Medication Question for Dr. Wise or SCINurse

CowboyCrip · 11-04-2003, 10:35 AM

Hi there,

Quick question:
Would ephedrine effect erection quality?

I take ephedrine when needed to boost my blood pressure when feeling lightheaded. (very rare)

I read other posts about BP and erections and wondered if it would help firm things up.

Secondly, can you take ephedrine with viagra?
Is it safe? Would it help or be deleterious?

Love this board. Thank you.

metronycguy · 11-04-2003, 10:38 AM

i can tell you that ephedrine can ruin erection quality.

Wise Young · 11-04-2003, 01:55 PM

cowboy, ephedrine has long been used to treat priapism (a condition of an erection that does not go down). Usually, it is injected. However, because it does elevate blood pressure, it is not usually favored these days. I have found some internet sites that even suggest the ephedrine might be good for erections but I think that there is no basis of such claims. Of course its effects depend on dose but it generally should reduce erections rather than "firm things up". Here are some references:

• Domer FR, Wessler G, Brown RL and Charles HC (1978). Involvement of the sympathetic nervous system in the urinary bladder internal sphincter and in penile erection in the anesthetized cat. Invest Urol 15:404-7. Summary: Male cats were anesthetized with pentobarbital. In one series of experiments a Foley catheter was placed suprapubically in the urinary bladder and physiologic saline, under a constant head of pressure, was allowed to flow at a constant rate through the bladder. Alpha-adrenergic stimulants such as ephedrine, norepinephrine, or methoxamine all caused a decrease or cessation in urinary flow. This effect was reversed by the alpha-adrenergic blocking agent, phentolamine. In addition, phentolamine administration caused penile erection. Erection also occurred after administration of the alpha-adrenergic blocking agent, phenoxybenzamine, or the beta2-adrenergic stimulants terbutaline or salbutamol. In each case the erection could be reversed, and usually terminated completely, by administration of the beta-adrenergic blocking agent, propranolol. Hypotension per se was not the required event to initiate erection because administration of acetylcholine, histamine, or prostaglandin E2 did not result in penile erection. In two of five experiments nitroprusside caused an erection. It was concluded that a predominance of beta2 activity in the penile vasculature is involved in erection.

• Miyabe M and Namiki A (1988). Ephedrine for treatment of penile erection during spinal anesthesia. Anesth Analg 67:1019-20. Summary:

• Mufti GR (1990). Re: Pharmacological treatment of erections during transurethral surgery. Br J Urol 66:219-20. Summary:

• Sundien E and Kolmert T (1987). Ephedrine: a possible alternative for treatment of penile erection in connection with transurethral resection of prostatic or bladder tumors. J Urol 138:411. Summary:

• Vaidyanathan S, Watt JW, Soni BM and Krishnan KR (1996). Intravenous salbutamol treatment for penile erection arising during cystoscopy of cervical spinal cord injury patients. Spinal Cord 34:691-5. Summary: Two patients with long-standing tetraplegia after spinal cord injury developed reflex penile erection in the operation theatre. One had not received any anaesthesia, and penile erection occurred after introduction of the cystoscope into the urethra, and also autonomic dysreflexia. Intravenous salbutamol, in a dose of 10 micrograms, produced immediate and persistent penile detumescence and salbutamol-induced fall in blood pressure was of therapeutic value. In the second patient, penile erection occurred during general anaesthesia prior to cystoscopy. Immediate and persistent penile detumescence was achieved with intravenous salbutamol 20 micrograms. There was transient fall of blood pressure which responded to intravenous infusion of 0.9% sodium chloride. Salbutamol-induced fall in blood pressure is of therapeutic value in those spinal cord injury patients who develop, in addition to penile erection, autonomic dysreflexia precipitated by urethral instrumentation, or bladder distension with the irrigating fluid. Intravenous salbutamol is preferable to intra-cavernosal phenylephrine, noradrenaline, metaraminol, and epinephrine, or intravenous ephedrine which are contraindicated in patients with hypertension. Regional Spinal Injuries Centre, District General Hospital, Merseyside, UK.

CowboyCrip · 11-05-2003, 11:44 AM

Thank you Dr. Young and Yonkers.

As for the second part of my question,

Is it safe to take Viagra if I have taken ephedrine to combat dizzy/weak spell earlier?

Wise Young · 11-13-2003, 08:41 AM

cowboy,

Many drugs interact with viagra and all the instructions on the use of the drug suggest that you should consult with your doctor. I was unable to find any specific recommendation against the combination of the ephedrine and viagra. On the other hand, it is probably not good to mix the two drugs, one of which has been shown to reduce erections. I would recommend that you not use the two drugs together. Besides, sexual activity may well stimulate autonomic dysreflexia and increase your blood pressure.

http://my.webmd.com/content/drugs/3/...n=Viagra#drugs

Wise.

CLC379 · 11-14-2003, 12:01 AM

if i take to much viagra i have low bp & headache for a day or 2, never heard of ephedrine for low bp?

CowboyCrip · 11-14-2003, 06:53 PM

CLC379, I find ephedrine very helpful in resolving faint/weak feelings that occasionaly result from low BP. I only need it 1 or 2 times / month.

Like Wise said, NOT wise to take together. Better safe then sorry. But if you experience the same feelings, in the absence of Viagra, Ephedrine may be beneficial. Ask your Dr.

CowboyCrip · 11-14-2003, 06:58 PM

Another Viagra combo question.

This was sparked by CLC379's post.

We both experience headaches (a common side effect) and I also experience sinus congestion (bad)

Can we chase our Viagra with an allergy med w/ antihistamine and ASA or Tylenol or Ibuprofin to combat the above symptoms?

CLC379 · 11-14-2003, 09:04 PM

cowboy,

what level sci are you?

if i take viagra on empty stomach 1/2 of the big pill or one small pill i usually have no bad side effects. i have taken 2 large pills same erection results then have a terrible viagra hangover.

i did ask my dr. not even a month ago about bp med he said he never heard of anything to raise bp will mention ephedrine to him.

allergy meds have about same effect on me as viagra hangover.

if your taking small dose viagra already try cutting pill in half see what kinda results you get.

CowboyCrip · 11-17-2003, 10:28 AM

I am a C 5-6 quad.
50 mg pretty good results no real side effects.
100 mg better but bad headache and congestion.
What's a guy gonna do?

11-04-2003, 10:35 AM	#1
CowboyCrip Senior Member Join Date: Nov 2003 Posts: 1,041	Medication Question for Dr. Wise or SCINurse Hi there, Quick question: Would ephedrine effect erection quality? I take ephedrine when needed to boost my blood pressure when feeling lightheaded. (very rare) I read other posts about BP and erections and wondered if it would help firm things up. Secondly, can you take ephedrine with viagra? Is it safe? Would it help or be deleterious? Love this board. Thank you.

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11-04-2003, 10:38 AM	#2
metronycguy Senior Member Join Date: Dec 2002 Location: ny Posts: 5,674	i can tell you that ephedrine can ruin erection quality.

11-04-2003, 01:55 PM	#3
Wise Young Administrator Join Date: Jul 2001 Location: New Brunswick, NJ, USA Posts: 37,975	cowboy, ephedrine has long been used to treat priapism (a condition of an erection that does not go down). Usually, it is injected. However, because it does elevate blood pressure, it is not usually favored these days. I have found some internet sites that even suggest the ephedrine might be good for erections but I think that there is no basis of such claims. Of course its effects depend on dose but it generally should reduce erections rather than "firm things up". Here are some references: • Domer FR, Wessler G, Brown RL and Charles HC (1978). Involvement of the sympathetic nervous system in the urinary bladder internal sphincter and in penile erection in the anesthetized cat. Invest Urol 15:404-7. Summary: Male cats were anesthetized with pentobarbital. In one series of experiments a Foley catheter was placed suprapubically in the urinary bladder and physiologic saline, under a constant head of pressure, was allowed to flow at a constant rate through the bladder. Alpha-adrenergic stimulants such as ephedrine, norepinephrine, or methoxamine all caused a decrease or cessation in urinary flow. This effect was reversed by the alpha-adrenergic blocking agent, phentolamine. In addition, phentolamine administration caused penile erection. Erection also occurred after administration of the alpha-adrenergic blocking agent, phenoxybenzamine, or the beta2-adrenergic stimulants terbutaline or salbutamol. In each case the erection could be reversed, and usually terminated completely, by administration of the beta-adrenergic blocking agent, propranolol. Hypotension per se was not the required event to initiate erection because administration of acetylcholine, histamine, or prostaglandin E2 did not result in penile erection. In two of five experiments nitroprusside caused an erection. It was concluded that a predominance of beta2 activity in the penile vasculature is involved in erection. • Miyabe M and Namiki A (1988). Ephedrine for treatment of penile erection during spinal anesthesia. Anesth Analg 67:1019-20. Summary: • Mufti GR (1990). Re: Pharmacological treatment of erections during transurethral surgery. Br J Urol 66:219-20. Summary: • Sundien E and Kolmert T (1987). Ephedrine: a possible alternative for treatment of penile erection in connection with transurethral resection of prostatic or bladder tumors. J Urol 138:411. Summary: • Vaidyanathan S, Watt JW, Soni BM and Krishnan KR (1996). Intravenous salbutamol treatment for penile erection arising during cystoscopy of cervical spinal cord injury patients. Spinal Cord 34:691-5. Summary: Two patients with long-standing tetraplegia after spinal cord injury developed reflex penile erection in the operation theatre. One had not received any anaesthesia, and penile erection occurred after introduction of the cystoscope into the urethra, and also autonomic dysreflexia. Intravenous salbutamol, in a dose of 10 micrograms, produced immediate and persistent penile detumescence and salbutamol-induced fall in blood pressure was of therapeutic value. In the second patient, penile erection occurred during general anaesthesia prior to cystoscopy. Immediate and persistent penile detumescence was achieved with intravenous salbutamol 20 micrograms. There was transient fall of blood pressure which responded to intravenous infusion of 0.9% sodium chloride. Salbutamol-induced fall in blood pressure is of therapeutic value in those spinal cord injury patients who develop, in addition to penile erection, autonomic dysreflexia precipitated by urethral instrumentation, or bladder distension with the irrigating fluid. Intravenous salbutamol is preferable to intra-cavernosal phenylephrine, noradrenaline, metaraminol, and epinephrine, or intravenous ephedrine which are contraindicated in patients with hypertension. Regional Spinal Injuries Centre, District General Hospital, Merseyside, UK.

11-05-2003, 11:44 AM	#4
CowboyCrip Senior Member Join Date: Nov 2003 Posts: 1,041	Thank you Dr. Young and Yonkers. As for the second part of my question, Is it safe to take Viagra if I have taken ephedrine to combat dizzy/weak spell earlier?

11-13-2003, 08:41 AM	#5
Wise Young Administrator Join Date: Jul 2001 Location: New Brunswick, NJ, USA Posts: 37,975	cowboy, Many drugs interact with viagra and all the instructions on the use of the drug suggest that you should consult with your doctor. I was unable to find any specific recommendation against the combination of the ephedrine and viagra. On the other hand, it is probably not good to mix the two drugs, one of which has been shown to reduce erections. I would recommend that you not use the two drugs together. Besides, sexual activity may well stimulate autonomic dysreflexia and increase your blood pressure. http://my.webmd.com/content/drugs/3/...n=Viagra#drugs Wise.

11-14-2003, 12:01 AM	#6
CLC379 Senior Member Join Date: Oct 2001 Location: oklahoma Posts: 2,335	if i take to much viagra i have low bp & headache for a day or 2, never heard of ephedrine for low bp?

11-14-2003, 06:53 PM	#7
CowboyCrip Senior Member Join Date: Nov 2003 Posts: 1,041	CLC379, I find ephedrine very helpful in resolving faint/weak feelings that occasionaly result from low BP. I only need it 1 or 2 times / month. Like Wise said, NOT wise to take together. Better safe then sorry. But if you experience the same feelings, in the absence of Viagra, Ephedrine may be beneficial. Ask your Dr.

11-14-2003, 06:58 PM	#8
CowboyCrip Senior Member Join Date: Nov 2003 Posts: 1,041	Another Viagra combo question. This was sparked by CLC379's post. We both experience headaches (a common side effect) and I also experience sinus congestion (bad) Can we chase our Viagra with an allergy med w/ antihistamine and ASA or Tylenol or Ibuprofin to combat the above symptoms?

11-14-2003, 09:04 PM	#9
CLC379 Senior Member Join Date: Oct 2001 Location: oklahoma Posts: 2,335	cowboy, what level sci are you? if i take viagra on empty stomach 1/2 of the big pill or one small pill i usually have no bad side effects. i have taken 2 large pills same erection results then have a terrible viagra hangover. i did ask my dr. not even a month ago about bp med he said he never heard of anything to raise bp will mention ephedrine to him. allergy meds have about same effect on me as viagra hangover. if your taking small dose viagra already try cutting pill in half see what kinda results you get.

11-17-2003, 10:28 AM	#10
CowboyCrip Senior Member Join Date: Nov 2003 Posts: 1,041	I am a C 5-6 quad. 50 mg pretty good results no real side effects. 100 mg better but bad headache and congestion. What's a guy gonna do?