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Nitrates and sildenafil — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsNitrates and sildenafilGPhC CRA

A 61-year-old man taking isosorbide mononitrate 60mg modified-release daily asks whether sildenafil bought online is safe because he has erectile dysfunction. He has stable angina and carries GTN spray. What would you advise the patient?

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Correct answer: D — Avoid sildenafil and seek prescriber advice because of severe hypotension risk

Sildenafil and nitrates can cause a dangerous fall in blood pressure when combined. This is clinically important in a patient using long-acting nitrate therapy and carrying GTN. Dose separation is not a safe community pharmacy workaround for regular nitrate users. The patient should be advised to avoid sildenafil and discuss alternatives with a prescriber.

Reference: BNF