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Human & Experimental Toxicology
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Reviews

Fatal overdosage with sildenafil citrate (Viagra1): first report and review of the literature

A Tracqui

Institut de Médecine Légale, 11 rue Humann, Strasbourg Cedex 67085, France; atracqui{at}mageos.com

A Miras

Institut de Médecine Légale, 12 avenue Rockefeller, Lyon 69008, France

A Tabib

Service d’Anatomopathologie, Hôpital Cardiologique, 59 boulevard Pinel, Lyon 69003, France

J S Raul

B Ludes

Institut de Médecine Légale, Faculté de Médecine de Strasbourg, 11 rue Humann, Strasbourg Cedex 67085, France

D Malicier

Institut de Médecine Légale, 12 avenue Rockefeller, Lyon 69008, France

A fatal case of sildenafil citrate (Viagra1) overdosage is presented. The deceased was a 56-year old male found dead at home, with a past history of diabetes mellitus, hypertension, chronic alcoholism, anxio-depressive disorders, and erectile dysfunction. The main autopsy findings were cardiomegaly (650 g) with dilated cardiomyopathy, diffuse coronary atherosclerosis with no sign of acute ischaemic disease, and extensive fibrosis of the myocardium, especially affecting the cardiac conducting tissue. As measured by HPLC/MS, sildenafil concentration in postmortem blood (6.27 mg/mL) exceeded at least four times the highest therapeutic levels previously reported. The results are discussed in the light of the literature about the cardiovascular side effects of sildenafil, with special emphasis on the recently evidenced arrhythmogenic potential of the drug. This is the first report of a fatality caused by sildenafil overdosage.

Key Words: fatality • heart disease • overdosage • plasma sildenafil • sildenafil • Viagra

Human & Experimental Toxicology, Vol. 21, No. 11, 623-629 (2002)
DOI: 10.1191/0960327102ht302oa
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This article has been cited by other articles:


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 Arch DermatolHome page
A. Yung, N. Reay, and M. D. Goodfield
Improvement in Digital Flexibility and Dexterity Following Ingestion of Sildenafil Citrate (Viagra) in Limited Systemic Sclerosis
Arch Dermatol, July 1, 2005; 141(7): 831 - 833.
[Full Text] [PDF]

Home page
 Hum Exp ToxicolHome page
R. L Siegel
Letter to the editor
Human and Experimental Toxicology, August 1, 2003; 22(8): 463 - 464.
[PDF]


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