Drug interactions
Tadalafil + Voriconazole
Severity: Major
Tadalafil and Voriconazole: 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
Voriconazole is a strong CYP3A4 inhibitor and is expected to substantially increase tadalafil exposure. This raises the risk of hypotension, priapism, visual disturbance and other adverse effects.
What this interaction means in plain words
Tadalafil and Voriconazole 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 belongs to Genitourinary; Voriconazole belongs to Anti Fungals.
Why it happens
Strong inhibition of CYP3A4 markedly reduces tadalafil clearance.
What to do
Reduce the tadalafil dose and limit the maximum dose and frequency during voriconazole therapy, per labeling for strong CYP3A4 inhibitors. For pulmonary hypertension, adjust per labeling and monitor blood pressure closely.
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 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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Frequently asked questions
Can I take Tadalafil with Voriconazole?
MediHelp rates the interaction as major. Tadalafil and Voriconazole 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. Voriconazole is a strong CYP3A4 inhibitor and is expected to substantially increase tadalafil exposure. This raises the risk of hypotension, priapism, visual disturbance and other adverse effects.
How serious is the interaction between Tadalafil and Voriconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the tadalafil dose and limit the maximum dose and frequency during voriconazole therapy, per labeling for strong CYP3A4 inhibitors. For pulmonary hypertension, adjust per labeling and monitor blood pressure closely.
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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