Orthostatic hypotension w/ antihypertensives. Enhanced vasodilatory hypotensive action of phosphodiesterase-5 inhibitors eg, sildenafil citrate, vardenafil HCl hydrate. Significant increase in exposure when co-administered w/ a strong CYP3A4 inhibitor eg, ketoconazole, itraconazole, ritonavir, atazanavir sulfate, indinavir sulfate, nelfinavir, saquinavir mesylate, clarithromycin, telithromycin. Do not use in combination w/ strong CYP3A4 inhibitors in patients known to be CYP2D6 poor metabolizers.