التداخل بين نيتروغليسرين وسيلدينافيل

Use of phosphodiesterase type 5 (PDE-5) Inhibitors, such as avanafil, sildenafil, tadalafil, or vardenafil, or soluble guanylate cyclase (sGC) stimulator (riociguat).

P DE-5 - I nhibitors and sGC- S timulators Do not use Nitroglycerin Lingual Spray in patients who are taking PDE-5-Inhibitors, such as avanafil, sildenafil, tadalafil, or vardenafil.

PDE-5-Inhibitors such as avanafil, sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates.

CONTRAINDICATIONS Administration of SILDENAFIL ORAL FILM to patients using nitric oxide donors, such as organic nitrates or organic nitrites in any form.

SILDENAFIL ORAL FILM was shown to potentiate the hypotensive effect of nitrates.

…its known effects on the nitric oxide/cGMP pathway [see Clinical Pharmacology ( 12.1 , 12.2 ) ] , SILDENAFIL ORAL FILM potentiates the hypotensive effects of nitrates, and its administration to patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently is therefore contraindicated.

After patients have taken SILDENAFIL ORAL FILM it is unknown when nitrates, if necessary, can be safely administered.

Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentration, it is unknown whether nitrates can be safely co-administered at this time point [see Dosage and Administration ( 2.2 ), Drug Interactions ( 7.1 ), and Clinical Pharmacology ( 12.2 ) ].