A night of passion turned into disaster for an Indian man who suffered a fatal stroke after drinking while on impotence pills.
The 41-year-old man from India took twice the usual dose of sildenafil, the main ingredient of Viagra.
Doctors sharing the case revealed that he had met a girlfriend at a hotel where he had taken two 50mg sildenafil tablets.
TThe unknown man, who had high blood pressure, had also been drinking. Tests after his death showed his blood alcohol level to be more than twice the legal driving limit in the UK.
He developed a headache and vomited the next morning.
Despite pleas from his companion to seek medical attention, he refused, claiming he had previously experienced similar symptoms.
Post-mortem scans of the man’s head revealed that he had suffered a stroke, resulting in a 300g mass of coagulated blood, pink and blue lines. Yellow arrows indicate blood vessels in the brain dilated by the hemorrhage
Indian doctors claimed the man’s death could be the result of taking both the erectile dysfunction medication sildenafil and alcohol at the same time
He then deteriorated and was taken to hospital. The man was pronounced dead on arrival.
Detailing his autopsy in the Journal of forensic and legal medicineexperts discovered that he had suffered a cerebral hemorrhage.
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 mass of 300g of clotted blood.
An investigation revealed that the man did not have a prescription for sildenafil.
Authors said they published the case to raise awareness about the risks of taking erectile dysfunction drugs without medical advice.
They said that sildenafil is now used for recreational purposes by men with no problems getting an erection who want to improve their sexual performance.
The pathologists also said the man’s fatal stroke could have been caused by the combination of sildenafil and alcohol widening the blood vessels in his body.
This combined with a pre-existing blood pressure disorder put pressure on his vessels in his brain, leading to the stroke, they said.
This increase in blood flow is how sildenafil helps men with erectile dysfunction 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 showed that he had a blood alcohol level of 186.61 mg/100 ml of blood.
In comparison, the legal limit for drunk driving is 80 mg/100 ml of blood.
He also took two grams of 50mg 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 a prescription was a growing problem and said the drug should be added to the screening tests that are done to determine the case of death.
“As forensic pathologists, we should be aware of this emerging problem and toxicology screening for sildenafil should become routine in deaths occurring under such suspicious circumstances as to indicate recent sexual activity of any kind, autoeroticism or men with erectile dysfunction.” , they wrote.
The medics did not specify what brand of sildenafil medication he was taking, or where in India or when the case took place.
Sildenafil can be bought without a prescription in the UK, although men should have a talk with the pharmacist first to rule out any potential health problems that could make taking the drug dangerous.
The NHS says people taking medicines for chest pain, have serious heart or liver problems, or have recently had a heart attack or stroke are some of the conditions that can make taking sildenafil dangerous.
However, the health department says taking sildenafil with alcohol is safe, but since drinking can make it difficult to get an erection, it recommends avoiding drinking to get the most benefit.
Viagra, made by pharmaceutical company Pfizer, and not available on the NHS, carries a warning that it can cause a stroke in up to one in 1,000 people who take it.
Official NHS advice adds that there appears to be no lasting harmful effects from taking sildenafil, even over months or years.