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PDE5 inhibitor and nitrates — GPhC CRA MCQ

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EasyDrug InteractionsPDE5 inhibitor and nitratesGPhC CRA

A patient using glyceryl trinitrate spray for angina asks to buy tadalafil for erectile dysfunction. He last used the spray yesterday. What is the most important interaction to flag?

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Correct answer: A — Risk of profound hypotension from nitrate and PDE5 inhibitor combination

Nitrates and PDE5 inhibitors can cause dangerous hypotension when combined. Tadalafil has a longer duration of action than sildenafil, so timing matters and specialist advice may be needed. The pharmacist should not supply without establishing safety. The patient's angina stability and nitrate use require clinical consideration.

Reference: BNF