Nitrate and erectile dysfunction medicine: which combination must be disclosed?

Sudden chest pain with breathlessness, faintness or sweating requires an urgent call to 15 or 112 according to French Health Insurance. Report any sildenafil taken and when it was taken. Its leaflet prohibits nitrates to relieve chest pain after taking it.

Combining sildenafil with a nitrate is contraindicated in the cited leaflets. It can cause a dangerous fall in blood pressure. The NATISPRAY leaflet also describes faintness, loss of consciousness or a cardiac event.

NATISPRAY contains glyceryl trinitrate, a nitrate used in cardiology. Spraying it under the tongue allows rapid entry into the blood. Not swallowing a tablet therefore does not remove the interaction risk with sildenafil.

The NATISPRAY leaflet specifies that this prohibition covers nitrates in any form. Show a professional the treatment name and formulation. A difference in presentation is insufficient to conclude that the combination is permitted.

The sildenafil leaflet also prohibits combining it with nitric oxide donors such as amyl nitrite, known as poppers. Disclose these even if they do not appear on a prescription. The described risk is again a dangerous fall in blood pressure.

Before a new prescription, the leaflet requires disclosure of medicines used now, recently or potentially. During an emergency, it requires stating when sildenafil was taken. Preparing this information helps the clinician; no personal interval allowing another intake is inferred here.