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Angioplasty done for two vessel disease. Taking medicine. Time interval between nitrocontin and sidenafil?

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Practicing since : 2009
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I am a male aged 57. About two and half years back, I was diagnised with Two Vessel disease. The angio gram revealed 100% occulsion of RCA and about 70% of LAD. The cardiologist advised that nothing much could be done to RCA, but LAD can be saved and over the years, collateral circulation might come about. I underwent angioplasty with two drug eluting stents. Since then, I have been taking Betaloc 25; olmestat 20 before breakfast. I take one Pan 40 also before breakfast. After breakfast, I take nitrocontin 2.6, one tablet, Flavedon MR 35 one; cordarone 25 (only during the last three months) and Becadexamin. At noon I take one omacar and one Tayo. At night, I take one nitrocontin 2.6; one flavedon MR35; one combiplet 150 and one Aztor EZ 20. My Blood Test, cholestrol , HDL/LDL are within normal limits. I have no sugar complaint. I go for walk, do Pranayam and continue working, though the work is stressful. The various web sites state that when one takes nitrates, sidenafil should not be taken and is XXXXXXX My cardiologist, when I asked casually ( I was hesitant to ask), stated that half a tablet once in a while should not be an issue. My question is can I stop nitrocontin, say 24 hours before taking sidenafil 20 mg, since Iam taking combiplet and other medicines.
Posted Sun, 14 Apr 2013 in Hypertension and Heart Disease
Answered by Dr. Arnab Maji 4 hours later
Thanks for your query.
To be XXXXXXX I can tell you that it is as yet unknown the exact time interval between nitrates and sildenafil. The only absolute contraindication of sildenafil use is concurrent use of nitrates either regularly or intermittently. Many researches have been done on this issue of time interval between them. Most of them have failed to conclusively establish the exact time interval. But few researchers have found that there should be atleast 72 hours gap between sildenafil and last dose of nitrates whatever may be the dose of sildenafil. Therefore i will ask you to have an interval of atleast 72 hours between them.
Hope i have answered your queries. If you have further queries you can write back to me.
Dr Arnab Maji
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