Drug interactions
Sildenafil + Voriconazole
Severity: Major
Sildenafil and Voriconazole: 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
Voriconazole strongly inhibits CYP3A4 and can substantially increase sildenafil exposure. This raises the risk of hypotension, visual effects and prolonged adverse reactions.
What this interaction means in plain words
Sildenafil and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4-mediated sildenafil metabolism.
What to do
Use a reduced sildenafil dose (25 mg for erectile dysfunction, with limited dosing frequency) and monitor blood pressure. Avoid the combination when hypotension would be dangerous.
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 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
Other interactions of Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Frequently asked questions
Can I take Sildenafil with Voriconazole?
MediHelp rates the interaction as major. Sildenafil and Voriconazole 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. Voriconazole strongly inhibits CYP3A4 and can substantially increase sildenafil exposure. This raises the risk of hypotension, visual effects and prolonged adverse reactions.
How serious is the interaction between Sildenafil and Voriconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a reduced sildenafil dose (25 mg for erectile dysfunction, with limited dosing frequency) and monitor blood pressure. Avoid the combination when hypotension would be dangerous.
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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