Multiple Cerebral Infarctions and Rhabdomyolysis After Sildenafil Citrate (Viagra®) Intoxication: A Case Report

-background: Sildenafil citrate (Viagra (R)) is used to treat male erectile dysfunction; however, little is known about the effects of sildenafil overdose and intox-ication. We report a patient who presented with cerebral infarction and rhabdomyolysis after intentional sildenafil intoxication. Case Report: A 61-year-old man visited the Emergency Department complaining of dysarthria about 1 h after taking more than 30 sildenafil tablets with the in-tention to commit suicide. Dysarthria and dizziness were observed, but there were no other neurological symptoms. The creatine kinase level was elevated to 3118 U/L, and the patient was diagnosed with rhabdomyolysis. Brain mag-netic resonance imaging revealed multiple scattered acute cerebral infarctions in both midbrain artery branches. At 4 h post-intoxication, the dysarthria had improved and we initiated dual antiplatelet therapy for cerebral infarction. Why Should an Emergency Physician Be Aware of This?: Emergency physicians should be able to anticipate and treat complications like cerebral infarction and rhabdomyolysis after sildenafil intoxication. (c) 2023 Elsevier Inc. All rights reserved.