QuestionSBA
QuestionChoice
These are both nitrates and therefore concurrent use would increase risk of side effects including hypotension, howvever GTN is often required for acute angina attacks; there is no contraindication.
62129
b
Glyceryl Trinitrate (GTN)
QuestionChoice
Sertraline is a serotonin reuptake inhibitor and does not interact with ISMN.
62131
d
Sertraline
QuestionChoice
Diltiazem is a calcium channel blocker. Concurrent use can increase risk of hypotension but is not a severe interaction.
62132
e
Diltiazem
QuestionChoice
Concurrent use increases the risk of hypotension and represents a severe interaction and manufacturer advises to avoid co-prescribing.
62128
a
Sildenafil
QuestionChoice
Bisoprolol is a beta-blocker commonly used alongside ISMN in treatment of ischaemic heart disease. Concurrent use can increase risk of hypotension but is not a severe interaction and can usually be continued.
62130
c
Bisoprolol
Concept
Chapter
# Indication

Sildenafil is used to treat erectile dysfunction. 

# Mechanism

It is a phosphodiesterase 5 (PDE5) inhibitor which  enhances the effect of nitric oxide causing smooth muscle relaxation and subsequent penile erection due to inflow of blood.

# Side effects

Sildenafil citrate is contra-indicated in patients taking organic nitrates due to risk of hypotension.

Side effects include flushing, headache, dyspepsia, nasal congestion, dizziness, diarrhoea, rashes and UTIs.
1778
1974
Viagra
Topic
57
Geriatrics
12487
A 67 year old male is suffering from worsening stable angina. The next step in management is to commence Isosorbide mononitrate.

Which of the following medications constitutes a severe interaction with isosorbide mononitrate (ISMN)?
a