Thursday, September 15, 2011

#AskDrKK:How to handle patients on nitrates who wants to take Viagra group of drugs?

#DrKKAnswers:
1. Men treated with PDE-5 inhibitors (Viagra group of drugs) and nitrates are at risk for severe hypotension and syncope (loss of consciousness).
2. Co-administration of Viagra group of drugs (sildenafil) with isosorbide mononitrate or sublingual nitroglycerin lowers blood pressure (52/29 mmHg with isosorbide mononitrate and 36/21 mmHg with sublingual nitroglycerin).
3. In men on Viagra group of drugs with chest pain nitrates should not be administered for 24 hours (or longer in patients with renal or hepatic dysfunction) of sildenafil, 24 hours of vardenafil, or up to 48 hours of tadalafil.

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