Isosorbide Mononitrate and Tadalafil: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Isosorbide Mononitrate and Tadalafil unless specifically directed by your doctor.
How Isosorbide Mononitrate interacts with Tadalafil
Nitrate-derived nitric oxide increases cyclic GMP production, while tadalafil inhibits PDE5-mediated cyclic GMP breakdown, causing profound and potentially life-threatening hypotension.
What you should do
Do not combine tadalafil with regular or intermittent nitrates. At least 48 hours should elapse after tadalafil before nitrate administration, and emergency use requires monitored specialist care.
Key facts
Severity
Major — avoid combination
Mechanism
Nitrate-derived nitric oxide increases cyclic GMP production, while tadalafil inhibits PDE5-mediated cyclic GMP breakdow...
Action
Do not combine tadalafil with regular or intermittent nitrates. At least 48 hours should elapse after tadalafil before n...
Frequently asked questions
Can I take Isosorbide Mononitrate and Tadalafil together?
No — this combination should generally be avoided. Do not combine tadalafil with regular or intermittent nitrates. At least 48 hours should elapse after tadalafil before nitrate administration, and emergency use requires monitored specialist care.
What is the severity of this interaction?
The interaction between Isosorbide Mononitrate and Tadalafil is classified as Major — avoid combination. Nitrate-derived nitric oxide increases cyclic GMP production, while tadalafil inhibits PDE5-mediated cyclic GMP breakdown, causing profound and potentially life-threatening hypotension.
What should I do if I'm prescribed both?
Do not combine tadalafil with regular or intermittent nitrates. At least 48 hours should elapse after tadalafil before nitrate administration, and emergency use requires monitored specialist care. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.