Drug interactions
Riociguat + Tadalafil
Severity: Contraindicated
Riociguat 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
Riociguat combined with a PDE5 inhibitor such as tadalafil produces additive systemic vasodilation and symptomatic hypotension. In a pulmonary hypertension trial this combination showed no favorable benefit and raised safety concerns, and labeling prohibits it.
What this interaction means in plain words
Riociguat 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.
Riociguat belongs to Cardiovascular; Tadalafil belongs to Genitourinary.
Why it happens
Riociguat stimulates soluble guanylate cyclase to produce cGMP while tadalafil prevents its breakdown, causing additive vasodilation.
What to do
Do not coadminister; choose one agent. When switching, follow labeled washout intervals between the drugs.
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
Other interactions of Riociguat
- Avanafil + Riociguat Contraindicated
- Dipyridamole + Riociguat Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Riociguat + Sildenafil Contraindicated
Frequently asked questions
Can I take Riociguat with Tadalafil?
MediHelp rates the interaction as contraindicated. Riociguat 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. Riociguat combined with a PDE5 inhibitor such as tadalafil produces additive systemic vasodilation and symptomatic hypotension. In a pulmonary hypertension trial this combination showed no favorable benefit and raised safety concerns, and labeling prohibits it.
How serious is the interaction between Riociguat 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 coadminister; choose one agent. When switching, follow labeled washout intervals between the drugs.
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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