Viagra is the world’s most popular drug for treating erectile dysfunction (ED). Its active ingredient, sildenafil, is a potent phosphodiesterase type 5 (PDE5) inhibitor. Valsartan is an angiotensin II receptor antagonist (ARA) used to treat hypertension. In this article, we compare the efficacy and safety of these two drugs when administered together.
Erectile Dysfunction (ED)
Erectile dysfunction can be defined as the inability to achieve or maintain an erection that is sufficient for satisfactory sexual activity. It is a condition that affects both men and women. According to a recent estimate, 12.1% of men aged 40-70 have experienced some degree of ED. The stigma that surrounds this condition is often underestimated. A recent study found that 36% of men with diabetes and/or heart disease feared that their sexual performance would be negatively affected by the medications they took for these conditions. Only 14% of men with no risk factors for heart disease or diabetes were afraid of experiencing adverse effects on their sex life due to medication use. Fear of sexual performance decreases desire and willingness to engage in sexual activity which leads to a vicious cycle, further perpetuating the problem. Finally, 15% of men with ED report that their condition negatively affects their quality of life.
The most common cause of ED is venous leakage which interrupts blood flow to the penis. This results in a condition known as “hypoactive sexual desire disorder” in men or “sexual dysfunction” in women. Stress is another common cause of ED in men. If you are anxious or nervous, you are less likely to achieve sexual arousal. Your doctor may advise you to try an antidepressant drug or a beta blocker for this condition. In severe cases, you may need a penile implant or a vacuum pump to restore adequate blood flow to the penis. These devices are not curative, but they can greatly improve your quality of life by enabling you to resume an intimate relationship with your partner.
Hypertension
Hypertension can be defined as a condition in which blood pressure is consistently high. According to the American Heart Association, almost 73.6 million American adults currently have hypertension. This is a nearly 25% increase from a recently revised estimate. Hypertension is a major risk factor for heart disease and stroke. It is also responsible for about 16% of all cancer deaths. For years, hypertension has been considered “the silent killer.” Because it is so frequently undiagnosed, many patients are not taking the medications they need to control their blood pressure. Untreated or poorly treated hypertension can lead to serious complications including heart disease and stroke. Fortunately, there are several effective treatments available. Your doctor may recommend one of these drugs — especially if your blood pressure remains above 140/90 despite treatment with two or more anti-hypertensive medications. Examples of these medications include valsartan and amlodipine.
Combination Therapy
In some instances, your doctor may advise you to try a combination of two or more medications to treat a particular condition. This is the case for men with both hypertension and ED. In such instances, your doctor may recommend that you try valsartan and sildenafil, or valsartan and amlodipine. The combination of valsartan and sildenafil is known as “compassionate use” and can be prescribed to eligible patients at the same time. Your doctor must initiate the process by writing a “compassionate use” prescription for you. Then, either you or your partner (if you are taking medication orally) must visit a local pharmacy to obtain the medication.
Valsartan
Valsartan is an angiotensin II receptor antagonist (ARA) that is used to treat hypertension. It works by blocking the action of angiotensin II on a specific receptor located in the blood vessels. This reduces blood pressure and improves blood flow throughout the body. It is also safe to use in combination with other blood pressure medications. In fact, valsartan has been shown to be more effective when used in combination with other blood pressure medications, particularly amlodipine. The vasodilatory effects of valsartan may also help to treat ED. This is because sildenafil, which is a component of Viagra, increases blood flow to the penis, resulting in an erection. Your doctor may suggest valsartan for the treatment of ED in men with hypertension. It is also an acceptable substitute for yohimbine, which was the previous medication of choice for ED. Yohimbine is a less preferred treatment because it frequently results in “flushing” in some patients. However, valsartan is much less likely to cause “flushing” than yohimbine. In a double-blind study of men with ED and hypertension, valsartan, at a dose of 40 mg, was nearly as effective as 50 mg of yohimbine in increasing sexual desire. In this same trial, both medications increased blood flow to the penis, as measured with penile plethysmography. When taken orally and measured against an active placebo, valsartan and amlodipine demonstrated superior efficacy in a double-blind trial. Further studies are needed to confirm these findings, however, it appears that valsartan and amlodipine, when used in combination, may be a very effective treatment for ED in men with hypertension.
Sildenafil
Sildenafil is a vasodilator, which means that it widens blood vessels. It is a potent inhibitor of phosphodiesterase type 5 (PDE5), an enzyme that breaks down cGMP inside the smooth muscle cells of blood vessels. This results in greater vasodilation and, ultimately, improved blood flow throughout the body. Sildenafil is used to treat “impotence” in men. In particular, it is the primary medication used to treat erectile dysfunction (ED). Sildenafil, at a dose of 50 mg, was shown to be superior to placebo in a 12-week trial of men with ED. In addition, patients taking 50 mg of sildenafil demonstrated greater sexual desire and increased responsiveness as measured with stop-watch timing. When compared to placebo, sildenafil produced a significant improvement in all three parameters of sexual performance (erectile function, sexual desire, and intercourse capacity). It was also well-tolerated with minimal side effects, especially at the high dose of 100 mg. It is estimated that 1 in 10 men have ED. This means that approximately 100 million men worldwide are currently taking sildenafil to treat their condition. It is the most popular medication for ED and remains one of the most effective medications available. However, it is important to note that sildenafil has many drug interactions, which your doctor must consider before prescribing it to a patient.
Drug Interactions
Like many other medications, sildenafil is prone to drug interactions. Therefore, your doctor must be mindful of any medications you are already taking, as well as those you plan to try. While some drug interactions result in beneficial effects, others result in dangerous effects. It is imperative that your doctor is aware of any interactions you are likely to experience so that they can properly warn you and/or adjust your medication schedule if necessary. Some of the most common sildenafil interactions are listed below.