Moderate
Bisoprolol × Sildenafil
Selective beta-adrenergic blockers×Phosphodiesterase type 5 inhibitors (PDE5)
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.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.