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Nitrates and sildenafil — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsNitrates and sildenafilGPhC CRA

A 61-year-old man taking isosorbide mononitrate modified-release 60mg daily asks to buy sildenafil after seeing an online advert. He has stable angina and uses GTN spray occasionally. What would you advise the patient?

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Correct answer: D — Sildenafil is unsuitable with nitrate therapy because of severe hypotension risk

PDE5 inhibitors such as sildenafil can interact dangerously with nitrates and cause profound hypotension. The patient uses both long-acting nitrate therapy and GTN spray, so supply should be refused and the patient signposted to the GP. The advice should be given sensitively and privately.

Reference: BNF