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Ecstasy and ViagraI would like to know if it is safe to mix Ecstasy and Viagra? Expert reply: I understand that there have now been two cases reported to Pfizer, the manufacturers of Viagra, of priapism associated with the use of Viagra together with ecstasy. (I don't know how many cases, if any, they have had reported of priapism with Viagra alone). Priapism is an unpleasant condition whereby the penis remains erect after sexual stimulation ceases. It can occur after the use of the older treatments for erectile dysfunction involving the direct injection of drugs into the penis. It is associated with a number of conditions where there may be abnormal blood flow or excessive clotting, e.g. abnormally viscous blood. These include multiple myelome, sickle cell anaemia (not, I think, sickle cell trait) and some leukaemias. The condition is nasty; it is painful and if left untreated clotting occurs in the erectile tissue of the penis and serious damage to the anatomy of the penis can follow. The mechanism may be that inhibitors of the drug metabolising enzyme system P450-3A4 are known to increase the concentration of sildenafil (the active component of Viagra) in blood. As a result the manufacturers of Viagra recommend a half tablet dose in patients taking known CYP3A4 inhibitors such as Ketoconazole, erythromycin and cimetidine). I can see obvious reasons why some users might want to try taking E and Viagra together. The advice has to be the same at that of Mr Punch to the young man about to marry, that is "don't", but if you must, try a half dose of each and if you get an erection that won't go down take yourself to a casualty department in fairly short order. |