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WARNING FOR VIAGRA USE BY PATIENTS ON NITRATES

VIAGRA tm (sildenafil) has received widespread publicity and use for the treatment of inpotence. This drug is very effective but in many cases is being used without consideration for its potential hazards. Sildenefil is a potent phosphodiesterase E5 inhibitor which potentates the effect of nitric oxide. PDE5 is highly expressed in the penile vasculature and affects vasodilation of the penile vasculature.

There have been numerous reports of death in patients using nitrates such as nitroglycerine while taking sildenafil. This is due to venous pooling leading to severe hypotension. Cardiologists should inform their patients of the danger of using sildenafil while taking any form of nitrate containing medication, most notably nitroglycerine. Other side effects include temporary headaches, flushing, nasal congestion, nausea and interference in blue-green discrimination.

The subject of impotence can be reviewed in detail on the web site below.

Urology for Medical Students Student Author: Jason Wallen, Med Class of '01 Supervisor: Dr. Doug Ackman, Department of Urology, Montreal General Hospital