발기부전제 특정약물 혼용시 부작용 위험

발기부전제 특정약물 혼용시 부작용 위험

미소비자단체, 56가지 위험약물 공개

발기부전 치료제를 섞으면 위험한 부작용이 나타날 가능성이 높다. 미국 소비자단체인 퍼블릭시티즌은 비아그라(화이자 제약회사), 시알리스(일라이 릴리 제약회사), 레비트라(를 바이엘 제약회사)는 56가지 특정 약물과 함께 사용하면 위험한 부작용을 일으킬 수 있다고 경고했다. 이단체의 보건연구실장 시드니 울프 박사는 발기부전 치료제 사용자가 대개 나이를 먹은 사람들이기 때문에 다른 약들을 복용하고 있을 가능성이 있다면서 이같이 밝혔다.

울프 박사는 특히 이 발기부전 치료제들은 혈관을 확장시켜 음경으로의 혈류를 증가시키기 때문에 같은 작용을 하는 다른 혈압약과 함께 사용했을 때 혈압이 위험한 수준까지 떨어져 심장마비나 뇌졸중에 이를 수도있다고 말했다. 또 에리스로마이신, 네파조돈, 자몽주스 등 발기부전 치료제를 적절히 분해시키는 효소를 억제하는 약과 함께 사용했을 땐 발기부전치료제가 체내에 축적될 수 있다고 울프 박사는 밝혔다. 이와 반대로 나프실린, 페노바르비탈 같이 이 효소를 활성화시키는 약을 함께 쓰면 발기부전 치료제의 효과가 줄어들 수 있다고 그는 지적했다. 퍼블릭 시티즌이 발기부전 치료제와 이러한 상호작용을 일으킬 수 있다고 지적한 56가지 약물의 명단은 이 단체가 운영하는 웹사이트(WorstPills.org)에있다. <퍼블릭시티즌 보고서> watch out for Interactions Between Drugs for Erectile Dysfunction and Other Medications Anyone with a television probably knows that three prescription medications currently are used to treat erectile dysfunction (ED): sildenafil (VIAGRA), tadalafil (CIALIS) and vardenafil (LEVITRA). These drugs, which belong to the class of drugs called phosphodiesterase-5 inhibitors (PDE5i), are widely used, especially in older men. And because older men are more likely to be concurrently taking other medications, they should be aware of the potential for dangerous interactions when ED drugs are mixed with other prescription drugs. This article deals only with these three approved prescription ED drugs, not the many untested ED products widely advertised on the Internet and elsewhere (see Tables 1, 2, and 3). How do ED drugs interact? Sildenafil, tadalafil and vardenafil are drugs that cause the dilation of blood vessels (vasodilators) and this effect can be magnified when they are used with other medications with similar vasodilating effects. It is this vasodilating effect that increases blood flow to the penis causing an erection. Most ED drug interactions, however, result from the fact that these drugs are metabolized by the enzyme CYP3A4 in the intestine and liver. CYP3A4 is the most important enzyme for drug metabolism, and many medications can interact with ED drugs by decreasing or increasing CYP3A4 activity, causing ED drug levels to increase or decrease, respectively. Interactions with vasodilators People who take nitrates (drugs commonly used to dilate the blood vessels in the heart for patients with coronary artery disease, such as nitroglycerin), either on a regular schedule or as needed, should not use these ED drugs. A dangerous reduction in blood pressure may occur, potentially leading to a heart attack or stroke, and so these drugs should not be used in combination. ED drugs also can enhance the blood pressure-lowering effects of alpha blockers such as doxazosin (CARDURA), prazosin (MINIPRESS), terazosin (HYTRIN), tamsulosin (FLOMAX) and alfuzosin (UROXATRAL). These drugs are used to treat both high blood pressure and enlarge prostate glands. If you are on an alpha blocker, consult your physician before taking an ED drug; he or she may recommend dosage adjustments or other precautions. Interactions with drugs that decrease CYP3A4 activity Drugs that inhibit CYP3A4 can substantially increase plasma concentrations of ED drugs, potentially leading to toxicity. See Table 2 for a list of drugs that inhibit CYP3A4. If you are taking any of these drugs, check with your physician before taking an ED drug. Your physician may advise a dosage reduction of the ED drug, especially if you are taking a potent CYP3A4 inhibitor such as ketoconazole, itraconazole or ritonavir. Keep in mind that grapefruit juice is also a CYP3A4 inhibitor. Interactions with drugs that increase CYP3A4 activity Drugs that increase CYP3A4 activity (see Table 3) tend to reduce the effect of ED drugs. This is not dangerous, of course, but it may render the ED drug ineffective. If the increased CYP3A4 activity is marked &#8212; such as in patients taking the antibiotic rifampin, even the highest recommended dose of the ED drug may be ineffective. Again, if you are taking any of the medications in Table 3, talk to your physician before starting an ED drug so he or she will know that the effect of the ED drug may be compromised. (See Tables 1, 2 and 3 on Page 3.) What You Can Do Many medications have the potential to interact with ED drugs, so it is important to make sure that the physician prescribing the ED drug is aware of all the other medications you are taking. If you start or stop other medications after receiving a prescription for an ED drug, check to make sure your ED drug effect will not increase or decrease as a result.

데일리엠디 김종필기자 (jp1122@nate.com)

기사 입력시간 : 2009-01-08 오전 10:32:11