Viagra, myocardial infarction or sudden cardiac death

[Guest guest]

Hi Hugo & All,

 

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a699015.html says:

Sildenafil may cause side effects. Tell your doctor if any of these symptoms

are severe or do not go away:

 

* headache

* heartburn

* diarrhea

* flushing (feeling of warmth)

* nosebleeds

* difficulty falling asleep or staying asleep

* numbness, burning, or tingling in the arms, hands, feet, or legs

* muscle aches

* changes in color vision (seeing a blue tinge on objects or having

difficulty telling the difference between blue and green)

* sensitivity to light

 

Some side effects can be serious. If you experience any of the following

symptoms, call your doctor immediately:

 

* sudden severe loss of vision (see below for more information)

* blurred vision

* sudden decrease or loss of hearing

* ringing in ears

* erection that is painful or lasts longer than 4 hours

* dizziness or lightheadedness

* fainting

* chest pain

* worsening shortness of breath

* itching or burning during urination

* rash

 

Some patients experienced a sudden loss of some or all of their vision after

they took sildenafil or other medications that are similar to sildenafil. The

vision loss was permanent in some cases. It is not known if the vision loss

was caused by the medication. If you experience a sudden loss of vision

while you are taking sildenafil, call your doctor immediately. Do not take any

more doses of sildenafil or similar medications such as tadalafil (Cialis) or

vardenafil (Levitra) until you talk to your doctor.

 

There have been reports of heart attack, stroke, irregular heartbeat,

bleeding in the brain or lungs, high blood pressure, and sudden death in

men who took sildenafil for erectile dysfunction. Most, but not all, of these

people had heart problems before taking sildenafil. It is not known whether

these events were caused by sildenafil, sexual activity, heart disease, or a

combination of these and other causes.Talk to your doctor about the risks of

taking sildenafil.

 

Some patients experienced a sudden decrease or loss of hearing after they

took sildenafil or other medications that are similar to sildenafil. The hearing

loss usually involved only one ear and may not get better. It is not known if

the hearing loss was caused by the medication. If you experience a sudden

loss of hearing, sometimes with ringing in the ears or dizziness, while you

are taking sildenafil, call your doctor immediately. If you are taking

sildenafil

(Viagra) for erectile dysfunction, do not take any more doses of sildenafil

(Viagra) or similar medications such as tadalafil (Cialis) or vardenafil

(Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio)

for

PAH, do not stop taking your medication until you talk to your doctor.

 

Sildenafil may cause other side effects. Call your doctor if you have any

unusual problems while you are taking this medication.

 

If you experience a serious side effect, you or your doctor may send a report

to the Food and Drug Administration's (FDA) MedWatch Adverse Event

Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by

phone [1-800-332-1088].

 

However, one group says that viagra does NOT increase risk of myocardial

infarction or sudden cardiac death:

 

Konstantinos Kontaras; Varnavas Varnavas; Zenon S. Kyriakides (2008)

Does Sildenafil Cause Myocardial Infarction or Sudden Cardiac Death?

Am J Cardiovasc Drugs. 8(1):1-7. © 2008 Adis Data Information BV.

Sildenafil was the first oral compound to be approved for the treatment of

erectile dysfunction. In this paper, we review the current knowledge of the

effects of sildenafil on myocardial infarction and sudden cardiac death. The

first factor we examine is the sexual activity itself. As several studies have

shown, the relative risk for an acute coronary syndrome during intercourse

is not very high. Several studies examining the effects of sildenafil on

mortality have been published during recent years. The great majority of

these studies found that sildenafil is not an extra risk factor for an acute

coronary syndrome or sudden cardiac death. In 1997, the rate of

myocardial infarction in men 55-64 years of age was 1542 per 1 000 000 in

the US. According to this, the expected number of deaths as a result of

myocardial infarction in patients 55-64 years of age receiving sildenafil, in

the 24-hour period after use, from late March 1997 to mid November 1998,

should have been 52. Instead, the number of reported deaths were only 15.

One very optimistic finding was that sildenafil not only does not increase

mortality, but in fact 'preconditions' the heart and has a cardioprotective

effect. Besides, many studies have shown that sildenafil does not reduce

the exercise tolerance in men with known coronary artery disease. As far as

BP is concerned, the differences before and after the use of sildenafil are

not clinically significant. The only contraindications for sildenafil are co-

administration with a-adrenoceptor antagonists or with nitric oxide donors.

According to the most recent studies, isoform 5 of phosphodiesterase has

also been detected in the myocardium and controls the soluble pool of 3',

5'-cyclic guanosine monophosphate (cGMP). Sildenafil is very specific for

cGMP but it may increase cyclic adenosine monophosphate in the

myocardium indirectly. This does not occur with small therapeutic doses of

the drug. There is some dispute regarding the association of sildenafil with

arrhythmias, where the available evidence is not clear. However, there are

suspicions that sildenafil may cause sympathetic activation. The overall

conclusion is that sildenafil is a safe drug and that its appropriate use does

not seem to increase the risk for myocardial infarction or sudden cardiac

death.

 

Best regards,