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Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitorsPatients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitorIn those patients who are stable on alpha-blocker therapyPDE5 inhibitors should be initiated at the lowest dosesee DOSAGE AND ADMINISTRATIONIn those patients already taking an optimized dose of a PDE5 inhibitoralpha-blocker therapy should be initiated at the lowest doseStepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure when taking a PDE5 inhibitorSafety of combined use of PDE5 inhibitors and alpha-blockers may be affected by other variablesincluding intravascular volume depletion and other anti-hypertensive drugs.<\/p>\n
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