PakMediNet Discussion Forum : Medical Education inside Pakistan : Viagra and the similar drugs
Viagra and the similar drugs
Salam wa alikom,
Viagra and the similar drugs are contraindicated in the patients of ischaemic heart disease. Are they absolutely contraindicated or can be prescribed with some modifications of the drugs, related to the cardiac disorder, already taken by the patient?
I request a physician to kindly answer.
Posted by: zain Posts: 35 :: 17-02-2008 :: | Reply to this Message
Re: Viagra and the similar drugs
Be aware that if you take any nitrate drug such as nitrate medication for heart disease, nitroglycerine for angina, or other nitrates, you should not use erection drugs such as Viagra, Levitra or Cialis. The combination of Viagra and nitrate drugs can cause a precipitous drop in blood pressure and possibly death. Before this problem was identified, the combination of Viagra and nitrate medication has killed hundreds of men.
Viagra, Levitra, and Cialis have increases tendency for blood to clot, so they are associated with the increased risk of heart attack and stroke etc. Therefore it is better for such patients to avoid these drugs because of having tendency for blood to clot and hypotension and both (blood clotting and hypotension) worsen cardiac ischemia leading to lethal outcomes.
Yohimbine drugs do not have such problems. The vast majority of men taking nitrate drugs can use Yohimbine safely and the incidence of cardiological events or deaths from using Yohimbine in conjunction with nitrate drugs is extremely rare. But still the cardiac patients are strictly advised to take opinion of their physician before using Yohimbine or other safer drugs.
Posted by: imtiazk Posts: 56 :: 27-02-2008 :: | Reply to this Message
Re: Viagra and the similar drugs
Best is look for such issues in places like www.pubmed.gov for hard data and guidance . Other good medical websites on such issue is www.medscape.com.
Without alluding to such guidelines , a practical way is to exclude active Ischemic heart disease or document its load/severity via ETT . Watching not just ST depression but exercise time , reason for termination , arrythmias etc . You can also assess social factors of marriage .
Overall Keep drugs dosages low and with good warning those with high likelihood of active ischemia need to be sent to good cardiologist for a second opinion.
In PPH we give Viagra TDS regularly and visual problems have been reported .
It seems that those with inactive IHD will not refrain from Viagra and you should be approving of it and those with active need specialist tests and consultation .
This post needs improvement .
Posted by: intruder1 Posts: 6 :: 01-04-2008 :: | Reply to this Message