A night of passion turned to disaster for an Indian man who suffered a fatal stroke after drinking while on impotence pills.
The 41-year-old man, from India, consumed twice the usual dose of sildenafil — the main ingredient in Viagra.
Doctors who shared the case revealed he had met up with a female friend at a hotel where he downed two 50mg sildenafil tablets.
The unidentified man, who had high blood pressure, had also drunk. Tests after his death showed his blood alcohol level was more than twice the legal UK driving limit.
He experienced a headache and was vomiting the next morning.
Despite pleas from his companion to call for medical help, he declined, claiming he had experienced similar symptoms before.
Post-mortem scans of the man's head revealed he had suffered a stroke, resulting in a 300g mass of clotted blood, pink and blue lines. Yellow arrows indicate blood vessels in the brain that have been extended as a result of the hemorrhage.
Investigations found the man did not have a prescription for sildenafil.
Authors said they published the case to raise awareness about the risks of taking the erectile dysfunction medication without medical advice.
They said that sildenafil is now being used for recreational purpose by men without issues getting an erection wanting to enhance their sexual performance.
The pathologists also said the man's fatal stroke could have occurred through the combination of sildenafil and alcohol dilating blood vessels in his body.
This combined with a pre-existing blood pressure disorder put his vessels in his brain under pressure, leading to the stroke, they said.
This increase in blood flow is how sildenafil helps men with ED maintain erections by increasing blood flow to the penis.
Alcohol can also increase blood flow at certain levels of intoxication.
A post-mortem blood test on the man revealed he had a blood alcohol level of 186.61mg/100 ml of blood.
For comparison the legal drink driving limit is 80mg/100 ml of blood.
He also consumed two 50mg grams of sildenafil that night.
This is twice the recommended dose for most men, according to the NHS.
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