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Nitrate and PDE5 inhibitor — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsNitrate and PDE5 inhibitorGPhC CRA

A 61-year-old man using a glyceryl trinitrate spray for stable angina asks whether he can take sildenafil supplied online for erectile dysfunction. He used his GTN spray twice last week and takes bisoprolol, aspirin and atorvastatin. What would you advise the patient?

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

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Correct answer: E — Avoid sildenafil and discuss erectile dysfunction treatment with his GP

Nitrates and PDE5 inhibitors can cause profound hypotension when used together. The risk applies because GTN is used as needed and angina symptoms may occur unpredictably. He should be advised not to use sildenafil with nitrate therapy and to seek prescriber review for safer options. Omitting aspirin or taking sildenafil with food does not remove the interaction risk.

Reference: BNF; NICE CKS Angina