NICORANDIL AND PHOSPHODIESTERASE TYPE-5 INHIBITORS
The manufacturers of sildenafil contraindicate the concurrent use of sildenafil and nitrates because potentially serious hypotension can occur, and myocardial infarction may possibly be precipitated. A number of fatalities have occurred as a result of this interaction with nitrates. Tadalafil and vardenafil interact similarly. Nicorandil is expected to interact in the same way as the nitrates.
The concurrent use of these phosphodiesterase inhibitors and nicorandil is contraindicated. Sildenafil should not be used within 24 hours of a nitrate, and some evidence suggests this is also a suitable separation for vardenafil. Nitrates should not be given for at least 48 hours after the last dose of tadalafil. Similar cautions would seem to apply to nicorandil.
The concurrent use of these phosphodiesterase inhibitors and nicorandil is contraindicated. Sildenafil should not be used within 24 hours of a nitrate, and some evidence suggests this is also a suitable separation for vardenafil. Nitrates should not be given for at least 48 hours after the last dose of tadalafil. Similar cautions would seem to apply to nicorandil.