Use of Sildenafil (Viagra) in Patients With Cardiovascular Disease

Authors: Melvin D. Cheitlin, Adolph M. Hutter, Ralph G. Brindis, Peter Ganz, Sanjay Kaul, Richard O. Russell, Randall M. Zusman, James S. Forrester, Pamela S. Douglas, David P. Faxon, John D. Fisher, Raymond J. Gibbons, Jonathan L. Halperin, Adolph M. Hutter, Judith S. Hochman, Sanjiv Kaul, William S. Weintraub, William L. Winters, Michael J. Wolk - Circulation 1999 cited by 496

A. Use of Viagra clearly contraindicated 1. Concurrent use of nitrates (see Appendix A) B. Cardiovascular effects of Viagra may be potentially hazardous (use dependent on individual clinical assessment) 1. Patients with active coronary ischemia who are not taking nitrates (eg, positive exercise test for ischemia) 2. Patients with congestive heart failure and borderline low blood pressure and borderline low volume status 3. Patients on a complicated, multidrug, antihypertensive program 4. Patients taking drugs that can prolong the half-life of Viagra (see Appendix B)