Drug interactions
Sildenafil + Sodium nitroprusside
Severity: Major
Sildenafil and Sodium nitroprusside: major 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
Sildenafil potentiates nitric oxide-mediated vasodilation, so combining it with nitroprusside, a nitric oxide donor, can cause profound hypotension. Labeling warns against use of PDE5 inhibitors with nitric oxide donors.
What this interaction means in plain words
Sildenafil and Sodium nitroprusside can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Sildenafil belongs to Genitourinary; Sodium nitroprusside belongs to Cardiovascular.
Why it happens
Nitroprusside releases nitric oxide, increasing cGMP, and sildenafil blocks cGMP breakdown through PDE5 inhibition.
What to do
Avoid giving nitroprusside to patients who recently took sildenafil unless no alternative exists. If needed, use very cautious titration with continuous arterial pressure monitoring.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Sodium nitroprusside
- Avanafil + Sodium nitroprusside Contraindicated
- Nitric oxide + Sodium nitroprusside Major
- Sodium nitroprusside + Tadalafil Major
- Sodium nitroprusside + Vardenafil Major
- Amlodipine + Sodium nitroprusside Moderate
- Benazepril + Sodium nitroprusside Moderate
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 Sildenafil with Sodium nitroprusside?
MediHelp rates the interaction as major. Sildenafil and Sodium nitroprusside can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Sildenafil potentiates nitric oxide-mediated vasodilation, so combining it with nitroprusside, a nitric oxide donor, can cause profound hypotension. Labeling warns against use of PDE5 inhibitors with nitric oxide donors.
How serious is the interaction between Sildenafil and Sodium nitroprusside?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid giving nitroprusside to patients who recently took sildenafil unless no alternative exists. If needed, use very cautious titration with continuous arterial pressure monitoring.
What other medicines interact with Sodium nitroprusside?
MediHelp also lists interactions of Sodium nitroprusside with, for example, Avanafil, Nitric oxide, Tadalafil. The full list is on the Sodium nitroprusside page.
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