Drug interactions
Nitroglycerin translingual + Sildenafil
Severity: Contraindicated
Nitroglycerin translingual and Sildenafil: 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
Translingual nitroglycerin spray used with sildenafil can produce profound hypotension. The risk is highest when the spray is used for acute angina after a recent sildenafil dose.
What this interaction means in plain words
Nitroglycerin translingual and Sildenafil 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.
Why it happens
Nitrates increase cGMP while sildenafil prevents its degradation via PDE5 inhibition, causing additive vasodilation.
What to do
Do not use nitroglycerin spray within 24 hours of sildenafil. Counsel patients to seek emergency help for chest pain after sildenafil instead of self-administering nitrate.
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 Sildenafil
- Amyl nitrite + Sildenafil Contraindicated
- Atazanavir + Sildenafil Contraindicated
- Cobicistat + Sildenafil Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Sildenafil Contraindicated
- Glyceryl trinitrate pr + Sildenafil Contraindicated
- Isosorbide dinitrate + Sildenafil Contraindicated
Frequently asked questions
Can I take Nitroglycerin translingual with Sildenafil?
MediHelp rates the interaction as contraindicated. Nitroglycerin translingual and Sildenafil 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. Translingual nitroglycerin spray used with sildenafil can produce profound hypotension. The risk is highest when the spray is used for acute angina after a recent sildenafil dose.
How serious is the interaction between Nitroglycerin translingual and Sildenafil?
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 nitroglycerin spray within 24 hours of sildenafil. Counsel patients to seek emergency help for chest pain after sildenafil instead of self-administering nitrate.
What other medicines interact with Sildenafil?
MediHelp also lists interactions of Sildenafil with, for example, Amyl nitrite, Atazanavir, Cobicistat. The full list is on the Sildenafil page.
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