Q. I had a major heart attack earlier this year and received a drug-eluting stent. My doctor tells me that it's now safe to exercise and engage in sexual activity. But is it safe to use erectile dysfunction (ED) medications?
A. Most men who have recovered from a heart attack can resume their usual sex life. Once your doctor allows you to engage in moderate aerobic activity — sexual activity is often equated to the exercise level of brisk walking — you may safely use ED medications with certain precautions.
These drugs, which include sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis), and avanafil (Stendra), are known as phosphodiesterase 5 (PDE5) inhibitors. They help relax blood vessels and increase blood flow to the penis. Sildenafil was initially investigated as a treatment for chest pain and high blood pressure. However, its actual effect on blood pressure is small and therefore not dangerous to men with heart disease.
Most men are aware of the dangerous interaction between PDE5 inhibitors and nitrates like nitroglycerin, which can result in a severe drop in blood pressure, so you need to avoid nitrate-containing medicine for 24 to 48 hours after using a PDE5 inhibitor. However, nitrate-rich foods, like root vegetables and dark leafy greens, are not a problem.
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