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Sildenafil and nitrates — GPhC CRA MCQ

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ModerateDrug InteractionsSildenafil and nitratesGPhC CRA

A 40-year-old man asks for a repeat supply of sildenafil bought online. He uses GTN spray for exertional chest pain and takes bisoprolol, aspirin and atorvastatin. He last used GTN two days ago. What is the most important interaction to flag?

Educational content. Not a substitute for clinical judgement or local policy.

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

PDE5 inhibitors are contraindicated with nitrates because of potentially severe hypotension. The patient has active nitrate therapy for angina, so supply is unsuitable. He should be referred to his GP or specialist for cardiovascular and erectile dysfunction review.

Reference: BNF; NICE CKS