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Heart failure - chronic - Management
Basis for recommendation
These recommendations and information are in line with recommendations in the National Institute for Health and Clinical Excellence (NICE) guideline Chronic heart failure: national clinical guideline for diagnosis and management in primary and secondary care [National Clinical Guideline Centre for Acute and Chronic Conditions, 2010], as well as European professional association guidelines [European Society of Cardiology, 2008].
Risk of sexual activity
Interaction between nitrates/nicorandil and phosphodiesterase inhibitors
- The combination of a phosphodiesterase inhibitor and a nitrate (including amyl nitrite) or nicorandil can result in excessive hypotension and possibly precipitate myocardial infarction [Baxter, 2010].
- The interaction with phosphodiesterase inhibitors is well established and clinically significant.
- It is not yet established whether nicorandil interacts with phosphodiesterase inhibitors to the same extent, but the manufacturers recommend that its use is contraindicated with phosphodiesterase inhibitors.
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