Which drug interaction is dangerous when using nitrates?

Nitrates are a class of medications commonly used to treat angina and other heart conditions by relaxing blood vessels and improving blood flow. One significant concern with nitrates is the potential for dangerous interactions with other medications that affect blood pressure or cause vasodilation.

Sildenafil, which is used to treat erectile dysfunction, works by inhibiting an enzyme that leads to vasodilation. When taken together with nitrates, the additive effects on lowering blood pressure can lead to severe hypotension (dangerously low blood pressure). This interaction can be life-threatening, as it may result in symptoms like dizziness, fainting, or even more severe cardiovascular events.

In contrast, the other medications listed—metoprolol, warfarin, and furosemide—do not present the same acute risk of severe hypotension when used in conjunction with nitrates. Beta-blockers like metoprolol can have some interactions but are primarily used for heart conditions and may be used in conjunction with nitrates to control heart rate and improve patient outcomes. Warfarin is an anticoagulant, and while it requires careful management, it does not have the same immediate dramatic effect on blood pressure when taken with nitrates. Furosemide is a