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
Both agents lower blood pressure, so concurrent use may produce additive hypotension. Dizziness or syncope can occur, particularly at initiation.
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.
Why it happens
Additive vasodilatory and blood pressure lowering effects of PDE5 inhibition and neprilysin/angiotensin receptor blockade.
What to do
Monitor blood pressure and orthostatic symptoms when starting tadalafil. Use a low initial tadalafil dose in patients on stable therapy.
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?
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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 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. Both agents lower blood pressure, so concurrent use may produce additive hypotension. Dizziness or syncope can occur, particularly at initiation.
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: Monitor blood pressure and orthostatic symptoms when starting tadalafil. Use a low initial tadalafil dose in patients on stable therapy.
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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