Good evening specialist discussion board members.

I would like to enquire any information on drug interactions that can cause adverse side effects on male fertility i.e. sperm count or quality if a patient is precribed with sildenafil citrate(Viagra)for mild-moderate level ED,metformin for diebetis(type 2) and lipitor for his history of high cholesterol. [?]

[u]History of patient and chronology leading to complication.</u>

Patient is 33 years old male. Diagnosed with diabeties 7 months back. History of high tryglycerides since 30 years old.

Blood analysis on July 2000, all parameters normal except high total cholestrol of 9.0,high uric acid and fatty liver. Control by diet and exercise due to age factor.

Blood analysis on May 2002, all parameters normal.
Blood analysis on sept 2004, all parameters normal except high cholesterol.

Blood analysis on July 2005,revealed high parameters as below:

Liver function (AST 53.4 U/L & ALT 100.9 U/L) others normal
Renal fuction- normal
cardiac enzime- AST53.4 u/l
Fasting lipid profile- Sr. Cholestoral- 7.7mmol & Sr Triglyserid 3.0mmol
Blood sugar- RBS non fasting 16.9mmol

Started on metformin 250mg/night and lovastatin 25mg/day

Patient seek treament for ED on Nov 2005,after taking a herbal product to increase sperm count. The same is mfg by a well known health care company in India. Stop taking the pills. Symtoms persisted for a month before patient was normal again.

Systoms reoccured a week later till now.Changed prescribtion to lipitor instead of lovastatin for cholesterol. Patient is on diet and routine exercice.

Blood check on Feb 06 revealed

Fasting Blood sugar - 6.5mmol
Diabetic monitoring- Hb A1c- 6.5mmol
Hormone studies -normal
Fasting lipid profile- Sr. Cholestoral- 5.6mmol & Sr Triglyserid 1.9mmol

Based on the info above, its unlikely high blood sugar or cholesterol could have done any damage to the blood vessel or nerves within a year and cause moderate ED.

Patient would like to start a family. Prescibed Viagra with existing medications i.e. metformin and lipitor. As mentioned above, will these medications have any adverse effects on sperm count, its quality or the future fetus

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