Vriligy 60 mg contains dapoxetine 60 mg, it is not the same type of medicine as sildenafil or tadalafil. Dapoxetine itself does not have the absolute nitrate contraindication that PDE5 inhibitors have. However, dapoxetine can cause dizziness, low blood pressure, and fainting, particularly at 60 mg. The EMA notes that 60 mg has a higher risk of syncope and should generally only be used after 30 mg has  Vriligy 60 mg tolerated without significant adverse effects. E European Medicines Agency (EMA) +1 Important: If you are taking nitrates such as nitroglycerin or isosorbide for angina, you should speak with your doctor/pharmacist before taking Vriligy 60 mg, particularly if you also use sildenafil, tadalafil, or another ED medicine. PDE5 inhibitors must not be combined with nitrates because of potentially dangerous blood-pressure lowering. E European Medicines Agency (EMA) If you tell me which nitrate you take (e.g., nitroglycerin, isosorbide mononitrate, or isosorbide dinitrate) and whether you also take Viagra/Cialis, I can explain the specific interaction.