Tag Archives: sildenafil

Health

Viagra, Cialis, Erectile Dysfunction Drugs Link to Eye Problems

Leave a comment

Photo: Getty (Getty Images)

Drugs known for helping men with erectile dysfunction may come with a higher risk of vision problems than currently thought. In new research out Thursday, scientists have documented an association between three serious eye disorders and drugs including Viagra and Cialis; the findings might prompt the need for added warning labels on these medications, the authors say, though the individual risk for experiencing these complications does appear to be very small.

Commonly used erectile dysfunction drugs such as sildenafil (sold under the brand name Viagra) and tadalafil (Cialis) primarily work by inhibiting an enzyme known as PDE5 that is found in the smooth muscle cells that line certain blood vessels. As a result, the drugs dilate these blood vessels and increase blood flow to specific parts of the body, including the penis during times of sexual stimulation. These drugs also can be used to treat high blood pressure linked to lung problems (pulmonary hypertension), and tadalafil is approved to help treat the symptoms of an enlarged prostate.

But no drug comes without some unwanted effects. PDE5 drugs have been linked to vision problems for quite some time, including a few serious complications. In 2005, the Food and Drug Administration required the makers of Viagra, Cialis, and Levitra to add a warning label about the association between their drugs and ischemic optic neuropathy (ION), a condition that can lead to permanent vision loss.

There have been case reports of other eye-related conditions tied to PDE5 use in the years since. And that made the researchers behind this latest study, published Thursday in JAMA Ophthalmology, curious about whether these reports were pointing to a real trend.

To find out, they analyzed insurance data from over 200,000 men who had been taking either Viagra, Cialis, Levitra, or Stendra. Importantly, none of these men had been diagnosed with vision problems prior to their use of these drugs. But when compared to similarly matched men not taking any PDE5 inhibitor, they were more likely to be diagnosed with ION as well as two other eye conditions, serous retinal detachment (SRD) and retinal vascular occlusion (RVO). The increased risk of these problems in PDE5 users was apparent even after accounting for other possible risk factors, such as high blood pressure.

G/O Media may get a commission

The findings seem to be the first from a large epidemiological study to link SRD and RVO to taking erectile dysfunction drugs. And according to lead author Mahyar Etiminan, it’s the first to quantify the added risk of these conditions. Compared to non-users, for instance, men taking these drugs were 2.58 times more likely to develop SRD, 1.44 times more likely to develop RVO, and 2.02 times more likely to develop ION. In general, they had a 85% increased risk of developing any one of these conditions.

This kind of research can’t definitively prove that these drugs are causing these conditions. But the authors suspect, Etiminan told Gizmodo in an email, that “these drugs can compromise blood flow to the optic nerve and arteries/veins of the retina.”

The authors note that the absolute odds of having any of these conditions following PDE5 use are still very small. But given that as many as 20 to 30 million men in the U.S. may have erectile dysfunction and could take these drugs, the risks are real enough that they warrant a clear warning label, they argue. They also say that people with preexisting eye problems should be more cautious about taking them.

“ION already has a warning but RVO and SRD don’t have strong warnings. We believe they should also have strong warnings,” said Etiminan, an eye disease researcher and epidemiologist at the University of British Columbia. “I would say men who have underlying ocular issues like glaucoma or retinal conditions should discuss with their ophthalmologist before starting the drugs.”

At the same time, he adds: “Men otherwise healthy should seek medical attention only if they see visual changes when taking these drugs.”

While this new study does indicate that PDE5 drugs in general can rarely cause these serious eye problems, the authors say that more research should be done to figure out whether certain drugs in this class are riskier than others.

Read original article here

Health

‘Covid Dick’ Is, Sadly, Real

Leave a comment

Photo: Roberto Machado Noa/LightRocket (Getty Images)

It seems we can add sexual dysfunction to the long list of unexpected and unpleasant effects of the coronavirus. Thankfully, this doesn’t appear to be a common occurrence, and there are some potential remedies that those afflicted can try.

This week, the Slate-run sex advice podcast How to Do It discussed the harrowing tale of an anonymous letter writer who was suffering from what’s come to be known as “covid dick.” The writer, who identified as a heterosexual man in his 30s, said that he had gotten very sick and was hospitalized from covid-19 last July. After he was discharged, he began experiencing erectile dysfunction (ED). Though his symptoms did improve after seeing a doctor, the man reportedly was left with a glaring reminder of his ordeal. Describing himself as above average in penis size before covid-19, he said that his penis had now shrunk about 1.5 inches and that he had “become decidedly less than average.”

The podcast hosts, to their credit, also interviewed a pair of urologists who rightly noted that there’s a clear trail of evidence linking covid-19 to erectile or sexual dysfunction. A study this past November, for instance, found that men with covid-19 were about three times as likely to develop a new case of ED than those who didn’t catch covid-19. Some research has suggested that the risk may be nearly six times higher, yet other estimates are smaller, suggesting around a 20% increased risk. A small percentage of people with long covid, including women, have also reported sexual dysfunction as one of their symptoms. And sometimes, ED can indeed lead to shrinkage, especially if it’s caused by physical damage and scarring that causes the penis to stop becoming regularly erect.

There are a few theories as to how covid-19 can cause ED. The infection can possibly reach penile tissue and directly damage to the surrounding blood vessels. It may also be due to the indirect effects of infection on the immune system, which may trigger damaging inflammation. (An over-reacting immune system and blood vessel damage are also the prime suspects behind “covid toes.”) And the experience of hospitalization in severe cases can take a toll on the body, penis included. The risk of ED from blood vessel damage is probably greater in people who already have other relevant health conditions that can affect circulation, such as type 2 diabetes. Many cases of ED can also be chalked up to stress and anxiety, and covid survivors are unfortunately at higher risk of experiencing that as well.

That said, age is by far the largest risk factor for ED, with as much as 70% of men experiencing some level of it by their 70s. And while we don’t seem to have solid data on the actual prevalence of covid-related ED, it doesn’t appear to affect a huge proportion of men. The November study, for instance, found that slightly less than 5% of men in the sample were diagnosed with ED after covid-19.

As the Slate hosts note, there are readily available treatments for ED, such as the drug sildenafil (Viagra). And even a shrunken penis can be treated or prevented through what one urologist refers to as “penile rehab,” which can involve stretching exercises and/or penis-pumping devices. So not all hope is lost if you’re worried about the dreaded covid dick. And for the record, there’s no evidence at this time of a link between ED and getting vaccinated for covid-19.

Read original article here

Health

5 Unexpected Things That Seem to Lower Dementia Risk

Leave a comment

5. Viagra (sildenafil)

A tablet of Pfizer’s Viagra, next to its generic equivalent. Both contain the active ingredient sildenafil
Photo: Richard Drew (Getty Images)

This is the most speculative thing on the list, but it’s one that could have some important implications.

Just this week, Cleveland researchers published a study claiming to show that sildenafil, the active ingredient in the erectile dysfunction drug Viagra, may help prevent or treat Alzheimer’s disease. In brain tissue collected from Alzheimer’s patients, they found evidence that high doses of sildenafil can boost the growth of brain cells and reduce the expression of amyloid and tau proteins. And when they looked at insurance claims data, they also found that people prescribed Viagra were 69% less likely to be later diagnosed with Alzheimer’s.

One of the main ways that sildenafil affects the body is by relaxing our blood vessels, and it’s already used to treat certain forms of high blood pressure. So it’s plausible that its effects on circulation could also reduce dementia risk. Even before this study, there had been evidence in animals that sildenafil could reduce the risk of vascular dementia, a condition closely linked to blood clots and circulation problems.

For the time being, though, not even the authors of this study are claiming that sildenafil should be taken for dementia. But given these findings, and the relatively low cost of sildenafil now that it’s become generic, it’s certainly worth studying further.

Read original article here

Health

Giant Study Finds Viagra Is Linked to Almost 70% Lower Risk of Alzheimer’s

Leave a comment

Usage of the medication sildenafil – better known to most as the brand-name drug Viagra – is associated with dramatically reduced incidence of Alzheimer’s disease, new research suggests.

 

According to a study led by researchers at the Cleveland Clinic, taking sildenafil is tied to a nearly 70 percent lower risk of developing Alzheimer’s compared to non-users.

That’s based on an analysis of health insurance claim data from over 7.2 million people, in which records showed that claimants who took the medication were much less likely to develop Alzheimer’s over the next six years of follow up, compared to matched control patients who didn’t use sildenafil.

It’s important to note that observed associations like this – even on a huge scale – are not the same as proof of a causative effect. For example, it’s possible that the people in the cohort who took sildenafil might have something else to thank for their improved chances of not developing Alzheimer’s.

Nonetheless, the researchers say the correlation shown here – in addition to other indicators in the study – is enough to identify sildenafil as a promising candidate drug for Alzheimer’s disease, the viability of which can be explored in future randomized clinical trials designed to test whether causality does indeed exist.

 

“Notably, we found that sildenafil use reduced the likelihood of Alzheimer’s in individuals with coronary artery disease, hypertension, and type 2 diabetes, all of which are comorbidities significantly associated with risk of the disease, as well as in those without,” explains computational biologist and senior author of the study, Feixiong Cheng from the Cleveland Clinic.

It’s not the first time sildenafil use has been linked with better health outcomes, with the drug previously showing promise in a range of different scientific contexts, including cancer and malaria research among others.

Here, Cheng’s team began by building over a dozen endophenotype modules, using computational techniques to map genetic factors that could hypothetically govern the manifestation of Alzheimer’s disease.

With 13 of these modules in hand, the researchers then looked at what kinds of FDA-approved drugs might hypothetically help against the identified phenotypes.

Out of over 1,600 such medications already approved by the FDA, sildenafil turned out to be one of the most promising candidates.

That might sound baffling – given the drug is so far used in the main only for treating erectile dysfunction and pulmonary hypertension – in the research community, there were already signs the sildenafil compound might have other kinds of health benefits, given its interactions with the amyloid and tau proteins implicated in Alzheimer’s pathology.

 

“Recent studies show that the interplay between amyloid and tau is a greater contributor to Alzheimer’s than either by itself,” Cheng says.

“We hypothesized that drugs targeting the molecular network intersection of amyloid and tau endophenotypes should have the greatest potential for success… Sildenafil, which has been shown to significantly improve cognition and memory in preclinical models, presented as the best drug candidate.”

The hypothesis appears to be borne out by the health insurance data, with the team finding sildenafil users had a 69 percent reduced risk of Alzheimer’s disease compared to non-users – a reduction that was notably stronger than other kinds of medications also investigated in the study, including losartan, metformin, diltiazem, and glimepiride.

Of course, the researchers emphasize that none of this establishes causality, but on that front there may be other promising leads.

In separate experiments studying human brain cells in vitro to explore how sildenafil might confer protection against Alzheimer’s cognitive decline, the researchers observed that neurons treated with the drug showed elevated growth and reduced tau accumulation.

It’s early days, but those effects could well have something to do with the reduced chances of developing Alzheimer’s in the insurance cohort. To that end, it’s important to follow these leads further, the team says.

“We are now planning a mechanistic trial and a phase II randomized clinical trial to test causality and confirm sildenafil’s clinical benefits for Alzheimer’s patients,” Cheng says.

“We also foresee our approach being applied to other neurodegenerative diseases, including Parkinson’s disease and amyotrophic lateral sclerosis, to accelerate the drug discovery process.”

The findings are reported in Nature Aging.

 

Read original article here