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Editor's Correspondence |

Use of Sildenafil Is Safe in Men With Congestive Heart Failure

Hans Mickley, MD, PhD; Tina Svenstrup Poulsen, MD
Arch Intern Med. 2004;164(18):. doi:10.1001/archinte.164.18.2068.
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Webster et al1 found that the PDE5 inhibitor sildenafil citrate can be safely used in the treatment of ED in men with NYHA classes II and III heart failure. The study by Webster and colleagues1 may include additional data of further clinical importance. It is generally recognized that the concomitant use of nitrates and PDE5 inhibitors is strictly contraindicated. Caution in using PDE5 inhibitors in patients receiving treatment with α-blockers has also been warranted, and combination therapy cannot be recommended. In the product summary of the most recent commercial available PDE5 inhibitor vardenafil hydrochloride (launched in 2003), it is emphasized that clinical data addressing the safety of combination therapy with vardenafil and α-blockers are insufficient. Similar conclusions can most likely be drawn for therapy with sildenafil or tadalafil.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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