A night of passion turned to disaster for an Indian man who suffered a fatal stroke after drinking while on impotence pills.
The 41-year-old man, from India, consumed twice the usual dose of sildenafil — the main ingredient in Viagra.
Doctors who shared the case revealed he had met up with a female friend at a hotel where he downed two 50mg sildenafil tablets.
The unidentified man, who had high blood pressure, had also drunk. Tests after his death showed his blood alcohol level was more than twice the legal UK driving limit.
He experienced a headache and was vomiting the next morning.
Despite pleas from his companion to call for medical help, he declined, claiming he had experienced similar symptoms before.
Post-mortem scans of the man’s head revealed he had suffered a stroke, resulting in a 300g mass of clotted blood, pink and blue lines. Yellow arrows indicate blood vessels in the brain that have been extended as a result of the haemorrhage
Indian doctors claimed the man’s death could be a result of taking both the erectile dysfunction medication sildenafil and alcohol at the same time
He then deteriorated and was whisked to hospital. The man was declared dead on arrival.
Detailing his autopsy in the Journal of Forensic and Legal Medicine, experts found he had suffered a cerebrovascular haemorrhage.
This type of stroke occurs when a blood vessel in the brain bursts.
Dr Jay Narayan Pandit, from the Department of Forensic Medicine, All India Institute of Medical Sciences, said post-mortem scans revealed a 300g mass of clotted blood.
Investigations found the man did not have a prescription for sildenafil.
Authors said they published the case to raise awareness about the risks of taking the erectile dysfunction medication without medical advice.
They said that sildenafil is now being used for recreational purpose by men without issues getting an erection wanting to enhance their sexual performance.
The pathologists also said the man’s fatal stroke could have occurred through the combination of sildenafil and alcohol dilating blood vessels in his body.
This combined with a pre-existing blood pressure disorder put his vessels in his brain under pressure, leading to the stroke, they said.
This increase in blood flow is how sildenafil helps men with ED maintain erections by increasing blood flow to the penis.
Alcohol can also increase blood flow at certain levels of intoxication.
A post-mortem blood test on the man revealed he had a blood alcohol level of 186.61mg/100 ml of blood.
For comparison the legal drink driving limit is 80mg/100 ml of blood.
He also consumed two 50mg grams of sildenafil that night.
This is twice the recommended dose for most men, according to the NHS.
Dr Narayan Pandit and colleagues said recreational use of sildenafil without prescription was a growing problem and said the drug should be added to the screening tests done to determine case of death.
‘As forensic pathologists, we should be aware of this emerging problem and toxicological screening for sildenafil should become routine in deaths occurring under such suspicious circumstances suggesting recent sexual activity of any kind, autoerotism, or men with erectile dysfunctions,’ they wrote.
The medics did not detail what brand of sildenafil medication he took, or where in India or when the case took place.
Sildenafil can be purchased over the counter in the UK though men must have a discussion with the pharmacists first to rule out any potential health conditions that could make taking the drug dangerous.
The NHS says people taking medication for chest pain, have serious heart or liver problems, or have recently had a heart attack or stroke as some of conditions that might make taking sildenafil dangerous.
However, the health service says taking sildenafil with alcohol is safe but as drinking can make it difficult to get an erection, recommends abstaining from booze to get the most benefit.
Viagra, which is made by pharmaceutical company Pfizer, and is not available on the NHS, carries a warning that it may cause a stroke in up to one in 1,000 people who take it.
Official NHS advice adds there does not seem to be any lasting harmful effects from taking sildenafil, even over the course of months and years.
