Nitrates drug interactions

Clinically relevant drug interactions Nitrates, protease inhibitors, Nitrates, a,-blockers3, Nitrates, anti-arrhythmic... 

Flypersensitivity to any component of the tablet administration with nitrates (either regularly and/or intermittently) and nitric oxide donors because of the potentiation of hypotension (see Drug Interactions) coadministration with alpha-blockers (vardenafil only) coadministration with alpha-blockers other than 0.4 mg/day tamsulosin (tadalafil only). 

ED and vascular disease commonly coexist. They share the same risk factors and endothelial dysfunction is the common denominator. ED may develop in an otherwise asymptomatic male and be an important predictor of subsequent acute or chronic cardiac events. ED may therefore offer an opportunity for risk assessment and therapeutic intervention to reduce the chance of a subsequent cardiac presentation. Cardiac patients with ED need a careful assessment to judge the safety of sexual activity and suitability for ED treatment. Properly assessed and counselled patients can safely enjoy sexual activity. ED therapy with phosphodiesterase type five inhibitors is safe and effective providing the patient and partner are advised on their use and the importance of avoiding drug interactions, especially with nitrates. 

Webb DJ, Freestone S, Allen MJ, Muirhead GJ. Sildenafil citrate and blood-pressure-lowering drugs results of drug interaction studies with an organic nitrate and a calcium antagonist. Am J Cardiol 1999 83(5A) C21-8. 

Drug interactions The concurrent use of sildenafil (used for erectile dysfunrtion) is contraindicated due to potentiation of hypotensive effects Of nitrates. Ergot alkaloids (used for migraine headaches) may cause increased blood pressure and decreased antianginai effects of nitrates—avoid concurrert use. 

There are advantages and disadvantages to each of these PDE5 inhibitors. Some can be taken with food and other cannot. Some have optimal durations of action, and others are much shorter. All, however, have been known to have adverse effects and drug interactions in common. Some of these adverse effects can be rather severe, and the drug interactions with nitrates can be fatal. 

D. Important drug interactions may result in toxicity. Hypotension is more likely to occur in patients taking beta blockers, nitrates, or both, especially if they are hypovolemic after diuretic therapy. Patients taking disopyramide or other... 

Drug-drug interactions Theuseofphospho-diesterase-5 inhibitors with concomitant medications has been reviewed from literature published in 1998-2007 [30 ]. Concomitant use of nitrates is completely contraindicated, and the authors suggested that precautions be taken with concomitant use of either alpha-blocking drugs or potent inhibitors of CYP3A. 

Drugs that may interact with nitrates include alcohol, alteplase, aspirin, beta-blockers, calcium channel blockers, dihydroergotamine, heparin, nondepolarizing muscle relaxants, phenothiazines, phosphodiesterase inhibitors (eg, sildenafil, tadalafil, vardenafil), and vasodilators. 

Drug/Lab test interactions Nitrates may interfere with the Z/af/c/s-Za/ccolor reaction causing a false report of decreased serum cholesterol. 

Isosorbide Dinitrate Hydralazine (BiDil) [Antianginal, Antihypertensive/Vasodilator, Nitrate] Uses HF in African Amer-icans improve survival functional status, prolong time between hospitalizations Action Relaxes vascular smooth muscle peripheral vasodilator Dose Initially 1 tab tid PO (if not tol ated reduce to 1/2 tab tid), titrate >3-5 d as tolerated Max 2 tabs tid Caution [C, /-] recent MI, syncope, hypovolemia, hypotension, hep impair Contra For children, concomitant use w/ PDE5 inhibitors (sildenafil) Disp Tabs SE HA, dizziness, orthostatic hypotension, sinusitis, GI distress, tach, paresthesia, amblyopia Interactions t Risk of severe hypotension W/ antihypertensives, ASA, CCBs, MAOIs, phenothiazides, sildenafil, tadalafil, vardenafil, EtOH X pressor response Wf i -1- effects W7 NSAIDs EMS Use ASA, antihypertensives and CCBs w/ caution, may t hypotension concurrent Viagra-type drug use can lead to profound hypotension concurrent EtOH use can t effects OD May cause N/V, profound hypotension, skin flushing, HA from ICP, bradycardia, confusion, and circulatory collapse activated charcoal may be effective, epi use is contraindicated... 

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