Drug interactions
Carbamazepine + Tadalafil
Severity: Moderate
Carbamazepine and Tadalafil: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Carbamazepine is a strong CYP3A4 inducer and can substantially lower tadalafil concentrations, which may cause loss of efficacy. This is particularly relevant when tadalafil is used for pulmonary arterial hypertension.
What this interaction means in plain words
Carbamazepine and Tadalafil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbamazepine belongs to Central Nervous System; Tadalafil belongs to Genitourinary.
Why it happens
Induction of CYP3A4 by carbamazepine increases tadalafil metabolic clearance.
What to do
Avoid the combination in pulmonary arterial hypertension. For erectile dysfunction, monitor response and consider a dose adjustment within the labeled range or an alternative.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Tadalafil
- Amyl nitrite + Tadalafil Contraindicated
- Isosorbide dinitrate + Tadalafil Contraindicated
- Isosorbide mononitrate + Tadalafil Contraindicated
- Nitroglycerin po + Tadalafil Contraindicated
- Nitroglycerin rectal + Tadalafil Contraindicated
- Nitroglycerin sublingual + Tadalafil Contraindicated
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Tadalafil?
MediHelp rates the interaction as moderate. Carbamazepine and Tadalafil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Carbamazepine is a strong CYP3A4 inducer and can substantially lower tadalafil concentrations, which may cause loss of efficacy. This is particularly relevant when tadalafil is used for pulmonary arterial hypertension.
How serious is the interaction between Carbamazepine and Tadalafil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination in pulmonary arterial hypertension. For erectile dysfunction, monitor response and consider a dose adjustment within the labeled range or an alternative.
What other medicines interact with Tadalafil?
MediHelp also lists interactions of Tadalafil with, for example, Amyl nitrite, Isosorbide dinitrate, Isosorbide mononitrate. The full list is on the Tadalafil page.
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