Drug interactions
Sodium nitroprusside + Tadalafil
Severity: Major
Sodium nitroprusside 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
Tadalafil potentiates nitric oxide-mediated vasodilation, so combining it with nitroprusside can cause profound and prolonged hypotension. The long half-life of tadalafil extends the period of risk.
What this interaction means in plain words
Sodium nitroprusside 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.
Sodium nitroprusside belongs to Cardiovascular; Tadalafil belongs to Genitourinary.
Why it happens
Nitroprusside releases nitric oxide, increasing cGMP, and tadalafil blocks cGMP breakdown through PDE5 inhibition.
What to do
Avoid nitroprusside in patients who recently took tadalafil, and use another agent if possible. If unavoidable, titrate cautiously with continuous arterial pressure 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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Other interactions of Sodium nitroprusside
- Avanafil + Sodium nitroprusside Contraindicated
- Nitric oxide + Sodium nitroprusside Major
- Sildenafil + Sodium nitroprusside Major
- Sodium nitroprusside + Vardenafil Major
- Amlodipine + Sodium nitroprusside Moderate
- Benazepril + Sodium nitroprusside Moderate
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 Sodium nitroprusside with Tadalafil?
MediHelp rates the interaction as major. Sodium nitroprusside 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. Tadalafil potentiates nitric oxide-mediated vasodilation, so combining it with nitroprusside can cause profound and prolonged hypotension. The long half-life of tadalafil extends the period of risk.
How serious is the interaction between Sodium nitroprusside 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 nitroprusside in patients who recently took tadalafil, and use another agent if possible. If unavoidable, titrate cautiously with continuous arterial pressure monitoring.
What other medicines interact with Sodium nitroprusside?
MediHelp also lists interactions of Sodium nitroprusside with, for example, Avanafil, Nitric oxide, Sildenafil. The full list is on the Sodium nitroprusside page.
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