ModerateSelective beta-adrenergic blockers×Phosphodiesterase type 5 inhibitors (PDE5)
Updated · Methodology
Mechanism
Sildenafil is a vasodilator via PDE5 blockade. Combined with bisoprolol: risk of symptomatic hypotension, especially with the first dose.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
The combination is acceptable in stable hypertension with a well-titrated beta-blocker. Take the first sildenafil dose lying down; do not exceed 25–50 mg. Warn the patient about orthostatic hypotension.
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Sources
- FDA: Bisoprolol tablet (Micro Labs Limited) – Prescribing Information (2016)– ; DailyMed setid c3ee566c-74c4-45f4-a947-526a7313e326