Sildenafil appears safe and effective for some heart failure patients
Sildenafil (Viagra) may be safe and effective for the treatment of erectile dysfunction in carefully selected men with moderate heart failure, a small trial indicates.
The study’s authors say that sildenafil use may be considered a
contraindication in congestive heart failure (CHF). However, erectile
dysfunction is common in patients with this condition and is often associated
with symptoms of depression.
The Canadian study, a 12-week, prospective, placebo-controlled crossover
trial, looked at 35 men with a mean age of 60 years. The men had moderate
CHF and suffered chronic erectile dysfunction. The men did not take nitrates,
which in combination with sildenafil can cause profound hypotension and
is contraindicated.
The tolerability of sildenafil was established by monitoring ambulatory
blood pressure for four hours after a single 50mg dose.
The drug caused a small decrease in blood pressure (mean 6mmHg), with
no patients experiencing symptomatic hypotension or other significant
side effects. Sildenafil improved erectile function and appeared to reduce
depression, improving perceived quality of life.
The authors conclude that this study provides new evidence that it is
safe and effective to treat men with erectile dysfunction and moderate
heart failure with sildenafil. However, they add that it is necessary
to complete baseline safety measurements to ensure adequate physical
fitness for sexual activity and absence of myocardial ischaemia that
would necessitate nitrate use.
“
Sildenafil is a reasonable alternative to the invasive solutions of the
past (eg, penile implants, intracavernosal injections of vasodilators)
for many CHF patients with erectile dysfunction,” they say (Archives of Internal Medicine 2004;164:514). |
The
Pharmaceutical Journal