No adverse hemodynamic interaction between sildenafil and red wine
Abstract
OBJECTIVE: Our objective was to investigate the hemodynamic interaction between sildenafil and red wine. Sildenafil citrate (Viagra), a phosphodiesterase type 5 inhibitor, is an effective treatment for male erectile dysfunction that potentiates nitric oxide-mediated vasodilation. Alcohol is a commonly used recreational substance with complex vascular effects, which may, in part, be mediated by nitric oxide. Thus there is potential for an adverse hemodynamic interaction.
METHODS: Eight healthy men received either 100 mg sildenafil, alcohol (750 mL red wine, 13.5% by volume), or the combination, in a 4-way, double placebo-controlled, randomized crossover study. Blood pressure, heart rate, and cardiac index were measured every 15 minutes up to 180 minutes.
RESULTS: Results are expressed as mean +/- SEM. Red wine increased cardiac index (by 15% +/- 8%, P = .04) and heart rate (by 27% +/- 5%, P < .0001). Mean arterial pressure initially increased by approximately 5% and then fell by a maximum of approximately 7%. Sildenafil reduced peripheral vascular resistance (by 24% +/- 8%, P = .03) and mean arterial pressure (by 7% +/- 3%, P = .03) with no effect on cardiac index or heart rate.
CONCLUSIONS: There is no clinically important hemodynamic interaction between sildenafil and alcohol (red wine).
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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