Drug interactions
Nitroprusside + Sildenafil
Severity: Contraindicated
Nitroprusside 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
Nitroprusside releases nitric oxide, and sildenafil prevents cGMP breakdown, which can cause profound and potentially dangerous hypotension. Nitric oxide donors are contraindicated with PDE5 inhibitors.
What this interaction means in plain words
Nitroprusside 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
Nitric oxide donation by nitroprusside increases cGMP, while PDE5 inhibition by sildenafil prevents its breakdown.
What to do
Avoid the combination. Avoid nitroprusside within at least 24 hours of sildenafil unless in a monitored emergency where no alternative exists.
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 Nitroprusside with Sildenafil?
MediHelp rates the interaction as contraindicated. Nitroprusside 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. Nitroprusside releases nitric oxide, and sildenafil prevents cGMP breakdown, which can cause profound and potentially dangerous hypotension. Nitric oxide donors are contraindicated with PDE5 inhibitors.
How serious is the interaction between Nitroprusside 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: Avoid the combination. Avoid nitroprusside within at least 24 hours of sildenafil unless in a monitored emergency where no alternative exists.
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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