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Drug interactions

Nitroglycerin + Vardenafil

Severity: Contraindicated

Nitroglycerin 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

Vardenafil greatly potentiates the vasodilating effect of nitrates and can cause profound, potentially fatal hypotension. The risk persists for many hours after the PDE5 inhibitor dose.

What this interaction means in plain words

Nitroglycerin 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.

Nitroglycerin belongs to Cardiovascular; Vardenafil belongs to Genitourinary.

Evidence level: High

Why it happens

PDE5 inhibition increases cGMP, amplifying nitric oxide-mediated vasodilation from nitroglycerin.

What to do

Do not use nitrates in patients who have taken vardenafil within the previous 24 hours. In an emergency, use non-nitrate alternatives and give nitrates only under close hemodynamic monitoring after a safe interval.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Nitroglycerin with Vardenafil?

MediHelp rates the interaction as contraindicated. Nitroglycerin 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. Vardenafil greatly potentiates the vasodilating effect of nitrates and can cause profound, potentially fatal hypotension. The risk persists for many hours after the PDE5 inhibitor dose.

How serious is the interaction between Nitroglycerin 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 use nitrates in patients who have taken vardenafil within the previous 24 hours. In an emergency, use non-nitrate alternatives and give nitrates only under close hemodynamic monitoring after a safe interval.

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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