Which of the following medications is contraindicated with nitroglycerin?

Rationale

Sildenafil is contraindicated with nitroglycerin.

Sildenafil, a phosphodiesterase type 5 (PDE5) inhibitor used to treat erectile dysfunction, can cause significant hypotension when taken with nitroglycerin, which is a nitrate that vasodilates blood vessels. This combination can lead to dangerous drops in blood pressure, making it a critical contraindication.

A (Amoxicillin) YOUR ANSWER

Amoxicillin is an antibiotic used to treat various bacterial infections and does not have any known interactions with nitroglycerin. It does not affect blood pressure or cardiovascular function, making it safe to use in conjunction with nitroglycerin.

B (Sildenafil) CORRECT

Sildenafil directly interacts with nitroglycerin by enhancing the vasodilatory effects of nitrates, leading to potentially severe hypotension. This interaction poses a serious risk to patients taking both medications, which is why it is explicitly contraindicated.

C (Levothyroxine) YOUR ANSWER

Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism and does not have any interactions with nitroglycerin. It functions independently of cardiovascular effects that would complicate treatment with nitroglycerin.

D (Metformin) YOUR ANSWER

Metformin is an oral medication used to manage type 2 diabetes. It does not interact adversely with nitroglycerin, as it primarily affects glucose metabolism rather than cardiovascular dynamics. Therefore, it is safe to use alongside nitroglycerin.

Conclusion

Among the choices presented, sildenafil stands out as the only medication with a serious contraindication when used with nitroglycerin due to the risk of severe hypotension. Other options, including amoxicillin, levothyroxine, and metformin, do not pose similar risks and can be safely administered with nitroglycerin. Understanding these interactions is crucial for patient safety in clinical practice.

Which of the following medications is contraindicated with nitroglycerin?

Sildenafil is contraindicated with nitroglycerin.

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