sildenafil-citrate and Glaucoma

To assess the short-term effects of sildenafil citrate on intraocular pressure in healthy male volunteers and participants in clinical trials.. Intraocular pressure and pupil diameter were measured in two placebo-controlled studies. Oral doses of sildenafil citrate (VIAGRA; Pfizer Inc, New York, New York) ranged from 10 mg to 150 mg.. No major changes in intraocular pressure or pupillometry were detected at any time (1.0-24 hours) after administration of sildenafil. Additionally, of 36 subjects with a medical history of increased intraocular pressure in the sildenafil safety database, none were reported to have a clinically significant increase of their intraocular pressure. During clinical trials, two glaucoma cases were listed as serious adverse events, but were not considered treatment related.. No clinical abnormalities were observed in intraocular pressure or pupil diameter in subjects receiving sildenafil. Currently, no evidence suggests that long-term treatment with sildenafil has an effect on intraocular pressure or is associated with the development or worsening of glaucoma.

Topics: 3',5'-Cyclic-GMP Phosphodiesterases; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Erectile Dysfunction; Glaucoma; Humans; Intraocular Pressure; Male; Phosphodiesterase Inhibitors; Piperazines; Pupil; Purines; Sildenafil Citrate; Single-Blind Method; Sulfones; Tonometry, Ocular

While decreased ocular blood flow is thought to be a possible contributor to glaucoma pathogenesis, it is unclear what role systemic phosphodiesterase inhibitors (PDEi) play. We performed a cross-sectional study of a nationally representative sample of the U.S. population to investigate the relationship between the most commonly used PDEi, sildenafil and theophylline, and self-reported glaucoma.. We used the National Health and Nutrition Examination Survey 2005-2008 cycles for this observational study. 7,042 participants, aged 40 years and over, responded to a survey item on glaucoma status and were included in the analysis. Multivariable logistic regression models were constructed to evaluate the association between at least 1 year of self-reported PDEi use and prevalent glaucoma. Regressions were adjusted for potential confounding variables, including demographics, socioeconomic status, and general health conditions, and accounted for the complex design of the survey. Sample weights were constructed and used to ensure the generalizability of results.. 482 respondents self-reported a diagnosis of glaucoma, of which 11 used sildenafil and 20 used theophylline for at least 1 year. Covariates significantly associated with higher odds of glaucoma prevalence in univariable analyses included older age, black race, former smoking status, diabetes, hyperlipidemia, myocardial infarction, and stroke. Conversely, higher education and income were significantly associated with lower odds of glaucoma prevalence. In regression analyses adjusted for demographic and socioeconomic variables, sildenafil (OR = 4.90, CI: 1.24-19.27, p = 0.025) and theophylline (OR = 3.15, CI: 1.46-6.80, p = 0.005) were significantly associated with higher odds of self-reported glaucoma. These associations held after further adjustment with general health behaviors and conditions for both sildenafil and theophylline.. Use of sildenafil and theophylline for one or more years was associated with greater prevalence of self-reported glaucoma, a finding which requires further prospective study to assess causality and possible mechanisms of action.

Topics: Aged; Cross-Sectional Studies; Female; Glaucoma; Humans; Male; Middle Aged; Phosphodiesterase Inhibitors; Sildenafil Citrate; Theophylline; United States

Topics: Antimetabolites, Antineoplastic; Antitubercular Agents; Cataract; Central Serous Chorioretinopathy; Corneal Opacity; Ethambutol; Glaucoma; Humans; Interferons; Phosphodiesterase 5 Inhibitors; Piperazines; Purines; Sildenafil Citrate; Steroids; Stevens-Johnson Syndrome; Sulfones; Tegafur; Vision Disorders

Topics: 3',5'-Cyclic-GMP Phosphodiesterases; Antihypertensive Agents; Drug Interactions; Glaucoma; Humans; Hypertension; Male; Piperazines; Purines; Sildenafil Citrate; Sulfones