Abstract
Background Sildenafil citrate (SIL) is contraindicated in patients with coronary heart disease who are treated with nitric oxide (NO) donators such as organic nitrates, as it potentiates NO-mediated vasodilation. The present study investigated whether SIL also affects the vasodilatory effects of nebivolol (NEB), a selective β 1-adrenoceptor blocker with an additional, endothelium-dependent NO-liberating property, in comparison to the combination SIL/glycerol trinitrate (GTN). Methods and results Experiments were performed in isolated vessel rings of rat aorta (Wistar rats, 8–12 weeks), which had been pre-contracted with phenylephrine (10 − 5 M). Isometric tension was measured by a force transducer, and cumulative concentration–response curves were obtained for each drug. The rank order of vasodilatory potency as measured by the concentration needed to achieve 50% relaxation (EC 50) was GTN (0.08 μM) > SIL (1.25 μM) ≥ NEB (3.5 μM). In the presence of both therapeutic (1 nM) and high (1 μM) concentrations of SIL, vasodilation of GTN was potentiated as indicated by a significant increase in vasodilatory potency (EC 50 GTN + low SIL: 0.019 μM, EC 50 GTN + high SIL: 0.002 μM; both P < 0.01 vs. GTN). In contrast, SIL did not potentiate the vasodilatory effect of NEB (EC 50 NEB + low SIL: 5.01 μM, EC 50 NEB + high SIL: 3.2 μM; n.s. vs. NEB). Conclusions These data demonstrate that SIL does not potentiate NEB-induced vasodilation in vitro. These findings indicate that the interaction between SIL and NO-donators/organic nitrates does not apply to the NO-liberating properties of NEB. Our findings suggest that SIL may safely be used in hypertensive patients treated with NEB.
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