title: Contraindications - Neonatal Intensive Care Drug Manual
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  Neonatal Intensive Care Drug Manual
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  bet | 550/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Contraindications
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  Hypersensitivity to sildenafil
  Not to be used in patients taking organic nitrates of any form e.g. glyceryl trinitrate, isosorbide mononitrate, sodium nitroprusside
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  Precautions
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  Use with caution in neonates with sepsis or uncontrolled hypotension.
  Sildenafil clearance (in adults) is reduced in hepatic and severe renal impairment.
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  Drug Interactions
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  Sildenafil metabolism is principally mediated by the cytochrome P450 (CYP) isoforms 3A4 (major route) and 2C9 (minor route). Inhibitors of these isoenzymes may reduce sildenafil clearance and inducers of these isoenzymes may increase sildenafil clearance. Thus, erythromycin and fluconazole may increase concentrations of sildenafil by reducing hepatic clearance and rifampicin may decrease concentrations by inducing its hepatic metabolism.
  Avoid concomitant use of sildenafil with: Alprostadil (prostaglandin E1), other antihypertensives and vasodilators, as they may have their effects potentiated by sildenafil.
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