Safety of Concomitant Opdivo and Sildenafil Use

Contraindications and Precautions

• The American College of Physicians recommends that concurrent use of nitrates in any form (e.g., nitroglycerin, isosorbide dinitrate) is an absolute contraindication for sildenafil due to risk of severe hypotension 1, 2
• Patients taking sildenafil should avoid nitroglycerine for at least 24 hours after sildenafil use, as recommended by the American Heart Association 3

Cardiovascular Risk Assessment

• The American College of Cardiology suggests that for patients with indeterminate cardiovascular risk, additional vascular disease assessment may be warranted, although this specific guideline is from Praxis Medical Insights, it is essential to consider cardiovascular risk assessment for patients on Opdivo 4