A New Perspective on the Nitrate-Phosphodiesterase Type 5 Inhibitor Interaction.

Kloner, Robert A and Goggin, Paul and Goldstein, Irwin and Hackett, Geoffrey and Kirby, Michael G and Osterloh, Ian and Parker, John D and Sadovsky, Richard (2018) A New Perspective on the Nitrate-Phosphodiesterase Type 5 Inhibitor Interaction. Journal of cardiovascular pharmacology and therapeutics. p. 1074248418771896. ISSN 1940-4034. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

Full text not available from this repository.
Official URL: http://journals.sagepub.com/doi/full/10.1177/10742...

Abstract

BACKGROUND

Nitrates and nitrate-containing compounds are vasodilators used for the treatment of angina and heart failure. Phosphodiesterase type 5 inhibitors used for the treatment of erectile dysfunction are also vasodilators, and when taken together with nitrates, synergistic effects that enhance hypotensive effects may occur. Phosphodiesterase type 5 inhibitors are therefore contraindicated in patients taking organic nitrates.

METHODS AND RESULTS

A literature review was performed to provide a historical overview of different phosphodiesterase type 5 inhibitors and nitrates and their interaction. The pharmacologic characteristics of phosphodiesterase type 5 inhibitors and nitrates are reviewed, and clinical recommendations for treating cardiovascular disease in men taking phosphodiesterase type 5 inhibitors are discussed. Pharmacologic and adverse drug reactions between nitrates and phosphodiesterase type 5 inhibitors are dependent on many variables. Organic nitrates remain an absolute contraindication in men treated with phosphodiesterase type 5 inhibitors. In general, nitrates may be taken 24 hours after the last dose of short-acting phosphodiesterase type 5 inhibitors and 48 hours after the last dose of long-acting phosphodiesterase type 5 inhibitors.

CONCLUSIONS

This literature review determined that the use of phosphodiesterase type 5 inhibitors with nitrates is a contraindication, with the duration between the last dose of phosphodiesterase inhibitor and nitrate use generally varying between short- and long-acting phosphodiesterase type 5 formulations. Patients receiving nitrates who wish to use phosphodiesterase type 5 inhibitors should be educated regarding the interaction and should be evaluated to determine whether nitrate treatment can be discontinued. Further research is needed to determine how soon phosphodiesterase type 5 inhibitors can be restarted after a patient has taken a nitrate and the effect of high and low phosphodiesterase type 5 inhibitor doses on the interaction effect.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WJ Urogenital system. Urology
Divisions: Planned IP Care > Urology
Related URLs:
Depositing User: Mrs Semanti Chakraborty
Date Deposited: 18 May 2018 12:35
Last Modified: 18 May 2018 12:35
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1657

Actions (login required)

View Item View Item