Drug interactions
Metolazone + Tadalafil
Severity: Moderate
Metolazone 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
Metolazone lowers blood pressure and intravascular volume, and tadalafil adds vasodilation. Together they may cause symptomatic hypotension, particularly in volume-depleted patients.
What this interaction means in plain words
Metolazone 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.
Metolazone belongs to Cardiovascular; Tadalafil belongs to Genitourinary.
Why it happens
Additive blood pressure lowering from PDE5-mediated vasodilation and diuretic-induced volume depletion.
What to do
Check volume status and blood pressure before and after starting tadalafil. Start at a low dose and advise slow rising from sitting or lying.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Metolazone and Tadalafil, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Metolazone
Frequently asked questions
Can I take Metolazone with Tadalafil?
MediHelp rates the interaction as moderate. Metolazone 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. Metolazone lowers blood pressure and intravascular volume, and tadalafil adds vasodilation. Together they may cause symptomatic hypotension, particularly in volume-depleted patients.
How serious is the interaction between Metolazone 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: Check volume status and blood pressure before and after starting tadalafil. Start at a low dose and advise slow rising from sitting or lying.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
