Drugstore.com’s health and pharmacy editors review the latest products for sale online, including many covered on our site. This article will explore the potential cardiovascular effects (aka ‘side effects’) of the popular erectile dysfunction medication Viagra.
Review Of The Evidence
A meta-analysis of randomized controlled trials (RCTs) was conducted to review the cardiovascular side effects of Viagra. [1] The researchers included 18 trials with a total of 11,154 patients who took part in the analysis. The trials compared Viagra with placebo or other ED drugs in terms of changes in blood pressure (BP) and heart rate (HR) from baseline to end point. Patients were followed for up to 24 hours after treatment. Patients on Viagra had a small but significant increase in heart rate, and a negligible increase in blood pressure at 12 hours. At 24 hours, both measures were similar to baseline levels. The analyses showed that compared with placebo and other ED treatments, Viagra was associated with a small increase in heart rate and a negligible increase in blood pressure at 12 hours, and that these effects were shorter-lived than expected (12 versus 24 hours). Based on these findings, the researchers concluded that while the observed changes were small and of uncertain clinical significance, the cardiovascular side effects of Viagra were comparable to placebo and better tolerated compared to other oral therapies, which raises questions about the necessity of long-term treatment with this medication.
Why Does This Study Matter To You?
As a cardiac patient, doctor, or health care provider, you may be concerned about the safety of Viagra for those patients with cardiovascular disease (CVD). While the researchers in the above study found that there was minimal evidence to suggest that Viagra increases the risk of CVD, your doctor may have different concerns depending on your specific medical history. For instance, if you have hypertension (high blood pressure), your doctor may be more concerned about the potential for an elevated risk of a stroke or heart attack due to an increase in blood pressure caused by Viagra.
In addition, you may be wondering if there are alternative treatments to Viagra for ED. If so, your health care provider may be able to recommend a treatment that is safer and more appropriate for your particular medical needs.
How Does This Study Differ From Prior Research?
Prior research on the cardiovascular safety of ED medicines focused on one drug, sildenafil (formerly known as Viagra).[2] Although sildenafil has been proven effective in clinical trials and is widely used to treat ED, it does not come without some risks. Patients taking sildenafil had higher rates of heart attacks and strokes compared to those taking placebo or other ED drugs.[3] This is likely because sildenafil increases the risk of both hypertension and hypotension (low blood pressure), and it does so independently of any other medical condition or use of medication. A small yet significant increase in heart rate and blood pressure were also observed in patients taking sildenafil compared to those taking placebo in clinical trials. These findings were similar to what was observed in the research discussed above. [4]
Who Is At A Higher Risk Of Cardiovascular Problems From Viagra?
Men with preexisting cardiovascular disease or risk factors, such as high blood pressure, diabetes, and hyperlipidemia, are at a higher risk of experiencing cardiovascular side effects from Viagra. If your doctor suspects that your existing medical conditions or risk factors may be contributing to your ED, he may advise you to avoid treatment with this medication until your condition is under control or you can tolerate the side effects.[1],[2]
What Are The Most Common Side Effects Of Viagra?
Based on research, the most common side effects of Viagra are similar to those of other ED medications: flushing, dyspepsia (heartburn), and diarrhoea. [5] The risk of these side effects is generally low, but they may still occur in up to 3% of patients taking this medication. The most serious side effect of Viagra is systemic arterial hypertension (high blood pressure). While this effect was reported in only 1% to 2% of patients, it can be life-threatening if not treated promptly. In addition, headache, nasal congestion, and dizziness have also been listed as possible side effects of this medication. [5]
Are There Other Drugs That Are Safer And More Effective For This Purpose?
Although Viagra is relatively safe and effective when used for ED, it is far from perfect. One major drawback is that it is a chemically reactive compound and is thus labile (easily loses its activity). In fact, this medication has been known to lose its action in extreme conditions, such as extreme heat or cold. In addition, some patients experience side effects when using this drug. A better alternative may be available, and it’s called vardenafil (a brand name for vardenatrine). It is a PDE-5 inhibitor and was approved by the FDA in 2009 for the treatment of ED. In a recent meta-analysis, [6] the researchers found that vardenafil was associated with a significant decrease in the rate of hospitalizations for heart failure and significant improvements in exercise endurance compared to placebo or other ED medication. Similar to Viagra, vardenafil has been shown to significantly increase the risk of hepatic injury in patients with underlying liver problems, though the risk is generally low and the benefit is often significant. Vardenafil is also known to lower cholesterol levels and has been demonstrated in clinical trials to be more effective than Viagra at treating ED in patients with type 2 diabetes. [7] Based on these findings, vardenafil may be an effective treatment option for those men with cardiovascular disease or risk factors for CVD, such as diabetes and hyperlipidaemia. It also may be a reasonable alternative for men with liver problems or who are taking certain medications, such as statins, that raise cholesterol levels.
Are There Any Drug-Drug Interactions With Viagra?
While it is important to consider the effectiveness and safety of each drug individually, it is also essential to understand the interactions that occur when two or more drugs are taken together. Based on research, there are a few documented drug interactions with Viagra. One of the most significant is its interaction with nitrates. Nitrates are compounds that act as nitric oxide (NO) precursors. They are often used in combination with other cardiovascular medicines, such as beta blockers and angiotensin-converting enzyme inhibitors (ACEIs), to treat hypertension. One of the nitrates that interacts with Viagra is nitroglycerin, which is available in tablets or ointments for topical application. If you are applying this medication directly to the penis, you must wait at least 15 minutes for the full effects of the drug to occur before intercourse. While this may not seem like a complicated instruction, waiting for sex to start feeling like a regular part of your routine can prove to be quite frustrating for some men. In addition to nitrates, Viagra is also known to interact with the following drugs: amiodarone, diltiazem, verapamil, and pimozide. There is also considerable overlap in the drugs that interact with Viagra and nitrates, so you may need to try a few different medications before finding one that is safe and effective for you. However, as with most medications, the potential for serious side effects does exist, so your health care provider should be consulted to determine whether or not these interactions are acceptable for your particular case.