Always inform your doctor about all medications you are taking, including over-the-counter drugs, herbal supplements, and recreational drugs. Sildenafil citrate can interact negatively with certain medications, potentially leading to dangerous side effects.
Nitrates
Combining sildenafil with nitrates (found in some heart medications like nitroglycerin) can cause a dangerous drop in blood pressure. This combination should be strictly avoided. Discuss alternative treatments with your doctor if you’re on nitrate therapy.
Alpha-blockers
Alpha-blockers, used to treat high blood pressure and benign prostatic hyperplasia (BPH), can cause a similar blood pressure lowering effect when taken with sildenafil. Your doctor may adjust your dosage or recommend alternative medications.
CYP3A4 Inhibitors
Medications that inhibit the CYP3A4 enzyme (like ketoconazole, erythromycin, and some protease inhibitors) can increase sildenafil levels in your blood, potentially intensifying its effects and side effects. Your doctor may recommend a lower dose of sildenafil.
CYP3A4 Inducers
Conversely, medications that induce the CYP3A4 enzyme (like rifampin and St. John’s Wort) can decrease sildenafil levels, reducing its effectiveness. This interaction warrants discussion with your physician.
Alcohol
Excessive alcohol consumption can worsen sildenafil’s side effects, including dizziness and headaches. Moderate alcohol intake is generally acceptable, but excessive use should be avoided.
Summary of Interactions
| Nitrates | Dangerous blood pressure drop | Avoid concurrent use |
| Alpha-blockers | Blood pressure lowering | Dosage adjustment may be needed |
| CYP3A4 Inhibitors | Increased sildenafil levels | Lower sildenafil dose may be necessary |
| CYP3A4 Inducers | Decreased sildenafil levels | Dosage adjustment may be needed |
| Alcohol (Excessive) | Increased side effects | Limit alcohol consumption |
This information is not exhaustive. Always consult your physician or pharmacist before taking sildenafil citrate, especially if you are on other medications or have underlying health conditions.
