Drug Interactions With Phosphodiesterase-5 Inhibitors Used for the Treatment of Erectile Dysfunction or Pulmonary Hypertension

Clinical Cardiology

“…10 PDE5-Is are contraindicated with nitrates because of the risk of severe hypotension that can result from a marked increase in cGMP (Nitrates increase the production of cGMP, and PDE5-Is prevent the breakdown of cGMP). 10 Although this patient listed nitroglycerin as a current medication, on questioning he says that he has not used nitroglycerin since his percutane- ous coronary intervention 1 year ago. The patient is instructed to stop his nitroglycerin and discard any remaining pills.…”

“…Caution and decreased doses may be indicated when PDE5-Is are coadministered with ␣-blockers or with drugs that affect the cytochrome P450 3A4 metabolic pathway such as erythromycin, ketoconazole, or HIVprotease inhibitors. 10 The patient is not currently taking any of the above medications, so he is prescribed a standarddose PDE5-I (Table 2).…”

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

“…Pacjentom, którzy niedawno przyjmowali inhibitor fosfodiesterazy 5 (tj. sildenafil lub wardenafil w cią-gu 24 h i 48 h w przypadku tadalafilu), nie należy podawać azotanów, gdyż istnieje ryzyko wystąpienia ciężkiego niedociśnienia [117].…”

Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer

“…There are currently no direct comparison studies available to determine which currently available PDE5i offers better results for ED or penile rehabilitation. 33 …”