Interactions médicamenteuses
Riociguat + Sildenafil
Gravité: Contre-indiquée
Riociguat and Sildenafil: contraindicated interaction.
Dernière mise à jour Sources: US FDA label
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Résumé
Combining riociguat with PDE5 inhibitors such as sildenafil causes additive systemic vasodilation and can lead to hypotension. In a pulmonary arterial hypertension study, adding riociguat to sildenafil showed no favorable benefit and was associated with unfavorable outcomes including more deaths. Riociguat labeling contraindicates concomitant PDE5 inhibitors.
Ce que signifie cette interaction, en termes simples
Riociguat 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.
Riociguat belongs to Cardiovascular; Sildenafil belongs to Genitourinary.
Pourquoi elle survient
Riociguat stimulates soluble guanylate cyclase to raise cGMP, and sildenafil blocks cGMP degradation via PDE5, so the effects on the nitric oxide-cGMP pathway are additive.
Conduite à tenir
Do not use the two together. When switching, stop sildenafil at least 24 hours before starting riociguat, and consider specialist guidance on the transition.
Questions à poser à votre pharmacien
- 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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Références
- Adempas (riociguat) Prescribing Information - Contraindications — FDA Label
- Adempas (riociguat) Summary of Product Characteristics — EMA SmPC
Autres interactions de Riociguat
- Avanafil + Riociguat Contre-indiquée
- Dipyridamole + Riociguat Contre-indiquée
- Isosorbide dinitrate + Riociguat Contre-indiquée
- Isosorbide mononitrate + Riociguat Contre-indiquée
- Nitroglycerin + Riociguat Contre-indiquée
- Riociguat + Tadalafil Contre-indiquée
Autres interactions de Sildenafil
- Amyl nitrite + Sildenafil Contre-indiquée
- Atazanavir + Sildenafil Contre-indiquée
- Cobicistat + Sildenafil Contre-indiquée
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Sildenafil Contre-indiquée
- Glyceryl trinitrate pr + Sildenafil Contre-indiquée
- Isosorbide dinitrate + Sildenafil Contre-indiquée
Questions fréquentes
Can I take Riociguat with Sildenafil?
MediHelp rates the interaction as contraindicated. Riociguat 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. Combining riociguat with PDE5 inhibitors such as sildenafil causes additive systemic vasodilation and can lead to hypotension. In a pulmonary arterial hypertension study, adding riociguat to sildenafil showed no favorable benefit and was associated with unfavorable outcomes including more deaths. Riociguat labeling contraindicates concomitant PDE5 inhibitors.
How serious is the interaction between Riociguat 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 the two together. When switching, stop sildenafil at least 24 hours before starting riociguat, and consider specialist guidance on the transition.
What other medicines interact with Riociguat?
MediHelp also lists interactions of Riociguat with, for example, Avanafil, Dipyridamole, Isosorbide dinitrate. The full list is on the Riociguat page.
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