Myocardial infarction following the combined recreational use of viagra® and cannabis

Abstract

SummarySildenafil citrate (Viagra ® ,Pfizer, Inc., New York, N.Y.) is widely prescribed as a treatment for male erectile dysfunction. It is metabolized predominantly by the cytochrome P450 3A4 hepatic microsomal isoenzyme and effects can, therefore, be potentiated by such inhibitors. The vasodilatory effects of Viagra necessitate caution in its use in patients with cardiovascular disease and it is contraindicated in patients receiving nitrates. Previous literature has drawn attention to Viagra use and myocardial infarction. This paper reports the case of a young man who presented with a myocardial infarction after taking Viagra in combination with cannabis, a known inhibitor of the cytochrome P450 3A4 isoenzyme.

Safety Issues Concerning the Medical Use of Cannabis and Cannabinoids

“…An increased relative risk of nonfatal myocardial infarction in the first hour following cannabis smoking has been described (41). Myocardial infarction following cannabis use and Viagra (Pfizer Canada Inc) consumption has been reported (42). The increase in heart rate following cannabis use may play a role by increasing myocardial oxygen demand, but other factors, such as plaque rupture and arrhythmias, may also have an effect (43)(44)(45).…”

Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time

“…4 Anecdotal reports of serious events have included young men abusing sildenafil in combination with other sex-related drugs such as amyl nitrate, or in combination with ecstasy or cannabis. [5][6] The aim of our single-dose, home-use study was to investigate whether sildenafil improves erectile function in young healthy males.…”

Marijuana as a trigger of cardiovascular events: Speculation or scientific certainty?

“…The authors attributed these differences primarily to higher heart rates, blood pressure, cardiac output, and venous carboxyhemoglobin levels associated with marijuana. Additionally, several case reports of myocardial infarction in close proximity to marijuana use in otherwise healthy individuals or those with low cardiovascular risk have also been reported [2,[18][19][20][21][22][23]. The majority of these patients had either normal coronary arteries or minimal irregularities on angiography.…”