Does Nitrates Interact with Sildenafil?
Nitrates and Sildenafil have a contraindicated drug interaction according to U.S. FDA drug labeling data. Administration of sildenafil with nitrates is contraindicated. Sildenafil potentiates the hypotensive effects of nitrates. The mechanism involves effects on nitric oxide/cgmp pathway. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.
- Severity
- Contraindicated
- Sildenafil Class
- Phosphodiesterase 5 Inhibitor
- Management
- Do not take together
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Nitrates and Sildenafil occurs because effects on nitric oxide/cgmp pathway. Clinically, this means administration of sildenafil with nitrates is contraindicated. sildenafil potentiates the hypotensive effects of nitrates. Because of the severity of this interaction, these medications are contraindicated — meaning they should not be taken together under any circumstances. If you are currently taking both, contact your healthcare provider immediately to discuss alternatives.
What To Tell Your Doctor or Pharmacist
If you are taking Nitrates and your doctor is considering prescribing Sildenafil (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask about alternative medications that do not interact with your current regimen
- Ask how frequently you should be monitored while these are co-prescribed
- Never stop or change either medication without first consulting your healthcare provider