Drug interactions
Nicorandil + Vardenafil
Severity: Contraindicated
Nicorandil and Vardenafil: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Nicorandil is a nitrate-like potassium channel opener, and PDE5 inhibitors greatly potentiate nitrate-induced vasodilation. The combination can cause profound, potentially life-threatening hypotension and is contraindicated with nitrates and guanylate cyclase pathway drugs.
What this interaction means in plain words
Nicorandil and Vardenafil are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Nicorandil belongs to Cardiovascular; Vardenafil belongs to Genitourinary.
Why it happens
Nicorandil's nitric oxide donor activity raises cGMP while vardenafil blocks its breakdown, producing excessive vasodilation.
What to do
Do not combine; choose an alternative anti-anginal if a PDE5 inhibitor is needed, or avoid the PDE5 inhibitor. If a nitrate-like drug is required, vardenafil should be avoided for a period after the last dose.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Vardenafil
- Amyl nitrite + Vardenafil Contraindicated
- Glyceryl trinitrate pr + Vardenafil Contraindicated
- Isosorbide dinitrate + Vardenafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Nitroglycerin po + Vardenafil Contraindicated
- Nitroglycerin rectal + Vardenafil Contraindicated
Frequently asked questions
Can I take Nicorandil with Vardenafil?
MediHelp rates the interaction as contraindicated. Nicorandil and Vardenafil are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Nicorandil is a nitrate-like potassium channel opener, and PDE5 inhibitors greatly potentiate nitrate-induced vasodilation. The combination can cause profound, potentially life-threatening hypotension and is contraindicated with nitrates and guanylate cyclase pathway drugs.
How serious is the interaction between Nicorandil and Vardenafil?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine; choose an alternative anti-anginal if a PDE5 inhibitor is needed, or avoid the PDE5 inhibitor. If a nitrate-like drug is required, vardenafil should be avoided for a period after the last dose.
What other medicines interact with Vardenafil?
MediHelp also lists interactions of Vardenafil with, for example, Amyl nitrite, Glyceryl trinitrate pr, Isosorbide dinitrate. The full list is on the Vardenafil page.
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