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Nitrate and sildenafil — GPhC CRA MCQ

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HardCardiovascular TherapeuticsNitrate and sildenafilGPhC CRA

A man using isosorbide mononitrate modified-release tablets for angina asks to buy sildenafil after seeing an online advert. He has had no recent cardiac review. What is the most important interaction to flag?

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Correct answer: D — Sildenafil with nitrates can cause severe hypotension

Phosphodiesterase type 5 inhibitors and nitrates both increase vasodilation and can cause profound hypotension when combined. Sildenafil should not be supplied in this scenario and the patient should be referred for appropriate medical advice. The other listed effects are not the main clinically important interaction.

Reference: BNF