Can You Take nitroglycerin and tadalafil Together?
Evidence-based clinical pharmacological assessment, adverse synergy evaluation, and administration separation protocols.
Co-administering nitroglycerin and tadalafil has documented pharmacodynamic or pharmacokinetic antagonism capable of triggering acute clinical harm. Do not combine without explicit specialist oversight.
Clinical Mechanism & Evidence Details
Inhibits intestinal CYP3A4-mediated first-pass metabolism, elevating systemic drug concentrations and increasing toxic adverse effect risks.
Inhibits intestinal CYP3A4-mediated first-pass metabolism, elevating systemic drug concentrations and increasing toxic adverse effect risks.
Synergistic cGMP accumulation causes profound systemic vasodilation and life-threatening refractory hypotension.
Clinical Guidance: Strictly contraindicated. Concomitant use is prohibited. Sildenafil must be separated by at least 24 hours, and Tadalafil by 48 hours, from nitrates.
Alcohol may enhance gastrointestinal irritation, trigger orthostatic hypotension, or alter drug absorption kinetics.
Alcohol may enhance gastrointestinal irritation, trigger orthostatic hypotension, or alter drug absorption kinetics.
Oxalic acid binds free calcium into insoluble calcium oxalate, rendering it unabsorbable and increasing kidney stone burden.
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.
Taking other supplements, foods, or medications with this pair?
Add your morning coffee, daily multivitamins, prescription pills, and dinner foods into our instant browser-based radar to check for multi-way chain reactions.
Clinical mechanism and interaction severity derived from openFDA Drug Structured Product Labeling (Section 7), NIH Office of Dietary Supplements (ODS), and NIH NCCIH clinical botanicals database.