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Sodium nitroprusside (SNP) produces hypotension by increasing nitric oxide-mediated generation of cyclic guanosine monophosphate (cGMP), which causes vasodilatation. On the other hand, sildenafil, a phosphodiesterase type 5 inhibitor (PDE5), increases cGMP by inhibiting its degradation by PDE5. Hence, theoretically, the two should be complementary. We present a case where the two agents were used together to manage a hypertensive crisis. This, to the best of our knowledge, is the first such case report worldwide.

Novel therapeutic option in hypertensive crisis: sildenafil augments nitroprusside-induced hypotension