[Cardiovascular safety of the recreational use of cannabis associated to sildenafil: Systematic review]

Objectives: The recreational use of drugs of abuse associated to therapeutically used drugs in sexual contexts forces the health care professional to know the possibility of drug-drug interactions among them. The aim of this review is updating the available information on cardiovascular safety of recreational use of sildenafil and cannabis.

Materials and methods: A systematic search in databases PubMed, PreMedline, Medline, Embase, ChemID, HSRPROJ, POPLINE and TOXLINE, from the start of the databases until to March 1, 2018 was made. Search terms were "sildenafil", "vardenafil", "tadalafil", "phosphodiesterase inhibitors" and "cannabis", combining and crossing them by means of Boolean operators with "adverse effects" and "cardiovascular". No restrictions for language or type of study were made.

Results: Thirteen papers were found, 5out of them analyzed cannabis and sildenafil combination as a new style of recreational non-medical use. Only 3papers related sildenafil-cannabis association with cardiovascular events: one posterior myocardial infarction without Q wave, one myocardial infarction without ST elevation and one acute coronary syndrome.

Conclusions: Severity of sildenafil-cannabis-related cardiovascular events forces the healthcare professionals to take them into account and considering them in clinical pictures of an ischemic cardiomyopathy hard to classify.