Phosphodiesterase type 5 inhibitors (PDE5i) – erectile dysfunction drugs sold as Viagra, Levitra and Cialis – and nitrates in chest pain medications can cause drops in blood pressure.
Swedish researchers studied 61,400 men on nitrates with 5,700 of those also using erectile dysfunction pills.
Men taking both had an overall higher risk of death plus heart attack, heart failure and other cardio issues.
Few events occurred within 28 days of men receiving an erectile dysfunction drug, indicating that there is low immediate risk.
Associate Professor Daniel Peter Andersson, of Karolinska Institutet in Stockholm, said there is a “need for careful patient-centred consideration” before prescribing both drugs.
The results are in the Journal of the American College of Cardiology.