Always inform your doctor about all medications you take, including over-the-counter drugs, herbal supplements, and vitamins, before starting sildenafil for pulmonary hypertension. This helps prevent potentially harmful interactions.
Sildenafil’s effects can be intensified or altered by certain medications. For example, combining sildenafil with nitrates can cause a dangerous drop in blood pressure. This combination should be strictly avoided.
Similarly, alpha-blockers, often prescribed for high blood pressure or enlarged prostate, can also interact with sildenafil, potentially leading to low blood pressure. Your doctor will carefully monitor your blood pressure if you take both.
Certain antifungal medications (like ketoconazole) and antibiotics (like erythromycin) can increase sildenafil levels in your blood, potentially increasing side effects. Your doctor might adjust your sildenafil dose accordingly.
Here’s a table summarizing some key interactions:
| Nitrates | Nitroglycerin | Severe hypotension | Avoid combination |
| Alpha-blockers | Terazosin | Hypotension | Close blood pressure monitoring |
| CYP3A4 Inhibitors | Ketoconazole, Erythromycin | Increased sildenafil levels | Dose adjustment may be needed |
| CYP3A4 Inducers | Rifampin | Decreased sildenafil levels | Dose adjustment may be needed |
This information is not exhaustive; consult your physician or pharmacist for a complete list of potential drug interactions and individualized advice.
