"Doctor, save my boyfriend, they all said that the medicine hurt the liver and kidneys, but he just didn't listen!" In the corridor of the emergency room, Xiao Wu's girlfriend said anxiously.
Xiao Wu, 28 years old this year, has always been not very confident in his ability, and his performance was a little crotch-pulling when he "ran errands" last time, which made him even more inferior.
So this time he took sildenafil an hour in advance, and increased the amount in order to have a better effect.
Unexpectedly, he had chest pain, sweating, confusion and other symptoms during this process, which lasted for 1 hour and was still the same, and he was diagnosed with acute myocardial infarction after being sent to the hospital.
Doctors say that sildenafil has the effect of dilating blood vessels, and taking too much can lead to coronary hypoperfusion, which in turn induces myocardial infarction.
Isn't sildenafil a drug that treats men's problems? How can you still dilate blood vessels? Here's what's going on.
1. In addition to treating the "male problem", sildenafil has 4 hidden effects?
When it comes to sildenafil, many people will have a familiar name "Viagra" in their minds, as sildenafil, which is popular all over the world for the benefit of countless people, the original purpose of research and development is actually to treat cardiovascular diseases, but in the clinical process, it was found that it has the unexpected joy of treating male erectile dysfunction, and finally was approved by the U.S. Food and Drug Administration in 1997 for the treatment of male erectile dysfunction.
With the discovery of scientific research, sildenafil also has the following hidden functions:
1. Treatment of pulmonary hypertension
Pulmonary hypertension is a very serious condition that, if left untreated, can lead to an average survival of only 2.8 years, which can eventually lead to heart and respiratory failure as the vascular resistance in the lungs increases.
According to the Chinese guidelines for the diagnosis and treatment of pulmonary hypertension, phosphodiesterase type 5 inhibitors are mentioned. Sildenafil helps to dilate the pulmonary arteries, reducing vascular resistance and lowering pulmonary artery pressure.
2. Alleviate altitude sickness
Sildenafil can reduce systolic pulmonary artery pressure, improve pulmonary microcirculation, help enhance gas exchange, reduce oxygen consumption, and prevent the occurrence of high-altitude hypoxemia.
3. Prevention or treatment of Alzheimer's disease
Sildenafil has been found to be associated with a reduced risk of Alzheimer's disease. Because it can significantly increase neurite outgrowth and reduce the expression of phosphorylated Tau protein, it further supports the potential application value of Alzheimer's disease from the mechanistic perspective.
4. Assisted reproduction
Some scholars have found that sildenafil can improve the thickness, morphology and blood flow of the endometrium, increase the implantation rate of embryos, and play a role in assisted reproduction. However, there is still great controversy in clinical application, and it is not possible to take drugs blindly.
2. Regular consumption of sildenafil will not only cause addiction and drug resistance, but also harm the liver and kidneys?
Sildenafil has always been very controversial, some people say that regular consumption will cause addiction, drug resistance, and even damage to the liver and kidneys, are these claims credible?
First of all, sildenafil mainly acts on vasoactive inhibitory enzymes in the body, and plays a role in improving local vascular blood flow and improving male-related problems by inhibiting the activity of related enzymes. Drugs with this mechanism do not make the body physiologically dependent, and the drug will have an effect, and there will be no withdrawal reaction or rebound symptoms without the drug.
However, it is undeniable that some people are psychologically dependent on drugs, and the problem itself is not big, but they feel that something is missing when they do not take medicine, and their self-confidence is greatly reduced when they have intercourse, and psychological and sexual dysfunction appears.
Let's take a look at the problem of drug resistance, from the perspective of the mechanism of action, sildenafil will not make the body develop drug resistance. Because the enzymes and blood vessels in the body do not change after taking the drug, it is natural that drug resistance will not develop with the increase of the number of doses.
Some cases that feel the same dosage but do not work well now are likely to be related to psychological problems and the further development of the disease, and are not the "pot" of sildenafil.
Finally, let's take a look at the impact on the liver and kidney, sildenafil is mainly metabolized by the liver, with a half-life of about 4 hours, and its metabolites are excreted through feces, and only a small part is excreted from the urine, which means that its burden on the kidneys is relatively light.
However, in patients with renal insufficiency, the clearance of sildenafil may be reduced, resulting in an increase in plasma sildenafil levels, which can adversely affect renal function, so this group of patients should be used with caution under the guidance of a doctor.
Dai Yutian, chief physician of the Department of Andrology of the Drum Tower Hospital Affiliated to Nanjing University School of Medicine, reminded that when taking sildenafil for liver cirrhosis, kidney damage and the elderly over 65 years old, it is recommended to consult a doctor to adjust the dose.
Sildenafil has a high safety profile, but it is not without side effects, and the most common adverse reactions of the drug are headache, nausea, facial flushing, and blurred vision. There are also some less common adverse reactions, such as increased heart rate, nasal edema, etc.
It should be reminded that if you have an erection for > 4 hours after taking the drug, you will have a painful erection >for 6 hours, you must seek medical attention in time to avoid causing damage to the body.
3. To take sildenafil safely, these 4 points must be clearly understood
Sildenafil is widely used in clinical practice, but there are also many precautions when taking medicine, and these things must be understood.
1. Several groups of people should take it with caution
It is not recommended for patients who have had myocardial infarction/shock/severe arrhythmia, heart failure/unstable angina, retinitis pigmentosa, and hypotension/hypertension within half a year.
2. Pay attention to drug interactions
Middle-aged and elderly people often have chronic diseases such as hypertension, diabetes, and coronary heart disease, so they should pay attention to drug interactions when taking medications.
For example, the combination of nitrates and sildenafil is easy to cause severe hypotension;
Combined with antihypertensive drugs such as nifedipine and valsartan, it will enhance the effect of antihypertensive drugs, and it is not recommended to take sildenafil 4 hours before and after taking antihypertensive drugs.
3. The dosage is different
The specifications of sildenafil are 25mg, 50mg, and 100mg, and the larger the specification, the stronger the efficacy, and patients should consult their doctor according to their own conditions.
The recommended dosage for most people is 50mg, and older people with liver and kidney insufficiency can take as little as 25mg.
The half-life of sildenafil is 3~5 hours, and the average peak time is 60 minutes, so it is generally recommended to take the drug 30~60 minutes before the start of the activity.
4. Do not drink a lot of alcohol when taking medication
Both sildenafil and alcohol can dilate blood vessels, and alcohol also has a neurodepressant effect, drinking alcohol while taking the drug can easily affect the normal effect of the drug, and there is a greater risk of hypotension.
The role of sildenafil is not only in andrology, and it is necessary to have a correct understanding of this. Men must consult a professional doctor before taking medication to avoid unnecessary threats to their health caused by improper medication.
Resources:
[1] "Sildenafil Discovers New Efficacy, New Research: Significantly Reduces the Risk of Alzheimer's Disease". Health Times 2021-12-17
[2] "Menopausal Men, How to Protect "Sexuality" Well-being? Attention should be paid to the use of "Viagra" drugs. Human Health 2022-04-18
[3] "Sildenafil: I Still Have 2 Hidden Effects". Medical Profession 2023-04-23
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