Taking Viagra in combination with common chest pain medications could be deadly, a study warns.
Nitrate drugs work by causing blood vessels to dilate, allowing more oxygen and nutrients to reach the heart, and are prescribed to people suffering from chest pain — in men that is normally those aged 42 years and over.
Doctors have advised against taking nitrates like Nitrostat and erectile dysfunction drugs — which also work by causing blood vessels to dilate — for decades due to fears they may cause a sudden drop in blood pressure that risks a fatal heart attack.
And now Swedish researchers has found evidence backing up the claim, after analyzing data on 61,000 men hospitalized after suffering from a heart attack.
Men are warned against taking Viagra and nitrates like Nitrostat close together. Doctors say this could cause a sudden drop in blood pressure risking a heart attack (stock image)
Doctors advise patients wait at least 24 hours after taking viagra before taking nitrate medications like Nitrostat (right), and vice versa
Doctors said those who were prescribed both drugs overall had a higher risk of any complication, including death.
The complications could be recorded up to 28 days after Viagra was prescribed to patients already receiving nitrates.
Doctors have previously advised patients on nitrates should wait at least 24 hours before taking Viagra, and vice versa.
In an editorial accompanying the study, the researchers said it was ‘reasonably safe’ to take Viagra 24 hours after using nitrates among patients 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 Viagra use was ‘ill-advised’ and ‘not recommended’.
Viagra and nitrate medications work by causing blood vessels to dilate, or expand, allowing for a surge in the blood supply to the penis — causing an erection — or the heart — boosting the supply of oxygen to the organ to help ease pain.
But — if the medications are taken close together — doctors say they can cause blood vessels to dilate too much, triggering a sudden dip in blood pressure.
This also cuts the supply of oxygen and vital nutrients to the heart, which raises the risk of suffering a heart attack.
About 4million men in the United States take Viagra every year, data suggests, while about 5.5million use nitrates to treat chest pain.
Doctors say men should take Viagra about an hour before sexual intercourse, and only take the drug about once per day.
For the study, Swedish researchers used database the Swedish Patient Register — which holds medical information on almost everyone in the country.
They searched for men who had suffered a heart attack — myocardial infarction or percutaneous coronary intervention — and received at least two nitrate prescriptions within six months.
Patients were also checked for whether they had received a prescription for Phosphodiesterase type 5 inhibitors (PDE5i) — or Viagra, Levitra and others.
Results showed 55,777 of the men in the group had received a prescription for nitrates while 5,710 had received a prescription for both.
Scientists said their analysis showed men who had received both drugs had a higher risk for all health outcomes — including death — compared to those who took nitrates alone.
They also discovered that this risk was not immediate, with health events occurring as late as 28 days after receiving the medication.
Professor Daniel Peter Andersson, a medical experet at the Karolinska Institutet in Stockholm, said: ‘Physicians are seeing an increase of requests for erectile dysfunction (ED) drugs from men with cardiovascular diseases (CVD).
‘While there is a positive association of ED medication for men with CVD, patients taking nitrates may experience an increased risk of negative health outcomes.’
He added: ‘Our goal is to underscore the need for careful patient-centred consideration before prescribing PDE5i medication to men receiving nitrate treatment.
‘Furthermore, it justifies our efforts for continued research into the ambiguous effects of ED drugs on men with CVD.’
Limitations of the study included they were not certain when men prescribed both medications had taken the drugs.
About 18million Americans have heart disease, which puts them at higher risk of 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.
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