Overnight, the prescription drug sensation is the new anti-impotence drug Viagra (sildenafil), constituting a staggering percentage of all new scrips being written. But a warning from AIDS Treatment News needs to be taken seriously: Sex use of poppers (nitrate inhalants) while taking Viagra could lead to dangerous hypotension (abnormally low blood pressure). Pfizer, Viagra’s manufacturer, tested the drug with the nitrates medically administered for angina (the legally sanctioned use for amyl nitrite), and their package insert cautions about hypotensive effects. But they didn’t try combinations with street version nitrates (usually butyl), which are very commonly used to enhance sex.
Inhalants, often sold as “odorizers” to skirt drug laws, provide a sensual and relaxing rush by dilating blood vessels. Viagra “potentiates” or magnifies the effect of the nitrate compounds to a possibly dangerous level, but consumers may not recognize Pfizer’s warning as including poppers, and it is unlikely that physicians would talk with patients about non-sanctioned substance use. For HIV-positive people taking Viagra, caution is also in order with protease inhibitors, ketoconazole, itraconazole or erythromycin: They magnify the effects of Viagra, so a lower dose may be in order.
If you are taking Viagra, be very frank with your doctor. Don’t be embarrassed! Information is also available from AIDS Treatment News (800/TREAT-1-2 or e-mail aidsnews@aidsnews.org) or from Pfizer (800/723-7529).
– Sandy Bartlett,
Community Information/Education Coordinator
AIDS Services of Austin
ASA Info Line: 458-AIDS
This article appears in May 15 • 1998 and May 15 • 1998 (Cover).