Final answer:
Nitroglycerin, a nitrate, can cause severe hypotension when combined with sildenafil, a phosphodiesterase-5 inhibitor. Alpha-blockers, calcium channel blockers, and ACE inhibitors may also interact with sildenafil but are not as risky as nitrates. Careful management is necessary with all these combinations.
Step-by-step explanation:
The medications that cause hypotension when used with phosphodiesterase-5 inhibitors, such as sildenafil, include nitrates (e.g., nitroglycerin). It is critically important that patients who are prescribed sildenafil for erectile dysfunction (ED) are aware of the potential risk of severe hypotension if they also take nitrates, often prescribed for cardiac conditions like angina pectoris. Other classes of antihypertensive medications like alpha-blockers, calcium channel blockers, and ACE inhibitors may also have interactions with sildenafil, but the combination of sildenafil with nitrates poses the highest risk of significant blood pressure drops.
Negative inotropic agents, such as certain beta blockers and calcium channel blockers, may reduce the strength of heart muscle contractions and are used to manage conditions like high blood pressure and angina. However, their combination with sildenafil is not as acutely dangerous as with nitrates but still requires careful monitoring by a healthcare professional. Sildenafil, a PDE5 inhibitor, promotes vasodilation and is used primarily to treat ED, but it can interact with these cardiovascular agents, leading to potentially risky drops in blood pressure.