- New research has found that taking erectile dysfunction medication and chest pain medication at the same time may increase your risk of death.
- This is largely because both medications can induce hypotension.
- Experts recommend prioritizing chest pain medication over erectile dysfunction medication and speaking to a healthcare professional if you have any questions or concerns about treating both conditions at the same time.
Taking erectile dysfunction medication and chest pain medication together may increase your risk of death, a new study finds.
When someone has erectile dysfunction (ED), they are often prescribed a drug known as a phosphodiesterase-5 inhibitor (PDE5i)—sometimes even if they have cardiovascular disease. As many as 9% of people have been prescribed both PDE5i and nitrates, a common drug used for chest pain.
However, a new study of nearly 62,000 men found that taking these two medications together could increase the risk of heart failure and early death.
The researchers found that both medications induce hypotension or low blood pressure, said Ylva Trolle Lagerros, MD, PhD, a lead author on the study, researcher at Karolinska Institutet, and senior physician at the Center for Obesity, Stockholm, Sweden, though she notes that they use different mechanisms.
For this reason, it may not be advisable to use these two medications together.
“Patients taking both PDE5is and nitrate medication face an increased risk of cardiovascular morbidity and mortality,” Lagerros explained. “This means that patients with stable coronary artery disease using nitrate medication for chest pain, who also use the most common treatment for erectile dysfunction (PDE5i such as Viagra), need to consider the benefits of PDE5i against the possible cardiovascular risk.”
Here’s how taking these medications together may affect you, the connection between erectile dysfunction and chest pain, and how to handle the treatment of both conditions at the same time.
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What Happens When These Meds Are Taken Together?
Taking ED drugs and nitrates together enhances the drugs’ antihypertensive effect. This can cause serious side effects—including death—when they’re taken together.
Researchers found that taking a PDE5i such as Viagra alongside nitrates for chest pain is associated with a 35% to 40% increased risk of death and about 70% higher risk of heart attack and heart failure.
“Our body has many ways to maintain blood pressure in the presence of either medication alone,” Scott D. Miller, MD, MBA, a board-certified urologist and medical director of Wellstar Urology in Atlanta, Georgia, told Health.
“However, when two separate mechanisms are simultaneously blocked, our body’s efforts to maintain a normal blood pressure can be overwhelmed,” he said.
Miller explained that if this scenario were to occur during a heart attack, which is the most likely time to take chest pain medication, the heart wouldn’t have the blood that it needs when it needs it.
That said, researchers note that people typically only use nitrates as emergency relief for a sudden onset of chest pain (or angina). When used this way, the medication is quickly absorbed by the body and then breaks down just as quickly.
Likewise, ED drugs are typically used only when needed.
Consequently, it is possible for people who have been prescribed both drugs to separate the use of the two.
The key is making sure people who are prescribed the drugs know the risk and realize that they cannot take the two together, or to prescribe them something else altogether.
The Connection Between ED and Chest Pain
According to Lagerros, people who take ED medication are often in the same demographic as those prescribed chest pain medication.
“I think that what we see here is that 75 is the new 55; men with stable coronary artery disease are well treated and thus still have an active life, and want to have an active sex life as well,” she said.
What’s more, being diagnosed with ED could potentially be a predictor for heart issues.
“[ED] can be a clinical marker for future heart health issues,” Lagerros explained. “It is sometimes called the harbinger for cardiovascular events.”
In fact, according to Miller, one of the risk factors for erectile dysfunction is underlying cardiovascular disease. As such, people with ED may have an increased risk of needing chest pain medications compared to men without ED.
“However, because of the well-documented contraindication of combining these medications, men taking ED medication are less likely to be prescribed chest pain medication (and vice versa),” he said.
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How You Can Address Both ED and Chest Pain Without Meds
Because chest pain can be life-threatening, and erectile dysfunction is not, you may need to prioritize nitrates over ED medication, Lagerros said.
And, there are other types of medications for erectile dysfunction that can be used instead of PDE5i, Miller said. Talking to a healthcare professional can help you determine which treatment method is right for you.
There are also non-medication ways to ease chest pain and erectile dysfunction symptoms. Lagerros recommends:
- Quit smoking if you smoke
- Be physically active
- Eat nutritious foods such as fruits, vegetables, and fish
- Try a Mediterranean diet
- Learn to manage stressful situations
Remember, whatever is good for the heart is good for every other body function and ailment.
“Rather than searching for the next best supplement, focus on the pillars of good health—a healthy diet, regular exercise, adequate sleep, stress management, smoking cessation, and monitoring health indicators such as blood pressure, cholesterol, lipids, and blood sugar,” Miller said.
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When Should You See a Doctor?
If you are experiencing chest pain, particularly during physical activity, it is important to get immediate medical attention. You also should contact a doctor if you experience difficulties in achieving or maintaining an erection.
“Sometimes the first symptom of underlying cardiovascular disease is erectile dysfunction,” said Miller. “The male organ can serve as a barometer to overall heart health.”
He explained that the blood vessels supplying the penis can be the first to narrow since they are smaller than those feeding the heart. More importantly, this is a body part that readily reveals any vascular deficiency.
“All men who experience a decrease in erectile quality should see their primary care physician to screen for serious underlying health issues such as cardiovascular disease or diabetes,” Miller said.
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