A new report will give recommendations for using Viagra in patients with heart disease. It'll comefrom the American College of Cardiology...and the American Heart Assoc.
They will caution physicians about giving Viagra to patients with angina...congestive heart failurewith low blood pressure...and patients on multiple drugs for hypertension.
These patients are especially at risk for a serious drop in blood pressure...or a heart attack afterusing Viagra. They recommend letting 24 hours elapse before using nitrates to treat Viagra patients who get chest pain orhave a heart attack. This time allows enough of the drug to be eliminated by the body.
Use an alternative to nitrates if patients have taken Viagra within 24 hours.
Suggest a beta-blocker to treat mild angina.
Treat a heart attack in the usual way...but WITHOUT nitrates.
If a patient on Viagra is inadvertently given a nitrate and develops severe hypotension, treat withaggressive fluids and drugs such as phenylephrine or norepinephrine to increase blood pressure.
Try not to give Viagra to patients taking erythromycin or cimetidine...or to those with liver or renaldisease. These drugs and conditions can prolong the half-life of Viagra and increase the potential forproblems.