Viagra and any form of nitroglycerine do not mix!

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 Viagra in Mexico. His 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.

DEAR READER » 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 medicines, your husband’s 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 nitroglycerinelike drugs.

DEAR DR. ROACH » During heat waves, is there an ideal indoor temperature for elderly people and people with heart conditions? I have a disabled brother with heart conditions, and for some reason he seems immune to the heat and doesn’t turn on the AC. His caregivers sometimes find him sitting in a room that’s 90 F! I would like to give instructions to his caregivers for setting the thermostat to a safe level.

— L.C.

DEAR READER » 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 84 F (29 C) do not increase medical risk, whereas in northern continental cities, a maximum safe temperature of 74 F (23 C) has been identified by the World Health Organization. Most people feel most comfortable with indoor temperatures between 68 and 74 F (2023 C). Humidity, air movement with wind or fans, and a person’s medical condition — thyroid disease in particular really changes a person’s temperature regulation — all have a role, so I can’t give you a single number that is right for everyone. I agree that 90 degrees (32 C) is too hot.