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PDE5 inhibitor and nitrate — GPhC CRA MCQ

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EasyDrug InteractionsPDE5 inhibitor and nitrateGPhC CRA

A 62-year-old asks to buy sildenafil for erectile dysfunction. His PMR includes glyceryl trinitrate spray for angina, bisoprolol and atorvastatin. He last used the spray two days ago. 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 are contraindicated with nitrates because the combination can cause profound hypotension. Intermittent nitrate use still matters because angina may recur unpredictably. The pharmacist should not supply sildenafil without appropriate assessment and exclusion of nitrate therapy. Atorvastatin and bisoprolol are not the principal contraindication here.

Reference: BNF