Priapism, pomegranate juice, and sildenafil: Is there a connection?

We report the development of low flow priapism in three patients related to simultaneous consumption of sildenafil with pomegranate [Punica granatum] [POM] juice. There were no other concurrent diseases, intake of drugs, and chemicals or other risk factors in these patients. We want to create awareness among patients and practitioners for recognition and timely intervention. Probable mechanisms are highlighted