drug interaction(s) of nitrates with phosphodiesterase-5-inhibitors

Drug interactions

• hypotension can be life threatening.

Management

• not taking the two medications in close temporal proximity may minimize interaction
• allow 24 hours after sildenafil (Viagra) or vardenaril (Levitra) or 48 hours after Cialis prior to administering a nitrate (longer if hepatic or renal insufficiency)
  • ok to prescribe sildenafil or vardenaril for elderly prescribed nitroglycerin provided patient is cautioned not to take sildenafil or vardenari within 24 hours of nitroglycerin use*
• allow 5 days after stopping long-acting nitrate prior to taking Viagra, Levitra or Cialis

* says nothing about the case of patient sensing a need for nitroglycerin after taking sildenafil or vardenaril

More general terms

• drug interaction