Drug interactions
Nitroglycerin translingual + Tadalafil
Severity: Contraindicated
Nitroglycerin translingual 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
Translingual nitroglycerin spray used with tadalafil can cause an exaggerated and potentially dangerous fall in blood pressure. The prolonged duration of tadalafil means an acute angina rescue dose may be hazardous for up to two days.
What this interaction means in plain words
Nitroglycerin translingual 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
Additive cGMP-mediated vasodilation from nitric oxide donation plus PDE5 inhibition.
What to do
Do not use nitroglycerin spray within 48 hours of tadalafil. Counsel patients to seek emergency care for angina in this period and to tell staff about recent tadalafil use.
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 translingual with Tadalafil?
MediHelp rates the interaction as contraindicated. Nitroglycerin translingual 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. Translingual nitroglycerin spray used with tadalafil can cause an exaggerated and potentially dangerous fall in blood pressure. The prolonged duration of tadalafil means an acute angina rescue dose may be hazardous for up to two days.
How serious is the interaction between Nitroglycerin translingual 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: Do not use nitroglycerin spray within 48 hours of tadalafil. Counsel patients to seek emergency care for angina in this period and to tell staff about recent tadalafil use.
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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