COMBINING erectile dysfunction (ED) medicines (such as Viagra, Levitra, and Cialis) with a common chest pain medication (nitrate) may increase the risk of death, according to a team of international researchers.
They added that these meds are often prescribed together, despite the combination of medicines not being recommended.
The researchers looked at Swedish national data including 55,777 men with heart issues who were treated with nitrates and 5,710 who received both nitrates and ED medication.
They found those prescribed both medications experienced a greater overall risk of death from any cause, and death from cardiovascular issues.
An accompanying editorial from the American College of Cardiology has stated these results, combined with previous studies that did not find a higher risk, indicate professionals should continue to consider the drug combination as ill-advised but discuss the risks with patients in cases where the combinations are required.
"Physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases," said A/Prof Daniel Peter Andersson at Karolinska Institutet in Stockholm and senior author of the study.
"While there is a positive association of ED medication for men with cardiovascular diseases (CVD), patients taking nitrates may experience an increased risk of negative health outcomes."
The results of the study indicate that the combined use of Phosphodiesterase type 5 inhibitors (PDE5i) treatment or ED medications with nitrates is associated with a higher risk for all health outcomes compared to those taking nitrates alone.
In those taking both PDE5i and nitrates, few events occurred 28 days after dispensing the PDE5is, with lower incidence rates than in subjects taking only nitrates, indicating that there is a low immediate risk for an event.
"Our over-arching goal is to underscore the need for careful patient-centred consideration before prescribing PDE5i medication to men receiving nitrate treatment," said Andersson.
"Furthermore, it justifies our efforts for continued research into the ambiguous effects of ED drugs on men with CVD." JG
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