Comparisons · FAQ
Why are sildenafil and tadalafil unsafe with nitrates?
Short answer
Sildenafil and tadalafil must not be used with nitrates because the combination can cause a dangerous drop in blood pressure. This includes nitroglycerin, isosorbide medicines, and recreational nitrites called poppers. If chest pain occurs after taking either ED medicine, call 911 and tell responders what you took and when.
Nitrates and PDE5 inhibitors both affect how blood vessels relax. Taking them together can lower blood pressure to a dangerous level. This can cause fainting or a medical emergency. Neither sildenafil nor tadalafil is a safe choice while you are using nitrates.
Nitrates include nitroglycerin tablets, sprays, patches, and ointments, as well as isosorbide medicines. Recreational nitrites, often called poppers, are also unsafe with these ED medicines. Tell your prescriber about products you use only occasionally, not just daily prescriptions.
If you develop chest pain during or after sex, stop activity and call 911. Tell responders whether you took sildenafil or tadalafil and the time of your last dose. Do not take nitroglycerin on your own after using an ED medicine. Emergency clinicians need this information to choose safe care.
Tadalafil stays in the body longer than sildenafil, so its interaction risk can last longer. Do not stop a prescribed nitrate or choose your own waiting period to make room for ED treatment. Your treating clinician must guide that decision.
Sources
Written by the Verra clinical team · Medical review pending
General information, not medical advice. If you're in crisis, call or text 988.
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