In which situation is nitroglycerin considered contraindicated?

Nitroglycerin is contraindicated in patients using erectile dysfunction (ED) medications due to the risk of severe hypotension. Both nitroglycerin and ED medications, such as sildenafil, vardenafil, and tadalafil, cause vasodilation, but when taken together, their combined effects can result in an excessive drop in blood pressure. This significant hypotensive response can lead to symptoms such as dizziness, fainting, or even more severe cardiovascular complications, which makes it critical to avoid the concurrent use of these medications.

In the context of the other options, nitroglycerin is commonly used for stable angina to relieve chest pain by dilating coronary arteries and improving blood flow. While nitroglycerin can be cautiously used in patients with hypertension, careful monitoring is necessary because it can lower blood pressure further. Additionally, nitroglycerin is sometimes used in patients with migrainous headaches as a secondary treatment, given its vasodilatory properties can help alleviate headache symptoms.