Presence of nitric oxide in Viagra/other drugs can lead to
dangerously low blood pressure in patients
The American Association of Nurse Anesthetists (AANA) advises Viagra users to exercise caution and common sense and not take this popular impotence treatment for at least 24 hours before surgery.
Viagra, which uses nitric oxide to open the blood vessels and relax the muscles, can cause a patient’s blood pressure to become dangerously low when combined with the effects of anesthesia and other drugs used during surgery. Though not found in anesthesia specifically, nitric oxide–not to be confused with nitrous oxide or "laughing gas"–may be present in the medication used to control a patient’s high blood pressure during an operation. The combination of the nitric oxide in these drugs with the use of anesthesia can mitigate the effectiveness of drugs used to raise low blood pressure and produce a host of short- and long-term side effects ranging from poor circulation to kidney and heart failure.
Bruce A. Schoneboom, CRNA, PhD, FAAN, who has conducted extensive research on this subject, notes that "drugs in the nitrate family do not mix with Viagra," and urges patients to disclose all information about substances, including non-pharmaceuticals like dietary supplements, ginseng, ginger and herbal treatments, to anesthesia providers before going into surgery.
"For various reasons, Viagra users don’t always inform their anesthesia provider that they are taking it," says Schoneboom. "Maybe they’re embarrassed, or they dismiss it as insignificant, or they simply forget. However, for the anesthesia provider, when assessing the anesthetic needs of an individual prior to surgery, the importance of being made aware of a patient’s Viagra use cannot be stressed enough."
Though no documented deaths involving Viagra and anesthesia have occurred, the AANA advises caution before surgery. The following guidelines can help Viagra users and anesthesia providers better prepare for any surgical procedure. Prior to surgery:
Inform your Certified Registered Nurse Anesthetist (CRNA) or anesthesia provider about your Viagra use.
Inform your CRNA or anesthesia provider about other prescription drugs as well as dietary supplements, ginseng, and ginger.
Do not take Viagra the day before surgery because it takes more than 24 hours for nitric oxide to clear the body’s system.