Drug interactions
Nefazodone + Tadalafil
Severity: Major
Nefazodone and Tadalafil: major 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
Nefazodone is a strong CYP3A4 inhibitor and can substantially raise tadalafil concentrations. This increases the risk of hypotension, flushing, headache, priapism and other PDE5-related adverse effects.
What this interaction means in plain words
Nefazodone and Tadalafil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Nefazodone inhibits CYP3A4, reducing the first-pass and systemic clearance of tadalafil.
What to do
For erectile dysfunction, cap tadalafil at 2.5 mg daily or 10 mg no more often than every 72 hours. Avoid the combination in pulmonary arterial hypertension, and counsel on symptoms of hypotension.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Frequently asked questions
Can I take Nefazodone with Tadalafil?
MediHelp rates the interaction as major. Nefazodone and Tadalafil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Nefazodone is a strong CYP3A4 inhibitor and can substantially raise tadalafil concentrations. This increases the risk of hypotension, flushing, headache, priapism and other PDE5-related adverse effects.
How serious is the interaction between Nefazodone and Tadalafil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: For erectile dysfunction, cap tadalafil at 2.5 mg daily or 10 mg no more often than every 72 hours. Avoid the combination in pulmonary arterial hypertension, and counsel on symptoms of hypotension.
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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