CGMP Specific PDE Type-5 Inhibitors/Nitrates Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Very Serious. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, the effects of your nitrate medicine may increase.

What might happen:

Your blood pressure may decrease and cause weakness, fatigue, dizziness, loss of consciousness. You may also experience a heart attack or stroke.

What you should do about this interaction:

Contact your healthcare professionals (e.g. doctor or pharmacist) right away about taking these two medicines together. They may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Stendra (avanafil) US prescribing information. Vivus, Inc. October, 2022.
  • 2.Viagra (sildenafil) US prescribing information. Pfizer Inc. December 14, 2017.
  • 3.Cialis (tadalafil) UK summary of product characteristics. Eli Lilly and Company Limited September 16, 2008.
  • 4.Cialis (tadalafil) US prescribing information. Eli Lilly and Company February, 2018.
  • 5.Levitra (vardenafil hydrochloride trihydrate) UK summary of product characteristics. Bayer plc December 20, 2006.
  • 6.Levitra (vardenafil hydrochloride) US prescribing information. Bayer Pharmaceuticals Corporation March, 2023.
  • 7.Levitra (vardenafil hydrochloride) Canadian prescribing information. Bayer, Inc. October 24, 2006.
  • 8.Ikorel (nicorandil) Australian prescribing information. Aventis Pharma August 13, 2003.
  • 9.Imdur (isosorbide mononitrate) US prescribing information. Key Pharmaceuticals, Inc. July, 2002.
  • 10.Nitrostat (nitroglycerin) US prescribing information. Pfizer January 24, 2018.
  • 11.Trolle Lagerros Y, Grotta A, Freyland S, Grannas D, Andersson DP. Risk of Death in Patients With Coronary Artery Disease Taking Nitrates and Phosphodiesterase-5 Inhibitors. J Am Coll Cardiol 2024 Jan 23; 83(3):417-426.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.