If you are taking medication for erectile dysfunction as well as treatment for angina, be careful. Indeed, researchers from the Karolinska Institute in Stockholm, Sweden found that “the co-prescription of powerful medications such as Viagra and the organic nitrates for angina is associated with an increased risk of death of 35% to 40% and a approximately 70% higher risk of heart attack and heart failure”. Their results are published in the Journal of the American College of Cardiology.
Erectile dysfunction and angina: these two drugs should not be taken in parallel, according to researchers
Starting point for this research, a remark shared by Daniel Peter Andersson, professor at Karolinska University Hospital in Stockholm (Sweden) in a press release: “Doctors are seeing an increase in requests for erectile dysfunction medications from men suffering from cardiovascular disease.”
However, this mixture is not without health risks, as the specialist points out. “Although this is associated with lower mortality compared to no treatment after myocardial infarction, patients who take nitrate medications may be at increased risk of negative health effects”.
Thus, as the researchers point out, erectile dysfunction medicationscomposed of phosphodiesterase type 5 inhibitors (PDE5i), such as Viagra or Avanafil, are contraindicateds in case of treatment against angina, if the medicine has organic nitrates. Indeed, “the two types of drugs mutually reinforce their antihypertensive effect”. Their common catch “may cause serious side effects or death if taken together.”
Treatment for erectile dysfunction and angina: it is recommended to consult a doctor to adapt the treatment
The researchers wanted to determine the real risk of prescribing these two treatments simultaneously. They therefore based themselves on Swedish health records from the period 2005 to 2013. In total, 61,500 men were prescribed organic nitrates, of whom 5,710 consumed nitrates and phosphodiesterase type 5 inhibitors in parallel ( treatments for erectile dysfunction). Participants had also received two prescriptions for nitrates, sublingual nitroglycerin or oral nitrates, within six months.
Taking into account different factors such as age, the researchers noted that “co-prescription of potent drugs with phosphodiesterase type 5 inhibitors and organic nitrates is associated with a risk of death increased by 35 to 40%”. The researchers add that there is a “an approximately 70% increased risk of heart attack and heart failure”.
However, the researchers recognize several shortcomings in their research methodology, including not knowing the frequency of treatment use, as well as their context.
Interviewed by CNN, Dr. Howard Herrmann, John W. Bryfogle Professor of Cardiovascular Disease at the University of Pennsylvania with CNN says it is “very surprised by the high frequency (9%) of patients who were prescribed both drugs” and calls has new research. Furthermore, he recommends that patients consult their doctor in order to prevent any risk of adverse events.
What the Vidal site confirms: “all PDE5 inhibitors (Viagra, Cialis…, Editor’s note) cause direct coronary vasodilation and potentiate the hypotensive effects of other nitrate derivatives, including those used to treat coronary artery disease. Use Concomitant use of nitrates and PED5 inhibitors may be dangerous and should be avoided. Patients who use nitrates only occasionally (eg, for rare episodes of angina) should discuss the risks, choice and appropriate timing of the possible use of a PDE5 inhibitor with a cardiologist.”
Sources:
- Risk of Death in Patients With Coronary Artery Disease Taking Nitrates and Phosphodiesterase-5 Inhibitors – Journal of the American College of Cardiology
- Researchers urge caution in co-prescribing potency drugs and nitrates – the Karolinska Institute in Stockholm
- Taking both erectile dysfunction and chest pain drugs linked with early death risk, study finds – CNN (01/15/2024)
- Erectile dysfunction, Vidal