Nitrate-containing medicines and phosphodiesterase-5 inhibitors

Phosphodiesterase-5 inhibitors, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), have revolutionized the treatment of erection problems (erectile dysfunction). But they can cause life-threatening side effects for anyone who also takes nitroglycerin or another medicine containing an organic nitrate. This combination can make your blood pressure fall too low, possibly leading to a stroke, a heart attack, or death. Do not take nitrate-containing medicines up to 24 hours after you take sildenafil (Viagra) or vardenafil (Levitra), or up to 48 hours after you take tadalafil (Cialis).

Medicines that contain organic nitrates include:

  • Nitroglycerin (such as Minitran, Nitro-Dur, Nitrolingual Pumpspray, Nitrostat).
  • Isosorbide mononitrate (such as ISMO, Monoket).
  • Isosorbide dinitrate (such as Dilatrate-SR, Isordil).
  • Sodium nitroprusside (such as Nitropress).
  • Amyl nitrite or amyl nitrate (sometimes called "poppers"), which are sometimes abused.

Nitrates found in foods are not a danger when taking phosphodiesterase-5 inhibitors.

Last Updated: May 21, 2008

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