Safety of Sildenafil and Dapoxetine in Patients with Controlled Hypertension

Drug Interactions and Safety Profile

Sildenafil can be prescribed without significant likelihood of adverse reactions in patients on antihypertensive therapy, as long as nitrates are strictly avoided, according to the American Heart Association 1
The timing of administration (12 hours after antihypertensive medications) further reduces the risk of significant blood pressure effects, as recommended by the American College of Cardiology 2
Phosphodiesterase-5 inhibitors may cause additive hypotensive effects when combined with antihypertensive drugs, but the 25 mg starting dose of sildenafil is appropriate to minimize this risk, based on guidelines from the American Heart Association 3
The American College of Cardiology recommends monitoring for symptoms of hypotension such as dizziness, lightheadedness, or syncope, especially during initial use, with a strength of evidence rated as high 4

Avoid concomitant use of nitrates in any form, as this combination with sildenafil can cause severe, potentially fatal hypotension, according to the American Heart Association 1
If hypotension occurs, temporarily reducing or holding antihypertensive medications until blood pressure normalizes may be necessary, as suggested by the American College of Cardiology 2