Peter is a 48 year old man with hypertension, COPD, erectile…
Peter is a 48 year old man with hypertension, COPD, erectile dysfunction and stable but moderately intense angina with physical exertion. He typically fails to keep appointments and declines invasive diagnostic and therapeutic interventions. His hypertension has been poorly controlled until recently. His current medications include metoprolol (Toprol*), ramipril (Altace*), amlodipine (Norvasc*), atorvastatin (Lipitor*) and a nitroglycerin patch (Nitro-Dur*) worn from 10AM to 10PM. He recently received tadalafil tablets (Cialis*) for erectile dysfunction from a questionable internet pharmacy and wants to know how to use them safely. Which statement is true about the use of tadalafil (Cialis*) in Peter? (Note: tadalafil inhibits phosphodiesterase for 36-48 hours)