sildenafil and nitrates

Sildenafil and Nitrates: the Detailed Look

Friday 10th of August 2018

In general, Viagra is a safe medication that is usually combined with other medicines without unsafe interactions.

However, there is a group of medicines, the use of which can lead to undesirable and even dangerous consequences when combined with Viagra. Nitrates are the most dangerous medicines in this regard. Below we will tell you why you cannot combine Viagra and nitrates and what safety measures should be taken.

Contents

  • 1 Viagra – Description and Key Features
  • 2 General Description of Nitrates
    • 2.1 Types of Nitrates Used in Medicine
  • 3 Interactions of Viagra and Nitrates
  • 4 Precautionary Measures

Viagra – Description and Key Features

Viagra is the most famous medical remedy for the treatment of disorders of male erection. The basic active agent of the medicament is sildenafil, which belongs to the group of PDE5 inhibitors. It suppresses the activity of PDE5, increasing the amount of substances necessary for adequate vasodilation (expansion) of the cavernous bodies of the male organ. The original version of the drug is produced by the American company Pfizer. However, it has a fairly high cost. Therefore, many men prefer the generic version of sildenafil, such as Canadian Viagra.

To achieve a persistent and prolonged erection, it is enough to drink one tablet (100 mg) approximately 30-60 minutes before the planned sexual intercourse. If necessary, the dosage of the drug can be changed to a greater or lesser extent, but it must be remembered that the maximum daily dose is 100 mg – exceeding it is strongly not recommended. It is undesirable to take more than one tablet a day.


Other features of Viagra:

  • the drug is well-tolerated by the male body;

  • it perfectly copes with deterioration of erectile function caused by psychological & organic problems;

  • the effect of the med lasts 4-6 hours;

  • the drug is completely eliminated from the body;

  • it treats ED without adversely affecting the heart and liver.

General Description of Nitrates

Nitrates are widely used as antianginal agents for various forms of ischemic heart diseases (angina pectoris, myocardial infarction, and the like). Most often, nitrate-containing drugs are used to treat angina – pain in the heart, caused by the narrowing of the coronary arteries in patents with atherosclerosis.

The therapeutic effect of nitrates (nitrovasodilators) is based on the ability to substantively increase the content of nitric oxide, which is an endothelial relaxing factor. This factor stimulates guanylate cyclase, increases the content of cyclic guanosine monophosphate (cGMP) inside the cell and, as a result, causes vasodilation. Thanks to this, it is easier for the blood to move through the vessels, so the load on the heart is reduced.

By the way, Viagra also increases the amount of cGMP and leads to vasodilation. That is why these types of drugs can enter into dangerous interactions.

Types of Nitrates Used in Medicine

The most commonly used in medicine are organic nitrates:

  1. Nitroglycerin. This medication is available in the form of prolonged-release capsule. It is used to prevent painful sensations in chest (angina) in individuals experiencing coronary artery disease. The med is typically taken 3 to 4 times per day or as directed by a healthcare professional. It doesn’t provide pain-relieving effect once the pain occurs. In addition, nitroglycerin is available in the form of sublingual tabs (brand name Nitrostat). Nitrostat is used immediately after the onset of angina attack or before physical activity, which presumably can cause an attack of angina. Nitroglycerin refers to short-acting nitrates.

  2. Isosorbide dinitrate. This medication is also available in two forms: extended release tables and sublingual tablets. Like nitroglycerin, isosorbide dinitrate is used to prevent pain in chest. However, it refers to long-acting nitrates, so patients use it less often than nitroglycerin, namely once or twice a day. Sublingual tablets are used in the same way as nitroglycerin.

  3. Isosorbide mononitrate. This medication is available in the form of immediate release tablets (5mg or 10mg dosage), which should be consumed twice a day. Also, there is a form of extended release tabs, the recommended dosage of which is from 40 to 240 mg per day. The full name of the active substance of this medication is Isosorbide-5-Mononitrate. It is available in online pharmacies under the brand names Ismo *, Imdur **, and Monoket ***.

In addition, males must not use Viagra with other form of nitrate-based remedies, including nitroglycerin patches and pastes. The same goes for the so-called poppers (amyl nitrate / amyl nitrite), recreational drugs, which are used by some male persons for sexual stimulation.

* For more information about Ismo, please visit this page: https://awcanadianpharmacy.com/item/ismo.html

** For more information about Imdur, please visit this page: https://awcanadianpharmacy.com/item/imdur.html

** For more information about Monoket, please visit this page: https://awcanadianpharmacy.com/item/monoket.html

Interactions of Viagra and Nitrates

Nitrates and PDE5iNitrate-containing drugs make the same effect as Viagra, they expand the arteries. As a result, simultaneous administration of these two drugs can cause a sharp and life-threatening lowering of arterial pressure. Back in 2000, cardiologists from Mayo Clinic stated that the combination of Viagra with nitrates caused a long-term decrease in blood supply to the heart in critically reduced coronary arteries.

In 2005, British scientists decided to find out if men with erectile problems and stable heart diseases can suspend administration of nitrates to safely use Viagra. They defined a stable heart disease as a disease in which there were no significant restrictions to doing the exercises, for example, a man could walk 1 mile on a non-inclined surface for one hour without stopping.

The scientists involved in their study fifty-five male persons who were regarded appropriate candidates for discontinuing the use of nitrates. The men were given aspirin in low dosage and other drugs for heart disorder. A week later only three male persons experienced increased heart symptoms. Over ninety per cent of the men started administering an ED drug and eighty-five of those who followed the three-month treatment course reported improved sexual function. In addition, they did not experience chest pain increase or heart attack. The Journal of Sexual Medicine published those findings in its July issue.

The researchers drew the following conclusion: it was possible to discontinue oral nitrates against the background of taking other drugs for heart disease in persons with stable heart disease to allow them to use safely ED drugs. Moreover, they stated that their findings could apply to all patients with heart disease who took oral nitrates, not only men who wanted to use impotence drugs.

Precautionary Measures

Thus, if you are constantly taking meds containing nitrates, you mustn’t take Viagra in order to avoid a sharp and serious increase in blood pressure.

If you have been using Viagra, and now are prescribed a nitrate-containing drug – you will have to give up Viagra, even if it helped you well, or alternatively look for a substitute for nitrates.

You should consult a doctor and discuss whether you can stop treatment with nitrates to safely use Viagra.

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