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Drug interactions

Sacubitril-valsartan + Tadalafil

Severity: Moderate

Sacubitril-valsartan and Tadalafil: moderate 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 is a vasodilator and combined with sacubitril-valsartan can lower blood pressure further. Symptomatic hypotension, dizziness or syncope may occur, especially at treatment initiation or in volume-depleted patients.

What this interaction means in plain words

Sacubitril-valsartan and Tadalafil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Sacubitril-valsartan belongs to Cardiovascular; Tadalafil belongs to Genitourinary.

Evidence level: Moderate

Why it happens

Additive vasodilation through PDE5 inhibition and angiotensin receptor blockade with neprilysin inhibition.

What to do

Start tadalafil at a low dose and monitor blood pressure and orthostatic symptoms; counsel patients to rise slowly.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Sacubitril-valsartan with Tadalafil?

MediHelp rates the interaction as moderate. Sacubitril-valsartan and Tadalafil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tadalafil is a vasodilator and combined with sacubitril-valsartan can lower blood pressure further. Symptomatic hypotension, dizziness or syncope may occur, especially at treatment initiation or in volume-depleted patients.

How serious is the interaction between Sacubitril-valsartan and Tadalafil?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start tadalafil at a low dose and monitor blood pressure and orthostatic symptoms; counsel patients to rise slowly.

What other medicines interact with Sacubitril-valsartan?

MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.

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