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Sildenafil citrate (Viagra; Pfizer US Pharmaceutical Group, New York, NY) is prescribed for millions of men with erectile dysfunction. There are well-known risks of cardiovascular events in patients taking sildenafil concomitantly with organic nitrates.1,2⇓ However, little is known about stroke risk in patients with previous cerebrovascular events who take sildenafil. In both placebo-controlled and open-label studies, sildenafil was not associated with an increased risk of stroke.2 These studies, however, excluded patients who had had myocardial infarction, life-threatening arrhythmia, or stroke in the previous 6 months2—a population at very high risk for subsequent stroke. We describe a patient who suffered a TIA followed by a stroke in the same distribution 6 days later, and each event was associated with sildenafil use.
Case report.
A 50-year-old, right-handed man ingested 50 mg of sildenafil without achieving an erection or participating in sexual intercourse. Two hours after taking the medication he developed right facial weakness, slurred speech, difficulty swallowing, altered right hemibody sensation, …
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- Transient ischemic attack and stroke associated with sildenafil (Viagra) use
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