sildenafil-citrate and Rhabdomyolysis

Sildenafil citrate (Viagra®) is used to treat male erectile dysfunction; however, little is known about the effects of sildenafil overdose and intoxication. We report a patient who presented with cerebral infarction and rhabdomyolysis after intentional sildenafil intoxication.. A 61-year-old man visited the Emergency Department complaining of dysarthria about 1 h after taking more than 30 sildenafil tablets with the intention to commit suicide. Dysarthria and dizziness were observed, but there were no other neurological symptoms. The creatine kinase level was elevated to 3118 U/L, and the patient was diagnosed with rhabdomyolysis. Brain magnetic resonance imaging revealed multiple scattered acute cerebral infarctions in both midbrain artery branches. At 4 h post-intoxication, the dysarthria had improved and we initiated dual antiplatelet therapy for cerebral infarction. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be able to anticipate and treat complications like cerebral infarction and rhabdomyolysis after sildenafil intoxication.

Topics: Cerebral Infarction; Dysarthria; Erectile Dysfunction; Humans; Male; Middle Aged; Piperazines; Purines; Rhabdomyolysis; Sildenafil Citrate

Topics: Drug Overdose; Humans; Male; Middle Aged; Phosphodiesterase 5 Inhibitors; Piperazines; Purines; Rhabdomyolysis; Sildenafil Citrate; Sulfones; Treatment Outcome; Visual Perception

A 66-year-old man with diabetes and hypertension using statin was admitted to the hospital with progressive myalgia. He had been on rosuvastatin for five months. After beginning the use of phosphodiesterase-5 inhibitors, he presented with severe muscle pain and maintained penile erection. Several days after interruption of therapy, muscle pain and penile erection disappeared. This case demonstrates the interaction of sildenafil with rosuvastatin might result in myopathy.

Topics: Aged; Drug Interactions; Fluorobenzenes; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Pain; Penile Erection; Phosphodiesterase Inhibitors; Piperazines; Purines; Pyrimidines; Rhabdomyolysis; Rosuvastatin Calcium; Sildenafil Citrate; Sulfonamides; Sulfones

Topics: Aged; Anticholesteremic Agents; Drug Interactions; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Phosphodiesterase Inhibitors; Piperazines; Purines; Rhabdomyolysis; Sildenafil Citrate; Simvastatin; Sulfones