Before discussing the potential dangers in using Viagra (Sildenafil) (and the following comments apply to Levitra and Cialis as well), I want to remind you in some words how Viagra acts to make erections better. Viagra renders inactive the natural enzyme which is in our cells. This enzyme breaks down nitric oxide (NO), an important messenger molecule that is involved in a lot of physiological and pathological processes within the body of mammals both detrimental and beneficial. To prevent this breakdown that usually happens within few seconds of being formed, Viagra can be used, prolonging its action, and releasing nitric oxide that causes an erection. So preventing the breakdown increases the erection strength and duration. Viagra, despite a number of myths, doesn’t increase the duration or enjoyment that is achieved in any orgasm, or to raise the ejaculate volume.

The men who are taking nitrates related to NO for heart disease should use Viagra carefully because of side effects. Imdur (isosorbide), Nitroglycerin and other forms of nitrate are usually used to prevent or treat angina, the pain which occurs in people having arteriosclerosis or coronary heart disease. A nitrate is given to somebody with angina in order to widen, or open the heart arteries that allows increasing blood flow and as a result less pain. Moreover the nitrates can open blood vessels all over the body, causing blood pressure drop that is often not noticeable or important.

If a man takes nitrates together with Viagra, the Viagra averts the natural quick nitrate breakdown, and greatly prolongs and increases the effect that can cause a heart attack or shock if a man experiences heart disease. Thus Viagra is certain not to be recommended for any person who takes nitrates. The same is true for men who use inhale butyl nitrate or amyl nitrate in order to improve orgasm condition. Such nitrate drugs may be hazardous if a man takes Viagra at the same time.

And how about a person who has diabetes? The answer is, if a diabetic isn’t using any drug that contains nitrate, then there isn’t any risk from using Viagra. On the other hand, since Viagra appearance, specialists have constantly been worrying if it is safe for a diabetic or any other man having heart disease the increased sexual activity caused by the drug usage or it can result in heart problems. In other words, in case a diabetic isn’t able to reach a strong erection, he can’t engage in the intercourse exertion, and consequently won’t get a heart attack that exertion may cause. Can sexual exertion result in a heart attack? Well, there’re many reports proving this, but at the same time, there’re countless reports on men who had heart disease and died while working in the garden. Therefore the sexual exertions are probably as dangerous as any strong exertion if a person experiences heart disease.

Diabetes really increases a person’s risk of the heart disease developing, particularly if a person hasn’t controlled the diabetes well for years. Though, it depends on various factors, such as the age of a person, other problems, for example, hypertension or increased cholesterol, family history, and so on. Furthermore a small number of sudden loss of vision cases in diabetics (or others having artery disease predisposion) who have used Viagra have been reported as well. It’s just been reported in patients having a low cup-to-disc ratio in their eyes, an ophthalmologist would have to do this measurement. Luckily this problem seems to be rare, and usually has involved just one eye.

Consequently I could answer in this way: Viagra has nothing that will be a problem to diabetics. There is a problem if this diabetic has also heart disease that could place her or him at risk with any strong exertion, such as having sex. Each diabetic must discuss this problem with the doctor. A younger diabetic, under 35 years old, is most likely to be at little risk taking Viagra, though if his father had diabetes and died of a heart attack when he was 34, that risk increases for the son. A well-controlled 65 year-old diabetic who has no hypertension, high cholesterol or heart disease signs can take Viagra safely as well, but I’d advise him to consult with his doctor. I have many diabetic patients in my practice who use Viagra without any problem. And I’d never prescribe Viagra to any person who is taking any drugs containing nitrate, and I constantly warn them of such a problem, because a great number of people get medications from various doctors.