PTCB Certified Pharmacy Technician (PTCE)Patient Safety and Quality AssuranceHard

A pharmacy technician is reviewing a patient's medication profile and notes that the patient is prescribed 'Tamsulosin 0.4 mg daily' for benign prostatic hyperplasia (BPH) and 'Sildenafil 50 mg as needed' for erectile dysfunction. The technician recognizes a potential drug interaction. What is the MOST likely adverse effect if these medications are taken concurrently?

  1. AEnhanced absorption of tamsulosin.
  2. BSignificant decrease in blood pressure.
  3. CDecreased efficacy of sildenafil.
  4. DIncreased risk of priapism.
Show answer & explanation

Correct answer: B. Significant decrease in blood pressure.

Both tamsulosin (an alpha-1 blocker) and sildenafil (a PDE5 inhibitor) can cause vasodilation and a drop in blood pressure. When taken concurrently, especially within a short timeframe, their hypotensive effects can be additive, leading to a significant and potentially dangerous decrease in blood pressure (orthostatic hypotension).

Why the other options are wrong

  • A. The primary interaction is pharmacodynamic (additive BP lowering), not pharmacokinetic (enhanced absorption).
  • C. The interaction primarily concerns blood pressure, not a decrease in sildenafil's efficacy; rather, it's an additive side effect.
  • D. While priapism is a rare side effect of PDE5 inhibitors like sildenafil, it's not the primary interaction concern with tamsulosin.

Alpha-Blocker/PDE5 Inhibitor Interaction

Concurrent use of alpha-blockers (e.g., tamsulosin) and PDE5 inhibitors (e.g., sildenafil) can lead to a significant, additive decrease in blood pressure.

  • Both drug classes cause vasodilation.
  • Additive hypotensive effect is the main risk.
  • Patients should be advised on timing and symptoms of hypotension.

Memory trick: Alpha-Blocker + PDE5 = BP Crash, Too Much Vasodilation in a Flash!

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