours after taking Viagra before taking nitrate medications such as Nitrostat (right) and vice versa.
Doctors said those prescribed both drugs generally had a higher risk of any complications, including death.
Complications could be recorded up to 28 days after the prescription of Viagra to patients who were already receiving nitrates.
Doctors have previously advised patients taking nitrates to wait at least 24 hours before taking Viagra, and vice versa.
In an editorial accompanying the study, researchers said it was “reasonably safe” for patients to take Viagra 24 hours after using nitrates. who had ischemic heart disease (a heart problem caused by narrowed arteries), mild angina, and the ability to exercise reasonably well.
But for those who needed to take nitrates regularly, they said the use of Viagra was “inadvisable” and “not recommended.”
Viagra and nitrate medications work by causing blood vessels to dilate or expand, allowing an increase in blood supply to the penis (causing an erection) or to the heart, increasing oxygen supply to the organ to help ease the pain.
But if the drugs are taken together, doctors say they can cause blood vessels to dilate too much, causing a sudden drop in blood pressure.
This also cuts off the supply of oxygen and vital nutrients to the heart, increasing the risk of having a heart attack.
Data suggests that about 4 million men in the United States take Viagra each year, while about 5.5 million use nitrates to treat chest pain.
Doctors say that men should take Viagra about an hour before having sex and only take the medication once a day.
For the study, Swedish researchers used the database the Swedish Patient Registry, which contains medical information on almost everyone in the country.
They looked for men who had had a heart attack (myocardial infarction or percutaneous coronary intervention) and received at least two nitrate prescriptions in six months.
It was also checked whether patients had received a prescription for phosphodiesterase type 5 inhibitors (PDE5i), or Viagra, Levitra and others.
The results showed that 55,777 of the men in the group had received a prescription for nitrates, while 5,710 had received a prescription for both.
The scientists said their analysis showed that men who had received both drugs were at higher risk of all health outcomes, including death, compared to those who took nitrates alone.
They also found that this risk was not immediate, as health problems occurred up to 28 days after receiving the drug.
Professor Daniel Peter Andersson, medical expert at the Karolinska Institutet in Stockholm, said: “Doctors are seeing an increase in requests for erectile dysfunction (ED) drugs from men with cardiovascular diseases (CVD).
“While there is a positive association between ED medications in men with CVD, patients taking nitrates may experience an increased risk of negative health outcomes.”
He added: “Our aim is to highlight the need for careful patient-centred consideration before prescribing iPDE5 medications to men receiving nitrate treatment.”
“Furthermore, it justifies our efforts to continue research on the ambiguous effects of ED medications in men with CVD.”
Limitations of the study included that they were not sure when the men who were prescribed both medications had taken them.
About 18 million Americans have heart disease, putting them at higher risk for chest pain and erectile dysfunction.
Causes of the condition include diabetes, obesity, high blood pressure, and excessive use of alcohol or caffeine.
The study was published in the Journal of the American College of Cardiology.