Stroke-An Adverse Reaction to Sildenafil

Abstract

Although cardiovascular side effects of sildenafil are recognized, little is known about stroke risk in patients who take this drug. We report a patient with multiple strokes in the posterior cerebral circulation in close temporal association with sildenafil use. This case report further emphasize that stroke is, although rare, real side effect of sildenafil. Potential users should be warned before taking it, especially if they have other stroke risk factors, as recommended by the manufacturer.

Bilateral cerebral hemispheric infarction associated with sildenafil citrate (Viagra®) use

“…Moreover, left atrial thrombus formation does occur in patients with acute atrial fibrillation less than a few days in duration [15]. In another recent report, the proposed mechanism of stroke was unidentified effect of sildenafil on the already damaged blood vessel because of other disease like hypertension or diabetes [16]. However, this hypothesis is discrepant from that of our case, because our patient had no causative diseases that damage the blood vessels.…”

Assessment of the acute effects of tadalafil on the cardiovascular system based on examination of serum oxidative status and paraoxonase activity in men with erectile dysfunction: a preliminary study

“…11,12,20,21 Paradoxically, the associations of PDE5 inhibitors usage and some life-threatening events, such as acute MI and stroke, in connection with some disorders, such as cardiac arrhythmias, hypo/hypertension, are related to the cardiac and neurovascular systems. 7,8 Nevertheless, recent reports strongly suggest that there is no increase in the incidence of acute MI or death rates during sexual activity while using PDE5 inhibitors. 8,22,23 Although weak, there is evidence of an association of sildenafil citrate with cardiac arrhythmias.…”

“…6 However, controversy remains about the tolerance of PDE5 inhibitors, especially regarding possible life-threatening acute cardiovascular system (CVS) and neurological system events, such as myocardial infarction (MI) and stroke. 7,8 It is well known that oxidative stress leads to impaired vasodilatation of the coronary, pulmonary and peripheral vascular beds. 9 There is limited information about the effect of PDE5 inhibitors on serum oxidative mechanisms, although it is well known that they can restore endothelial nitric oxide (NO), resulting in vasodilatation and the inhibition of chemotaxis and platelet aggregation.…”

Sildenafilo oral en medicina neonatal “Investigado para adultos, usado también por neonatos”

“…Se ha demostrado que el sildenafilo induce hiperalgia por la activación de la vía del óxido nítrico-GMPc en el modelo neuropático de dolor de la rata 59 . En adultos, los informes recientes asocian el sildenafilo a un aumento de la reactividad cerebrovascular medida por Doppler transcraneal 60 , ataques agudos de cefaleas 61 , y el accidente cerebrovascular (stroke) 62 . En resumen, los estudios básicos, animales y de adultos humanos sugieren unos efectos adversos que podrían ser potencialmente peores en el organismo, la retina y el sistema nervioso central en desarrollo, pero no hay ningún estudio publicado al respecto.…”