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Not to add to doubts and misery, but have members heard of the connections of ED drugs and ophthalmological impairments? Here’s the link: https://bit.ly/3uwuO0N JAMA Ophthalmology, online April 7, 2022.
Visual impairments from ED drugs
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Archives1
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Side effects related to vision are considered "rare" but they can be serious.
Talk to your doctor and make your judgment on the risk-benefit balance.
From the prescribing information:
5.5 Visual Los s
When used to treat erectile dysfunction, non-arteritic anterior ischemic optic neuropathy (NAION), a
cause of decreased vision including permanent loss of vision, has been reported postmarketing in
temporal association with the use of phosphodiesterase type 5 (PDE-5) inhibitors, including sildenafil.
Most, but not all, of these patients had underlying anatomic or vascular risk factors for developing
NAION, including but not necessarily limited to: low cup to disc ratio (“crowded disc”), age over 50,
diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. Based on published
literature, the annual incidence of NAION is 2.5 to 11.8 cases per 100,000 males aged ≥ 50 per year in
the general population.
An observational case-crossover study evaluated the risk of NAION when PDE-5 inhibitor use, as a
class, occurred immediately before NAION onset (within 5 half-lives), compared to PDE-5 inhibitor
use in a prior time period. The results suggest an approximate 2-fold increase in the risk of NAION,
with a risk estimate of 2.15 (95% CI 1.06, 4.34). A similar study reported a consistent result, with a risk
estimate of 2.27 (95% CI 0.99, 5.20). Other risk factors for NAION, such as the presence of
“crowded” optic disc, may have contributed to the occurrence of NAION in these studies.
Neither the rare postmarketing reports, nor the association of PDE-5 inhibitor use and NAION in the
observational studies, substantiate a causal relationship between PDE-5 inhibitor use and NAION [see
Adverse Reactions (6.2].
Advise patients to seek immediate medical attention in the event of a sudden loss of vision in one or both eyes while taking PDE-5 inhibitors, including sildenafil. Physicians should also discuss the increased risk of NAION with patients who have already experienced NAION in one eye, including whether such
individuals could be adversely affected by use of vasodilators, such as PDE-5 inhibitors.
There are no controlled clinical data on the safety or efficacy of sildenafil in patients with retinitis pigmentosa, a minority whom have genetic disorders of retinal phosphodiesterases. Prescribe sildenafil with caution in these patients.
Talk to your doctor and make your judgment on the risk-benefit balance.
From the prescribing information:
5.5 Visual Los s
When used to treat erectile dysfunction, non-arteritic anterior ischemic optic neuropathy (NAION), a
cause of decreased vision including permanent loss of vision, has been reported postmarketing in
temporal association with the use of phosphodiesterase type 5 (PDE-5) inhibitors, including sildenafil.
Most, but not all, of these patients had underlying anatomic or vascular risk factors for developing
NAION, including but not necessarily limited to: low cup to disc ratio (“crowded disc”), age over 50,
diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. Based on published
literature, the annual incidence of NAION is 2.5 to 11.8 cases per 100,000 males aged ≥ 50 per year in
the general population.
An observational case-crossover study evaluated the risk of NAION when PDE-5 inhibitor use, as a
class, occurred immediately before NAION onset (within 5 half-lives), compared to PDE-5 inhibitor
use in a prior time period. The results suggest an approximate 2-fold increase in the risk of NAION,
with a risk estimate of 2.15 (95% CI 1.06, 4.34). A similar study reported a consistent result, with a risk
estimate of 2.27 (95% CI 0.99, 5.20). Other risk factors for NAION, such as the presence of
“crowded” optic disc, may have contributed to the occurrence of NAION in these studies.
Neither the rare postmarketing reports, nor the association of PDE-5 inhibitor use and NAION in the
observational studies, substantiate a causal relationship between PDE-5 inhibitor use and NAION [see
Adverse Reactions (6.2].
Advise patients to seek immediate medical attention in the event of a sudden loss of vision in one or both eyes while taking PDE-5 inhibitors, including sildenafil. Physicians should also discuss the increased risk of NAION with patients who have already experienced NAION in one eye, including whether such
individuals could be adversely affected by use of vasodilators, such as PDE-5 inhibitors.
There are no controlled clinical data on the safety or efficacy of sildenafil in patients with retinitis pigmentosa, a minority whom have genetic disorders of retinal phosphodiesterases. Prescribe sildenafil with caution in these patients.
Archives1
Staff member
Oh Damn. Okay, now someone translate Slawrence's input. :O
Stryder and Slawrence. Have you read the full article/study? Can you legally give us more info?
Almost an hour of research resulted in the following.
Aside from the various pills for ED, there is an injection called Bi-Mix. There's a Tri-Mix, also. Bi-Mix is Papaverine 30MG and Phentolmine 1MG/ML. Drugs.com does list Paraverine. Drugs.com has recently begun limiting use, but I got as far as the drugs that cause negative interactions. There are usage rules, like how much to increase per time to determine the right dose, and how often it can be used. (Not more than once in 24 hours, never in consecutive days, and not more than 3 times per week, if my research is correct.) I haven't looked up the pills.
The book "The Pornography Industry: What everyone Needs to Know", by Shira Tarrant, 2016, the Oxford University Press, details a few other problems, although few of us are sex workers, I'm guessing. Are the drugs in Bi-Mix and Tri-Mix in the above classifications? I can't answer that. I'd sure as hell ask the doctor! The Abstract seems to imply the issue is rare? What does that mean? I don't know. Most of my research on PubMed is for two other medical issues I have, and I subscribe to a company that links me to the article abstracts, and most of what I want to read gets on PubMed.
Anyone can read the Abstracts. JAMA charges $40 to read this full article/study. Some University Libraries have subscriptions, and students can use them. Most public libraries, even Hospital Libraries, either dropped their subscriptions to the companies that make these studies available, or hospitals now don't allow the public to use them. It's expensive! You wouldn't believe what people like JAMA charge for a years' subscription. Same for nursing journals. Phew!
PubMed.gov (the free government website) only lists this study, directs you back to JAMA. The law is: the medical publications have a year of exclusive content. Then, they only have to publish it on the free PubMed site if there is US Government money in the study. The article is too new.
This probably isn't very helpful, but I'm filling in the dots, if anyone wants to do more research or ask their Doc.
Another thought. What if you were on anti-coagulants? (Blood thinners)?
If you're a woman and breastfeeding, don't use Bi-Mix, according to Drugs.com.
How does "The Hitchhiker's Guide to the Galaxy" put it? In nice, friendly letters? DON'T PANIC!
Thanks, Stryder.
Good luck, everyone.
Stryder and Slawrence. Have you read the full article/study? Can you legally give us more info?
Almost an hour of research resulted in the following.
Aside from the various pills for ED, there is an injection called Bi-Mix. There's a Tri-Mix, also. Bi-Mix is Papaverine 30MG and Phentolmine 1MG/ML. Drugs.com does list Paraverine. Drugs.com has recently begun limiting use, but I got as far as the drugs that cause negative interactions. There are usage rules, like how much to increase per time to determine the right dose, and how often it can be used. (Not more than once in 24 hours, never in consecutive days, and not more than 3 times per week, if my research is correct.) I haven't looked up the pills.
The book "The Pornography Industry: What everyone Needs to Know", by Shira Tarrant, 2016, the Oxford University Press, details a few other problems, although few of us are sex workers, I'm guessing. Are the drugs in Bi-Mix and Tri-Mix in the above classifications? I can't answer that. I'd sure as hell ask the doctor! The Abstract seems to imply the issue is rare? What does that mean? I don't know. Most of my research on PubMed is for two other medical issues I have, and I subscribe to a company that links me to the article abstracts, and most of what I want to read gets on PubMed.
Anyone can read the Abstracts. JAMA charges $40 to read this full article/study. Some University Libraries have subscriptions, and students can use them. Most public libraries, even Hospital Libraries, either dropped their subscriptions to the companies that make these studies available, or hospitals now don't allow the public to use them. It's expensive! You wouldn't believe what people like JAMA charge for a years' subscription. Same for nursing journals. Phew!
PubMed.gov (the free government website) only lists this study, directs you back to JAMA. The law is: the medical publications have a year of exclusive content. Then, they only have to publish it on the free PubMed site if there is US Government money in the study. The article is too new.
This probably isn't very helpful, but I'm filling in the dots, if anyone wants to do more research or ask their Doc.
Another thought. What if you were on anti-coagulants? (Blood thinners)?
If you're a woman and breastfeeding, don't use Bi-Mix, according to Drugs.com.
How does "The Hitchhiker's Guide to the Galaxy" put it? In nice, friendly letters? DON'T PANIC!
Thanks, Stryder.
Good luck, everyone.
Archives1
Staff member
Hi, AlasSouth: Sorry that I can't provide more information besides the full prescribing info which I listed. I'm a patient and a PhD behavioral health provider but not an MD; so I can read this stuff (and understand much of it) but I won't try to interpret it further. Best bet is to use the prescribing information as a guide, find the articles where you can (and yes, I did read the full article) and then list questions for your urologist or opthalmalogist. Don't rely on a PCP for questions about these specialized medications. Good luck!
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