CONTRAINDICATIONS
4.1 PDE-5-Inhibitors and sGC-Stimulators
Do not use GONITRO in patients who are taking PDE-5-Inhibitors, such as avanafil, sildenafil, tadalafil, or
vardenafil. Concomitant use can cause severe hypotension, syncope, or myocardial ischemia [see Drug
Interactions (7.1)].
Do not use GONITRO in patients who are taking soluble guanylate cyclase (sGC) stimulators, such as riociguat.
Concomitant use can cause hypotension.
4.2 Severe Anemia
GONITRO is contraindicated in patients with severe anemia (large doses of nitroglycerin may cause oxidation
of hemoglobin to methemoglobin and could exacerbate anemia).
4.3 Increased Intracranial Pressure
GONITRO may precipitate or aggravate increased intracranial pressure and thus should not be used in patients
with possible increased intracranial pressure (e. g. cerebral hemorrhage or traumatic brain injury).
4.4 Hypersensitivity
GONITRO is contraindicated in patients who are allergic to nitroglycerin, other nitrates or nitrites or any
excipient.
4.5 Circulatory Failure and Shock
GONITRO is contraindicated in patients with acute circulatory failure or shock.