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Sildenafil and Hydralazine/Isosorbide Dinitrate Interaction

Drug interaction information between Sildenafil and Hydralazine/Isosorbide Dinitrate.

Sildenafil and Hydralazine/Isosorbide Dinitrate have a documented major interaction in FDA labeling.

FDA drug labeling documents a major-severity interaction between Sildenafil and Hydralazine/Isosorbide Dinitrate. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.

Drug A

Sildenafil

PDE5 Inhibitor

Drug B

Hydralazine/Isosorbide Dinitrate

Vasodilator / Nitrate Combination

How They Interact

Both drugs work to relax blood vessels, and taking them together can cause your blood pressure to drop to a dangerously low level.

What To Do

Do not take these two medications together.

FDA Label Information

7 DRUG INTERACTIONS 7.1 Phosphodiesterase Inhibitors BiDil is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), PDE5 inhibitors such as avanafil, sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates.

Hydralazine/Isosorbide Dinitrate Also Interacts With

View all Hydralazine/Isosorbide Dinitrate interactions →

Frequently Asked Questions

Can I take Sildenafil and Hydralazine/Isosorbide Dinitrate together?

This is a major interaction. Do not take these two medications together.

How serious is the interaction between Sildenafil and Hydralazine/Isosorbide Dinitrate?

This interaction is classified as "major" severity by the FDA. Major interactions may be life-threatening or cause serious side effects.

Why do Sildenafil and Hydralazine/Isosorbide Dinitrate interact?

Both drugs work to relax blood vessels, and taking them together can cause your blood pressure to drop to a dangerously low level.

Understanding the Sildenafil and Hydralazine/Isosorbide Dinitrate Interaction

FDA-approved prescribing information for these two drugs flags their combination as a major-severity interaction. Sildenafil belongs to the PDE5 Inhibitor class and Hydralazine/Isosorbide Dinitrate belongs to the Vasodilator / Nitrate Combination class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Both drugs work to relax blood vessels, and taking them together can cause your blood pressure to drop to a dangerously low level. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.

Context around a specific patient determines real-world impact. Sildenafil has 10 total documented interactions on file in this dataset, and Hydralazine/Isosorbide Dinitrate has 2. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Do not take these two medications together. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.

An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Sildenafil or Hydralazine/Isosorbide Dinitrate based on a web page, speak with your prescriber or pharmacist before making any change.

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.