Dear Dr. Roach: My husband is taking Eliquis 5 mg (half a tab daily). He has had erectile dysfunction for 15 to 20 years and is 78 years old. Since we are in a new marriage, he obtained 颅Viagra in Mexico. His 颅cardiologist would not prescribe it. What precautions should he take or symptoms to look for when he starts taking it? He also takes hydralazine, metoprolol, Lipitor and Isordil.
J.B.
While I wish you both a happy marriage, he should absolutely listen to his cardiologist. This doctor is refusing to prescribe Viagra for a very good reason: It cannot be taken with any form of nitroglycerine.
Isosorbide mononitrate (Isordil) is a long-acting form of nitroglycerine. In combination with Viagra or similar 颅medicines, your husband鈥檚 blood pressure can drop into a very dangerously low level and stay that way a very long time. He should talk to his regular doctor or a urologist about other options (such as alprostadil) that can be safely taken along with nitroglycerine-like drugs.
Dear Dr. Roach: During heat waves, is there an ideal indoor temperature for elderly people and people with heart 颅conditions? I have a disabled brother with heart conditions, and for some reason he seems immune to the heat and doesn鈥檛 turn on the AC. His caregivers sometimes find him sitting in a room that鈥檚 32 C! I would like to give instructions to his 颅caregivers for setting the thermostat to a safe level.
L.C.
The most comfortable indoor temperature varies greatly among individuals. The highest temperature that is safe for a population also varies, based on the area of the world and the temperatures people are used to. In Mediterranean countries, indoor temperatures up to 29 C do not increase medical risk, whereas in northern continental cities, a maximum safe temperature of 23 C has been identified by the World Health Organization. Most people feel most comfortable with indoor temperatures between 20 C and 23 C. Humidity, air movement with wind or fans, and a person鈥檚 medical condition 鈥� 颅thyroid disease in particular really changes a person鈥檚 temperature regulation 鈥� all have a role, so I can鈥檛 give you a single number that is right for everyone. I agree that 32 C is too hot.
Dr. Roach regrets he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
