Drug interactions
Mifepristone + Sildenafil
Severity: Moderate
Mifepristone and Sildenafil: 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
Mifepristone inhibits CYP3A4 and may increase sildenafil concentrations, raising the risk of hypotension and other dose-related adverse effects. This is more relevant with the repeated daily dosing used in Cushing's syndrome than with single-dose use.
What this interaction means in plain words
Mifepristone and Sildenafil 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.
Mifepristone belongs to Endocrine; Sildenafil belongs to Genitourinary.
Why it happens
Inhibition of CYP3A4 reduces sildenafil metabolism.
What to do
Use the lowest effective sildenafil dose, such as 25 mg, during long-term mifepristone therapy. Monitor blood pressure and tolerability.
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 Sildenafil
- Amyl nitrite + Sildenafil Contraindicated
- Atazanavir + Sildenafil Contraindicated
- Cobicistat + Sildenafil Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Sildenafil Contraindicated
- Glyceryl trinitrate pr + Sildenafil Contraindicated
- Isosorbide dinitrate + Sildenafil Contraindicated
Other interactions of Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Mifepristone with Sildenafil?
MediHelp rates the interaction as moderate. Mifepristone and Sildenafil 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. Mifepristone inhibits CYP3A4 and may increase sildenafil concentrations, raising the risk of hypotension and other dose-related adverse effects. This is more relevant with the repeated daily dosing used in Cushing's syndrome than with single-dose use.
How serious is the interaction between Mifepristone and Sildenafil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective sildenafil dose, such as 25 mg, during long-term mifepristone therapy. Monitor blood pressure and tolerability.
What other medicines interact with Sildenafil?
MediHelp also lists interactions of Sildenafil with, for example, Amyl nitrite, Atazanavir, Cobicistat. The full list is on the Sildenafil page.
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