In patients taking sildenafil, which medication should be avoided due to possible hypotension?

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor commonly prescribed for erectile dysfunction and pulmonary hypertension. One of its effects is vasodilation, which can lead to a drop in blood pressure. Therefore, when prescribing medications alongside sildenafil, it’s essential to consider their potential interactions, particularly concerning the risk of hypotension.

Isosorbide, which is a nitrate, should be avoided in patients taking sildenafil. Nitrates are known for their vasodilatory effects and can significantly lower blood pressure. When combined with sildenafil, the synergistic effects of these medications can lead to profound hypotension, which may cause dizziness, fainting, or even severe cardiovascular consequences.

Other medications listed, like lisinopril, diltiazem, and hydralazine, are not contraindicated as they don’t carry the same level of hypotensive risk when used in conjunction with sildenafil. Lisinopril is an ACE inhibitor that generally doesn’t cause significant acute hypotension. Diltiazem is a calcium channel blocker that can lower blood pressure but is often used in controlled settings without the same level of risk as nitrates. Hydralazine is a vasodilator but is usually used in a monitored environment, making