title: Viagra deafness--sensorineural hearing loss and phosphodiesterase-5 inhibitors.
abstract: BACKGROUND
  Viagra and PDE-5 inhibitors use has mushroomed since its launch over a decade ago. A growing body of evidence indicates significant morbidity associated with the side effect profile of this class of drug. Hearing loss associated with PDE-5 inhibitor use has recently been reported, but few studies have evaluated the causal link.
  
  
  OBJECTIVE
  To review and scrutinise the current literature on the subject and propose possible physiologic mechanisms and to investigate the global reporting of this side effect.
  
  
  METHODS
  Pharmacovigilance agencies around North America, Europe, and Australasia were contacted requesting reports of hearing loss associated with PDE-5 inhibitors. Reports were scrutinised to exclude those where others causes of hearing loss existed.
  
  
  RESULTS
  Forty-seven cases of sensorineural hearing loss with a temporal association with PDE-5 inhibitor ingestion were obtained from both published literature and pharmacovigilance agencies. Cases had a mean age 56.6 years, male-to-female ratio of 7:1. Eighty-eight percent of reports were unilateral with an even left/right distribution. Hearing loss occurred within 24 hours of ingestion of PDE-5 inhibitor in 66.7% (n = 18) of cases. Sildenafil accounted for over 50% of cases.
  
  
  CONCLUSIONS
  There is increasing evidence that PDE-5 inhibitors may induce sensorineural hearing loss via plausible physiological mechanisms. There needs to be more awareness of this disabling side effect among healthcare professionals responsible for prescribing this drug.
authors.affiliation: Ear, Nose and Throat Department, Charing Cross Hospital, London, United Kingdom. afroze.khan@hs.net
authors.forename: Afroze Shah
authors.initials: AS
authors.lastname: Khan
authors.forename: Zishan
authors.initials: Z
authors.lastname: Sheikh
authors.forename: Shahnawaz
authors.initials: S
authors.lastname: Khan
authors.forename: Raghav
authors.initials: R
authors.lastname: Dwivedi
authors.forename: Elliot
authors.initials: E
authors.lastname: Benjamin
mesh_terms: D000328:Adult; D000368:Aged; D044362:Australasia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000009:adverse effects*; D010879:Piperazines / Q000009:adverse effects*; D011358:Product Surveillance, Postmarketing; D011687:Purines / Q000009:adverse effects; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate