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For a client requesting sildenafil for erectile dysfunction, which of the following currently prescribed medications is a contraindication?

  1. Isosorbide

  2. Metformin

  3. Atenolol

  4. Levothyroxine

The correct answer is: Isosorbide

Isosorbide is a contraindication when sildenafil is prescribed for erectile dysfunction because both medications can cause hypotension. Isosorbide is a vasodilator that can further lower blood pressure when combined with sildenafil, which is also a vasodilator. The combination of these medications can result in a severe drop in blood pressure, leading to serious health complications. Therefore, it is essential to avoid prescribing isosorbide along with sildenafil to prevent potential adverse effects. Metformin, atenolol, and levothyroxine do not have significant interactions with sildenafil for erectile dysfunction and are generally safe to be used together.