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How Soon Can Viagra Be Taken After Discontinuing Isosorbide?
Question: My doctor took me off Isorsorbide so I can take Viagra.( he ordered 1/2 tab 25 mg once a week. He did not give me a replacement for isosorbide. Do I need a replacement for Isorsorbide?. I have been on it for 10 years and have no chest pain. How soon can I take Viagra after stopping Isosorbide? Attached below is my med list. I had cardiac bypass 10 years ago and have diabetes. Thank You.
1. Aspirin 81 MG Chew Tab Chew One Tablet by mouth everyday for Heart
2. Atorvastatin Calcium 20 MG Tab take one-Half Tablet by mouth at bedtime for Cholesterol
3. AmLODIPine Besylate 10 MG Tab Take one Tablet by mouth every day for Heart/Blood Pressure
4. Calcium 600 MG/vitamin D 400 Unit Tab Take 1 tablet by mouth twice a day
5. Finasteride 5 MG Tab Take one tablet by mouth every day for Prostate
6. Furosemide 4 0MG Tab Take one tablet by mouth every morning for heart/blood pressure
7. HydrALAZINE HCL 50MG Tab take two tablets by mouth every 8 hours for high blood Pressure
8. Insulin, Aspart, ZHuman Inj 25 units under skin three times daily before meals and insulin coverage for blood sugarz: 150 – 200 Add 2 units; 201 – 250 Add 4 Units; 251 – 300 Add 6 Units; 301 – 350 Add 8 Units; 351 – 400 Add 10 Units
9. Isosorbide Mononitrate 60MG SA Tab Take one tablet by mouth every day for heart
10. Magnesium Oxide 400 MG Tab Take one tablet by mouth every 48 hours for supplement
11. Metoprolol Tartrate 100 MG Tab Take one tablet by mouth twice a day for heart/Blood pressure
12. MetFORMIN HCL 1000 MG Tab take one tablet by mouth twice a day with meal for blood sugar (Diabetes)
13. Omeprazole 20 MG EC Cap Take Two capsules by mouth every day for the stomach. Take Before a Meal.
14. Terazosin HCL 2 MG Cap Take one capsule by mouth every day
1. Aspirin 81 MG Chew Tab Chew One Tablet by mouth everyday for Heart
2. Atorvastatin Calcium 20 MG Tab take one-Half Tablet by mouth at bedtime for Cholesterol
3. AmLODIPine Besylate 10 MG Tab Take one Tablet by mouth every day for Heart/Blood Pressure
4. Calcium 600 MG/vitamin D 400 Unit Tab Take 1 tablet by mouth twice a day
5. Finasteride 5 MG Tab Take one tablet by mouth every day for Prostate
6. Furosemide 4 0MG Tab Take one tablet by mouth every morning for heart/blood pressure
7. HydrALAZINE HCL 50MG Tab take two tablets by mouth every 8 hours for high blood Pressure
8. Insulin, Aspart, ZHuman Inj 25 units under skin three times daily before meals and insulin coverage for blood sugarz: 150 – 200 Add 2 units; 201 – 250 Add 4 Units; 251 – 300 Add 6 Units; 301 – 350 Add 8 Units; 351 – 400 Add 10 Units
9. Isosorbide Mononitrate 60MG SA Tab Take one tablet by mouth every day for heart
10. Magnesium Oxide 400 MG Tab Take one tablet by mouth every 48 hours for supplement
11. Metoprolol Tartrate 100 MG Tab Take one tablet by mouth twice a day for heart/Blood pressure
12. MetFORMIN HCL 1000 MG Tab take one tablet by mouth twice a day with meal for blood sugar (Diabetes)
13. Omeprazole 20 MG EC Cap Take Two capsules by mouth every day for the stomach. Take Before a Meal.
14. Terazosin HCL 2 MG Cap Take one capsule by mouth every day
Brief Answer:
please wait and watch for angina.
Detailed Answer:
Dear Sir
1. The current literature do not recommend long term use of nitrates for most patients of coronary artery disease (CAD). The continued use of nitrates for 10 years without any angina is difficult to understand and your primary physician may be aware for justification of such a use. Yes. Sudden withdrawal of nitrates is known to induce angina in certain proportion of patients of CAD. We always withdraw it gradually in our patients, by decreasing the dose over a period of days.
2. The use of Viagra (sildenafil) is absolutely contraindicated in first 24 hours of taking isosorbide mono or dinitrate. Since the withdrawal is sudden and there may be chances of rebound angina (may be minimal), the use of sildenafil should be avoided for a further period of at least 24 hours (Total 48 hours). The reason for this precaution is as follows. If by any chance you develop angina after use of viagra (sildenafil), you will not be able to treat it with nitrates, as they will be contraindicated for 24 hours after use of viagra (sildenafil). Hence adequate precautions must be taken.
Sincerely
Sukhvinder
please wait and watch for angina.
Detailed Answer:
Dear Sir
1. The current literature do not recommend long term use of nitrates for most patients of coronary artery disease (CAD). The continued use of nitrates for 10 years without any angina is difficult to understand and your primary physician may be aware for justification of such a use. Yes. Sudden withdrawal of nitrates is known to induce angina in certain proportion of patients of CAD. We always withdraw it gradually in our patients, by decreasing the dose over a period of days.
2. The use of Viagra (sildenafil) is absolutely contraindicated in first 24 hours of taking isosorbide mono or dinitrate. Since the withdrawal is sudden and there may be chances of rebound angina (may be minimal), the use of sildenafil should be avoided for a further period of at least 24 hours (Total 48 hours). The reason for this precaution is as follows. If by any chance you develop angina after use of viagra (sildenafil), you will not be able to treat it with nitrates, as they will be contraindicated for 24 hours after use of viagra (sildenafil). Hence adequate precautions must be taken.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
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