Heart Disease & Sexual Health


Heart Disease & Sexual Health

Are ED drugs safe?
The safety of drugs for sexual dysfunction is an important question for cardiac patients because so many are affected with ED. After the launch of Viagra in 1998, reports of deaths associated with its use caused concern. Since then, research involving thousands of patients using all three currently available drugs of this class indicate that they are well-tolerated and safe for men with stable cardiovascular disease.

Side effects do occur with use of these drugs. The most common adverse reactions with all three are headache (7-22%), flushing (5-13%), and dyspepsia (1-11%). Vision disturbances, particularly changes in certain colors have been reported in some patients taking both Viagra and Levitra. The effect relates to the fact that these drugs also inhibit an enzyme in the eye. Cialis does not affect this enzyme. There have been sporadic reports of vision loss with these agents called nonarteritic anterior ischemic optic neuropathy (NAION). Whether the cause is truly due to use of ED drugs is not confirmed, but patients are now advised to stop the drug and contact their doctor for any sudden vision loss.

Some precautions necessary
All PDE5 inhibitors can modestly lower blood pressure. This effect is amplified by use of nitrates in any form with a potentially severe drop in blood pressure. Accordingly, short or long-acting nitrates (e.g., nitroglycerin, isosorbide) must not be combined with these drugs.

Many men with ED also have benign enlargement of the prostate gland or high blood pressure. Treatment can include alpha blockers such as doxazocin (Cardura) and terazocin (Hytrin), medications that can also potentiate the blood pressure lowering effect of ED drugs. This effect is not as pronounced as nitrates, but caution is advised when combining alpha blockers with PDE5 inhibitors.


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Last Modified Date: May 15, 2013

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