Isosorbide Dinitrate and Tadalafil: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Isosorbide Dinitrate and Tadalafil unless specifically directed by your doctor.
How Isosorbide Dinitrate interacts with Tadalafil
Organic nitrate-derived nitric oxide increases cyclic GMP, while tadalafil inhibits PDE5-mediated cyclic GMP breakdown, producing potentially profound and prolonged hypotension.
What you should do
Do not coadminister. Ensure tadalafil has been discontinued for at least 48 hours before nitrate administration, and seek specialist guidance if emergency nitrate therapy is considered.
Key facts
Severity
Major — avoid combination
Mechanism
Organic nitrate-derived nitric oxide increases cyclic GMP, while tadalafil inhibits PDE5-mediated cyclic GMP breakdown, ...
Action
Do not coadminister. Ensure tadalafil has been discontinued for at least 48 hours before nitrate administration, and see...
Frequently asked questions
Can I take Isosorbide Dinitrate and Tadalafil together?
No — this combination should generally be avoided. Do not coadminister. Ensure tadalafil has been discontinued for at least 48 hours before nitrate administration, and seek specialist guidance if emergency nitrate therapy is considered.
What is the severity of this interaction?
The interaction between Isosorbide Dinitrate and Tadalafil is classified as Major — avoid combination. Organic nitrate-derived nitric oxide increases cyclic GMP, while tadalafil inhibits PDE5-mediated cyclic GMP breakdown, producing potentially profound and prolonged hypotension.
What should I do if I'm prescribed both?
Do not coadminister. Ensure tadalafil has been discontinued for at least 48 hours before nitrate administration, and seek specialist guidance if emergency nitrate therapy is considered. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.