Drug interactions
Nitroglycerin transdermal + Tadalafil
Severity: Contraindicated
Nitroglycerin transdermal and Tadalafil: contraindicated 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
Tadalafil greatly amplifies the vasodilator effect of nitroglycerin patches, which deliver nitrate continuously. This can cause severe hypotension, syncope and cardiac ischemia.
What this interaction means in plain words
Nitroglycerin transdermal and Tadalafil are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Nitric oxide donation increases cGMP and tadalafil inhibits PDE5-mediated cGMP degradation, causing additive vasodilation.
What to do
Avoid the combination; remove the patch and do not give nitrates within 48 hours of tadalafil. Use a non-nitrate antianginal if the patient needs ongoing tadalafil.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Nitroglycerin transdermal with Tadalafil?
MediHelp rates the interaction as contraindicated. Nitroglycerin transdermal and Tadalafil are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Tadalafil greatly amplifies the vasodilator effect of nitroglycerin patches, which deliver nitrate continuously. This can cause severe hypotension, syncope and cardiac ischemia.
How serious is the interaction between Nitroglycerin transdermal and Tadalafil?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; remove the patch and do not give nitrates within 48 hours of tadalafil. Use a non-nitrate antianginal if the patient needs ongoing tadalafil.
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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