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Interactions

A. Top Drug-Drug Interactions:

1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

Other Drug-Drug interactions:

• Ketoconazole, itraconazole (used to manage fungal infection)
• Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
• Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
• Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
• Other medicines used to improve blood flow to the penis (Ex. sildenafil)

B. Drug-Food Interactions:

Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.

Auth: E-mail:Aspen Scientific Pharma Ltd, 330 White Way, Ellsclusive, Hampshire, H75 J05 1C1, [email protected]​

1. Nitrates (e.g., Nitroglycerin, Isosorbide Dinitrate): This medication reduces blood pressure by blocking the enzyme in the pulmonary vasodilator system. It can also reduce blood pressure by increasing blood flow to the penis.
2. Alpha-blockers: Combining these medications may result in higher blood pressure-lowering effects, potentially leading to symptoms like dizziness or fainting.
3. Other Antihypertensive Drugs: For sensitive individuals who need to manage blood pressure-lowering effects, the choice between Cialis with nitrates or alpha-blockers is important. While these medications are usually safe when used with Cialis, they can cause side effects including dizziness or fainting. Seek immediate medical attention if you experience these side effects.

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STORAGEolin vs dapoxetine interaction

Do not take this medication if you:

• are allergic to any medicine
• take any medicines containing Tadalafil (e.g. nafil / cialis)
• are taking nitrates (e.g. isosorbide dinitrate, amyl nitrate) because they are used to treat angina (chest pain) or heart problems
• have a severe kidney problem
• have severe liver problems
• have severe depression
• have severe depression taking concomitant medications for high blood pressure or other mental problems
• have severely low blood pressure
• are having surgery
• have uncontrolled high blood pressure
• have a history of bleeding disorders
• have ever had severe stomach ulcers or other serious medical problems
• have a history of fainting or other serious problems for which you would like to you take a nitrate, such as isosorbide dinitrate, amyl nitrate or ketoconazole

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By Dr. R. A. Narayan

In this article, Dr. Narayan, Head of Pharmacy and Medical Supervision at The University of British Columbia, explains the importance of consulting a healthcare professional before taking any medication.

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