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PDE5 inhibitor and nitrates — GPhC CRA MCQ

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EasyDrug InteractionsPDE5 inhibitor and nitratesGPhC CRA

A 63-year-old man uses GTN spray for angina and asks for tadalafil for erectile dysfunction. He took GTN yesterday after walking uphill. What is the most important interaction to flag?

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

PDE5 inhibitors are contraindicated with nitrates because the combination can cause marked hypotension. Tadalafil has a longer duration of action than sildenafil, so timing remains important. The patient should be referred to the prescriber for safe erectile dysfunction management.

Reference: BNF