Warfarin And Priapism

[Marty]

I am happy to say this is not personal. However the constant barrage of ads
referring to Viagra, Levitra, and Cialis all mention priapism as a possible complication and advise immediate treatment. Hoping to learn more I googled
priapism and found that in some cases warfarin and /or heparin can be a cause of priapism. I am interested to know if Al or any body else has some information relating to warfarin and priapism.

 

[Guest]

I have never been told of a case either personally or via the website. I suppose I could get more hits if I made a page. There seems to be only 3 cases in the medical literature reviewed by the National Library of Medicine. Interestingly enough, one was a 65 yo man who started warfarin for an aortic valve replacement.

It also seems to be related to protein C deficiency which is related to clotting when you first start warfarin. This is also associated with skin necrosis. So as the ads say, "Do not attempt this at home."

 

[Duff Man]

Um, yeah.... I had a bout of priapism that woke me up out of my sleep from the pain and made me take a cold shower this morning. Not sure what's up with that, but it wasn't good. I wish I were joking.

I'm not going to blame it on coumadin just yet, because I did reduce my dose of diazepam a few days ago... maybe that's what caused it.

 

[Guest]

As you can see from this thread not having a post in over 6 years, it is extremely rare. There are many other drugs with a much higher incidence of priapism. You might check out other causes. You are extremely lucky that a cold shower took care of this. I know of cases where it took an injection into the penis. In other cases the erection lasted for so long that there was permanent nerve damage.

 

[Duff Man]

There were a few things going on that could be in play here, most make coumadin seem an unlikely source, albeit my inr was high this morning at 3.9 and I should be at 2-3 (i guess). Here's why I think it's probably not the coumadin: I am slowly tapering my dose of diazepam, I've had a bout of priapism before after taking an SSRI just a few times, and I'm willing to bet the beta blockers and/or ARB I take has an equal probability of causing the priapism as either of the other drugs in question.

So I'm not real convinced it was the coumadin, but it was bad enough for me to do some googling on the subject and come across this thread. I hope it never happens again, whatever the case may be. It would probably be funny to the ER people if it got that bad... and I could seriously see it getting that bad with that kind of pain.