Protocol Change - Viagra

In recent weeks there have been a number of cases involving complications in patients taking Viagra in combination with Nitroglycerin. According to the manufacturer, "Viagra was shown to potentiate the effects of nitrates." Administration of Viagra and Nitroglycerin together can, therefore, result in dangerous drops in blood pressure.

After consulting with John Benanti, MD, State EMS Medical Director, we have implemented the following additions to Protocol 3.5 Chest Pain and 3.6 CHF/Pulmonary Edema:

1.  Administration of Nitroglycerin is contraindicated if the patient has taken Viagra within the last 12 hours;

2.  If the patient has taken Viagra within the last 24 hours, contact medical control prior to the administration of Nitroglycerin.

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