Drug interactions
Tadalafil + Verapamil
Severity: Moderate
Tadalafil and Verapamil: 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
Verapamil is a moderate CYP3A4 inhibitor and can raise tadalafil exposure, while both agents lower blood pressure. This may increase the risk of hypotension and tadalafil adverse effects.
What this interaction means in plain words
Tadalafil and Verapamil 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 belongs to Genitourinary; Verapamil belongs to Cardiovascular.
Why it happens
CYP3A4 inhibition reduces tadalafil clearance, combined with additive vasodilation.
What to do
Use the lowest effective tadalafil dose and monitor blood pressure and tolerability. Limit tadalafil dose frequency for erectile dysfunction if symptoms occur.
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
Other interactions of Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Tadalafil with Verapamil?
MediHelp rates the interaction as moderate. Tadalafil and Verapamil 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. Verapamil is a moderate CYP3A4 inhibitor and can raise tadalafil exposure, while both agents lower blood pressure. This may increase the risk of hypotension and tadalafil adverse effects.
How serious is the interaction between Tadalafil and Verapamil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective tadalafil dose and monitor blood pressure and tolerability. Limit tadalafil dose frequency for erectile dysfunction if symptoms occur.
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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