Drug interactions
Rifampin + Tadalafil
Severity: Major
Rifampin 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
Rifampin markedly reduces tadalafil exposure through enzyme induction. This can lead to loss of therapeutic effect, which is clinically important in pulmonary arterial hypertension.
What this interaction means in plain words
Rifampin 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
Rifampin is a potent CYP3A4 inducer that increases tadalafil metabolism.
What to do
Avoid concurrent use in pulmonary arterial hypertension. In erectile dysfunction, expect reduced efficacy and consider an alternative or monitor the response closely.
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 Rifampin with Tadalafil?
MediHelp rates the interaction as major. Rifampin 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. Rifampin markedly reduces tadalafil exposure through enzyme induction. This can lead to loss of therapeutic effect, which is clinically important in pulmonary arterial hypertension.
How serious is the interaction between Rifampin 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: Avoid concurrent use in pulmonary arterial hypertension. In erectile dysfunction, expect reduced efficacy and consider an alternative or monitor the response closely.
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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