title: Myocardial infarction following the combined recreational use of Viagra and cannabis.
abstract: Sildenafil citrate (Viagra, Pfizer, Inc., New York, N.Y.) is widely prescribed as a treatment for male erectile dysfunction. It is metabolized predominantly by the cytochrome P450 3A4 hepatic microsomal isoenzyme and effects can, therefore, be potentiated by such inhibitors. The vasodilatory effects of Viagra necessitate caution in its use in patients with cardiovascular disease and it is contraindicated in patients receiving nitrates. Previous literature has drawn attention to Viagra use and myocardial infarction. This paper reports the case of a young man who presented with a myocardial infarction after taking Viagra in combination with cannabis, a known inhibitor of the cytochrome P450 3A4 isoenzyme.
authors.affiliation: Department of Cardiology, Western General Hospital, Edinburgh, UK. a.McLeod@ed.ac.uk
authors.forename: A L
authors.initials: AL
authors.lastname: McLeod
authors.forename: C J
authors.initials: CJ
authors.lastname: McKenna
authors.forename: D B
authors.initials: DB
authors.lastname: Northridge
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects*; D010879:Piperazines / Q000009:adverse effects*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate