Drug interactions
Posaconazole + Tadalafil
Severity: Major
Posaconazole and Tadalafil: major interaction.
Last updated Sources: UK SmPC
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
Posaconazole is a strong CYP3A4 inhibitor and can markedly raise tadalafil exposure. This increases the risk of hypotension, priapism, visual changes and other adverse effects.
What this interaction means in plain words
Posaconazole 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.
Posaconazole belongs to Anti Fungals; Tadalafil belongs to Genitourinary.
Why it happens
Strong inhibition of CYP3A4-mediated tadalafil metabolism by posaconazole.
What to do
For erectile dysfunction, limit tadalafil to 2.5 mg daily or no more than 10 mg every 72 hours. For pulmonary hypertension, avoid the combination or adjust the dose per labeling with close monitoring.
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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References
- Adcirca 20 mg film-coated tablets - SmPC sections 4.3/4.5 (class statement: Azole antifungals; "Azole antifungals") — electronic medicines compendium (UK SmPC)
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Posaconazole with Tadalafil?
MediHelp rates the interaction as major. Posaconazole 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. Posaconazole is a strong CYP3A4 inhibitor and can markedly raise tadalafil exposure. This increases the risk of hypotension, priapism, visual changes and other adverse effects.
How serious is the interaction between Posaconazole 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, limit tadalafil to 2.5 mg daily or no more than 10 mg every 72 hours. For pulmonary hypertension, avoid the combination or adjust the dose per labeling with close monitoring.
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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