Drug interactions
Nelfinavir + Tadalafil
Severity: Major
Nelfinavir 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
Nelfinavir inhibits CYP3A4 and can raise tadalafil exposure. This may cause hypotension, syncope, visual disturbance and prolonged erection.
What this interaction means in plain words
Nelfinavir 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.
Nelfinavir belongs to Anti Virals; Tadalafil belongs to Genitourinary.
Why it happens
Nelfinavir inhibits CYP3A4, reducing tadalafil clearance.
What to do
Use the labeled reduced tadalafil doses for erectile dysfunction and monitor blood pressure and priapism. For pulmonary hypertension, follow labeling on stopping and low-dose restart.
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
Other interactions of Nelfinavir
- Alfuzosin + Nelfinavir Contraindicated
- Avanafil + Nelfinavir Contraindicated
- Dronedarone + Nelfinavir Contraindicated
- Eletriptan + Nelfinavir Contraindicated
- Ergotamine + Nelfinavir Contraindicated
- Flibanserin + Nelfinavir Contraindicated
Frequently asked questions
Can I take Nelfinavir with Tadalafil?
MediHelp rates the interaction as major. Nelfinavir 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. Nelfinavir inhibits CYP3A4 and can raise tadalafil exposure. This may cause hypotension, syncope, visual disturbance and prolonged erection.
How serious is the interaction between Nelfinavir 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: Use the labeled reduced tadalafil doses for erectile dysfunction and monitor blood pressure and priapism. For pulmonary hypertension, follow labeling on stopping and low-dose restart.
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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