Heart disease is the No. 1 killer in the world, accounting for around 30% of all global deaths.1 Heart disease is also the leading cause of disability worldwide, with around 16% of the world’s population (684 million people) currently living with the condition.2 Heart disease doesn’t just affect the quality of people’s lives; it also puts a huge financial strain on healthcare systems.3
There are multiple risk factors associated with heart disease, and the only way to prevent it is to reduce the number of unhealthy lifestyle habits that contribute to the condition. One of the most popular ways of doing this is through medication.
Statins are a type of medication that has been shown in clinical trials to reduce the risk of heart disease by up to 33%.4 They are also one of the most commonly prescribed medications worldwide.5 This article will examine the effects of combining statins with a commonly used erectile dysfunction (ED) medication, sildenafil (Viagra) and whether or not this is a dangerous combination.
The Risks Of Combining Statins With Viagra
It’s well-established that individual statins have beneficial effects on the human heart. As previously mentioned, statins have been shown in clinical trials to reduce the risk of heart disease by up to 33% and, in some cases, this reduction in risk has been seen even in people who are not yet diagnosed with heart disease.6
However, there are also significant risks associated with taking statins. Statins can cause myopathy (muscle pain) in up to 5% of cases,7 liver damage in around 2% of cases,8 diabetes in 1% of cases,9 and rhabdomyolysis (a severe form of muscle damage) in 1% of cases.10 These are serious side effects that can lead to acute kidney injury, liver dysfunction, and even death.11,12
In light of this, it’s important to keep in mind the risks of combining statins with Viagra. Sildenafil (Viagra) is a medication commonly used to treat erectile dysfunction. It is a PDE-5 inhibitor and, as the name suggests, works by increasing the blood flow to the penis (and the surrounding areas), allowing for more intense erections. 13
PDE-5 inhibitors are contraindicated with statins due to the increased risk of rhabdomyolysis resulting from their combination.13,14 This risk is increased even more significantly in people with prior kidney disease or dysfunction.15,16 Similarly, people with diabetes are also highly likely to experience serious complications from combining these medications due to the likelihood of developing kidney disease or dysfunction.17
Is There A ‘Good’ Combination?
While statins and Viagra are not a good combination, there is occasionally a case where they can be used beneficially. In rare cases, people who are unable to get sufficient amounts of cholesterol from their diet can benefit from statins, while those who have already developed heart disease can use Viagra as a treatment for their condition.
There have been various case reports documenting the successful use of statins in combination with either sildenafil or tadalafil (Cialis), another PDE-5 inhibitor.18-20 In all cases, the combination had a positive effect, with the person’s cholesterol levels decreasing significantly while also experiencing an improvement in erectile function.18-20 However, there is one major caveat associated with these case reports: none of the people in these studies had previously taken statins, meaning that the benefits of the drug were likely due to the fact that it was not yet known that this patient had high cholesterol in the first place.
In light of this, it is best to avoid combining statins with sildenafil or tadalafil (Cialis), as well as any other PDE-5 inhibitor, if you are already taking this medication. The risk of suffering from serious side effects substantially outweighs the benefits in most cases, with some people experiencing myopathy (muscle pain) or liver damage from the combination.21,22
Is It Possible To Reverse The Effects Of Combining Statins With Viagra?
While there is no evidence that combining statins with Viagra can be reversed, it is possible to significantly reduce the risks by regularly taking statins and ensuring that you follow the recommended dosage and duration (see below for more information).
There are also various approaches that one could take to reduce the risk of developing myopathy (muscle pain) as a result of taking statins and Viagra. First, it is advisable to take the medication at different times of the day to reduce the risk of accumulating toxic substances in the body. Second, people with myopathy should avoid taking strong painkillers (such as codeine) or alcohol while on the medication, as this can further increase the risk of side effects. Third, people with myopathy should avoid exercise during the time that they are taking the medication, as this can further increase the risk of side effects.23 Finally, patients should regularly test for liver and kidney function, as deficiencies in these systems can significantly increase the risk of experiencing adverse drug reactions from statins and Viagra. In summary, taking statins with Viagra is not recommended due to the significant risks involved, but under certain circumstances, the two medications can be used beneficially together. If you are already taking these medications and decide to continue, it is advised that you consult with a physician or specialist to determine the proper dosage and duration of treatment.24-26
Risks Vs. Benefits Of Combining Statins With Other Medications
The risks and benefits of combining statins with other medications must be considered on a case-by-case basis. It is highly recommended that people with hypertension (high blood pressure) try and avoid combining statins with thiazide diuretics (water pills) as this can significantly increase the risk of rhabdomyolysis (severe muscle damage).27 Likewise, combining statins with aspirin can also increase the risk of rhabdomyolysis, especially in people with a history of kidney disease.28 In these cases, discussing the risks and benefits of combining the two medications with a physician is highly advised.29
There are also various other medications that are contraindicated with statins, including digoxin (Lanoxin), and various immunosuppressants (such as cyclosporine and tacrolimus).30-32 However, the benefits of statins in lowering cholesterol often outweigh the risks associated with combining the two medications in these cases, so treatment is typically not withheld.33
This is not to suggest that people with heart disease should automatically be prescribed statins – it is always best to first try and avoid medications as much as possible in people with heart disease. However, in rare cases where this is not possible, statins can be a highly effective and simple way of lowering cholesterol, with or without sexual dysfunction.34-36
Recommended Dosage And Duration Of Treatment
As previously mentioned, statins have been shown in clinical trials to reduce cholesterol levels significantly and, in some cases, this reduction in cholesterol has been seen even in people who are not yet diagnosed with heart disease. In cases where cholesterol levels are a contributing factor to heart disease, statins generally fall under the class of drugs known as HMG-CoA reductase inhibitors (also known as ‘statins’ or ‘mevacor’).
The dose of statins that Dr. Fauci recommends for patients with heart disease is:
- 40 mg/day for those with normal cholesterol levels;
- 20 mg/day for those with hypercholesterolemia (excessive cholesterol levels) without any other risk factors for heart disease; and
- 10 mg/day for those with hypercholesterolemia and one or more risk factors for heart disease.
It is essential to regularly monitor cholesterol levels in people who are taking statins. This can be done by either testing for cholesterol levels or looking at the patient’s symptoms (e.g., shortness of breath). In most cases, this will be done by a primary care physician or specialist. They will also be responsible for monitoring the patient’s progress and adjusting the medication as necessary.