Tadalafil oral tablets can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.
Examples of drugs that can cause interactions with tadalafil are listed below.
Angina drugs (nitrates)
If you take tadalafil with nitrates, your blood pressure could suddenly drop to dangerously low levels. This could make you dizzy or cause you to faint. Examples of nitrates include:
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- nitroglycerin
- isosorbide dinitrate
- isosorbide mononitrate
- amyl nitrite
- butyl nitrite
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High blood pressure or prostate drugs (alpha-blockers)
If you take tadalafil with certain alpha-blockers, your blood pressure could suddenly drop to low levels that are dangerous. This could make you dizzy or cause you to faint. Examples of these drugs include:
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- terazosin
- tamsulosin
- doxazosin
- prazosin
- alfuzosin
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Certain HIV drugs
Taking tadalafil with certain HIV drugs could increase tadalafil levels in your blood. This can lead to low blood pressure, dizziness and fainting, and vision problems. In men, it can also lead to priapism. These drugs are protease inhibitors and include ritonavir and lopinavir/ritonavir.
Oral antifungal drugs
Taking certain antifungal drugs with tadalafil may increase levels of tadalafil in your blood. This can lead to low blood pressure, dizziness and fainting, and vision problems. In men, it can also lead to priapism. Examples of these drugs include ketoconazole and itraconazole.
Antibiotics
Taking certain antibiotics with tadalafil may raise the level of tadalafil in your blood. This can lead to low blood pressure, dizziness and fainting, and vision problems. In men, it can also lead to priapism. Examples of these drugs include:
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- clarithromycin
- erythromycin
- telithromycin
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Other types of antibiotics may lower the level of tadalafil in your blood. This could prevent tadalafil from working well. This includes drugs such as rifampin.
Other erectile dysfunction (ED) drugs
These medications work in the same way as tadalafil. If you take them with tadalafil, it increases your risk for side effects. Examples of these drugs include sildenafil and vardenafil.
Other pulmonary arterial hypertension (PAH) drugs
If you take tadalafil with other types of PAH drugs, your blood pressure could suddenly drop to dangerously low levels. The drug riociguat is in this drug class.
Stomach acid drugs
Taking these medications with tadalafil may keep your body from absorbing tadalafil well. An example of this type of drug is magnesium hydroxide/aluminum hydroxide.
Epilepsy drugs
Taking certain anti-seizure drugs with tadalafil may lower the level of tadalafil in your blood. This could prevent tadalafil from working well. Examples of these drugs include:
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- carbamazepine
- phenytoin
- phenobarbital
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