CriticalOrganic nitrate×Phosphodiesterase type 5 (PDE-5) inhibitor
Updated · Methodology
Mechanism
Both raise cGMP in vascular smooth muscle. Synergistic systemic vasodilation – fatal hypotension with MI. Tadalafil's long T1/2 requires 48-hour washout.
Symptoms
Sudden hypotension, syncope, MI.
Management
Combination contraindicated. 48 hours between tadalafil and nitrate.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- AEMPS: Ficha tecnica de Cialis (tadalafilo) (2024)– AEMPS CIMA, 2024
- AEMPS: Ficha técnica: Nitroglicerina (nº registro 60314), sección 4.3 (2025)– AEMPS, CIMA, nº registro 60314, revisión 09/2025, sección 4.3