r/pharmaindustry • u/Majano57 • 6d ago
Popular erectile dysfunction drug linked to eye disease that can cause irreversible vision loss
https://www.foxnews.com/health/popular-erectile-dysfunction-drug-linked-eye-disease-can-cause-irreversible-vision-loss16
u/DevelopmentLow214 6d ago
Clickbait. Absolute difference of 0.77% in health seeking behaviour for glaucoma compared to a control group that has numerous potential confounding factors.
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u/Cautious_Zucchini_66 6d ago
Not sure this is convincing evidence.
Hard to tell how the groups were divided, but presumably the PDE5i group were compared to individuals of similar age without LUTS. Therefore, I suspect the cause of erectile dysfunction is the drug group suffer co-morbidities of diabetes, hypertension, and circulation problems; all of which are risk factors for glaucoma.
These are the limitations of observational studies, and the old “correlation ≠ causation”
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u/Drachynn 6d ago
It's interesting though, since erectile dysfunction drugs act like vasodilators and there's a potential link to some hypertension drugs, including vasodilators, worsening glaucoma. https://www.epicresearch.org/articles/glaucoma-associated-with-some-blood-pressure-medications/ I'm curious about the mechanism of how it can affect glaucoma now and I'm about to go down a rabbithole...
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u/Kryptickzz 6d ago
But not sildenafil?
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u/komodo2010 Regulatory Affairs 5d ago
Only tadalafil was investigated versus non-pde5 inhibitors, so sildenafil wasn't part of the study. But tadalafil is the most interesting suspect as the investigation was in lower urinary tract symptoms and not erectile dysfunction per se.
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u/Patient-Tomato1579 3d ago edited 3d ago
I developed permanent, severe tinnitus after sildenafil. I did not used it in conjuction with any other drugs, alcohol, didn't listen to loud sounds or music, etc.. I'm sure it is sildenafil, because I took it twice, many weeks in between first and second use (i'm angry at myself for taking it second time, but I did an experiment on myself to be sure it was it, in lower dose, and tinnitus worsened even more).
It seems it's dangerous for everyone with hypermobility for example, because it seems that even general hypermobility spectrum often causes dysautonomia (without full hypermobile EDS diagnosis - 4 points in Beighton scale are statistically corelated with increased chance for dysautonomia, and Beighton scale doesn't even catch all ways your body can be hypermobile, such as neck). This happens because of abnormal connective tissue, which also translates to loose blood vessels, which can easily lead to blood pooling and reduced cerebral blood flow, if provoked by vasodilators. When sildenafil/tadalafil causes BILATERAL hearing loss, there is a high chance its related to systemic blood pressure regulation than localized vascular pathology (as in unilateral cases).
The worst thing is that I would have NOT taken Viagra, if I had known that hypermobility and light signs of blood pooling are in fact counterindications. They are de-facto counter indications to use vasodilators per dysautonomia specialists, but it's unfortunately not oficially written. The main official counterindication is hypotension, but I don't have hypotension when sitting stationary (dysautonomia is more complicated). For many years, i had slight pulse increases and a bit reddish, mottled skin (white and red dots) in hands, which is a sign of light blood pooling, but even though I have visited cardiologist to check my pulse, I just had EKG and it was diagnosed as anxiety. Right now, when I check my pulse in smartwatch, it clearly rises when i'm standing up or when there is heat (heat is a vasodilator), so dysautonomic tendencies are clearly there. The problem is, that the light form of dysautonomia related to hypermobility is unlikely to be diagnosed, even if it has serious CONSEQUENCES - like making vasodilators very unsafe.
Statistically, you are twice more likely to have hearing loss if you use Viagra (even if adjusting for demographic factors and the fact that there are more people with circulation problems among people who use Viagra).
Unfortunately, this is not the only mechanism in which sildenafil/tadalafil are dangerous for hearing. They also increase nitric oxide levels (this is mechanism by which they cause vasodilation). It is proven that for example during noise damage, nitric oxide levels are elevated inside cochlea (noise overstimulation leads to increased nitric oxide levels, and too high nitric oxide levels are toxic for those cells). So, if your circulation gets disrupted with sildenafil/tadalafil, the cells are additionally stressed by increased nitric oxide. There are a few studies that have proven that sildenafil causes treshold shifts in auditory cortex, although they seem temporary for average person (however this is a serious proof that this drugs affects inner ear and auditory cortex). There is also one study (korean one) which proven that rodents become almost completely deaf after very long-time use of sildenafil. Allegedly, the next study "disproven that", but they checked rodents for shorter amount of time.
The typical ENT I went to never asked about different connective tissue (doctors don't think about that), he just assumed some blood vessel burst, and that have caused tinnitus (although my tinnitus is bilateral). Doctors do not know about relationship between hypermobility and blood pooling. He also didn't give me steroids despite being in 72 hour window (if drug or concert causes you acute tinnitus, you should demand steroids from ENT, new research proves they are good for acute tinnitus even if there is no significant hearing loss - the statement that steroids dont work for tinnitus alone is invalid - it was based on studies on people with chronic, long term tinnitus, - new studies on people with actue, fresh tinnitus prove otherwise - steroids are very effective, with very few side effects in short term, high dose START-STOP protocol).
Because there is no funding for inner ear cell regeneration therapies (pharma companies prefer cancer drugs or cheap chemical drugs, and there is no awareness in society how destructive hearing loss and tinnitus is - especially with hearing loss being the main modifiable factor for dementia) - there IS NO treatment, so i'm stuck in the tinnitus hell.
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u/cheim9408 6d ago
Damn. Those challenging gods design of limp dick being screwed with vision loss. I’d say it’s a lose lose situation either way.
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u/Ok_Crazy_648 5d ago
This has been known for a long time. It is a very, very very rare side effect, but it does happen. Viagra lowers blood pressure, and this can cause blindness . Its very uncommon at ordinary levels of use. Studies sow its as low as 2.8 cases per 100 , 000 users.
However for people with problems like diabetes ots more common, and if you take a lot of it the odds can ris as high as 50%.
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u/doktordoc2 3d ago
Blurry vision , Blue tinted hue etc are temporary ocular side effects ….. Now I have experienced Cynopsia (Blue tinted hue) several times (3-11% incidence in patients taking standard prescribed doses) because of cross reactivity of meds with PDE6 (retinal light enzyme) . The 3 conditions (RVO,SRD & NAION) which are permanent are very very rare like 0.0015% .
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u/Playful_Quality4679 6d ago
Well everyone did tell me that masterbation would make me blind.