Rheumatic heart disease and viagra

Have you done any echocardiography and what is your ejection fraction? Do your doctors tell you you have heart failure? If you have only mild mitral and aortic regurgitation and there is no heart failure, it should be ok if you take viagra but please take lower dose e.g. 25mg daily if you are worried.

Below is some drug info about Viagra from mims.com, one of the online drug reference that I always referrong to. Please pay your attention to contraindications which I highlight in red.

Contents
Sildenafil citrate

Indications
Treatment of erectile dysfunction.

Dosage
Adult 50 mg once daily, taken approx 1 hr before sexual activity. The dose may be increased to 100 mg or decreased to 25 mg. Max: 100 mg once daily. Elderly >65 yr Initially 25 mg, may increase to 50-100 mg based on efficacy & tolerability.

Overdosage
View Viagra overdosage for action to be taken in the event of an overdose.

Administration
May be taken with or without food

Contraindications
Men for whom sexual activity is inadvisable (patients w/ severe CV disorders eg unstable angina or severe cardiac failure). Severe hepatic impairment, hypotension (<90/50 mm Hg), recent history of stroke or MI, known hereditary degenerative retinal disorders such as retinitis pigmentosa. Co-administration w/ nitric oxide donors (eg amyl nitrite), nitrates in any form. Hypersensitivity to sildenafil.

Special Precautions
A medical history & physical exam should be undertaken to diagnose erectile dysfunction & determine potential underlying causes, before Viagra is considered. Anatomical deformation of the penis (angulation, cavernosal fibrosis or Peyronie's disease), conditions which may predispose to priapism (sickle cell anaemia, multiple myeloma or leukaemia). Patients w/ bleeding disorders, active peptic ulceration, or untreated proliferative diabetic retinopathy. Co-administration w/ ritonavir not advised, if necessary, max dose of sildenafil is 25 mg/48 hr.

Adverse Drug Reactions
Headache, flushing, dizziness, dyspepsia, nasal congestion, altered vision.

Drug Interactions
Organic nitrates, nitric oxide donors (amyl nitrite), ritonavir, ketoconazole, itraconazole, erythromycin, cimetidine, saquinavir

Pregnancy Category (US FDA)
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Storage
View Viagra storage conditions for details to ensure optimal shelf-life.

Mechanism of Action
View Viagra mechanism of action for pharmacodynamics and pharmacokinetics details.

MIMS Class
Drugs for Erectile Dysfunction

ATC Classification
G04BE03 - Sildenafil ; Belongs to the class of drugs used in erectile dysfunction.

Poison Schedule
B