Adcirca Disease Interactions
There are 9 disease interactions with Adcirca (tadalafil).
- Cardiovascular disease
- Renal dysfunction
- Pulmonary disease
- Priapism
- Alcoholism
- Hearing loss
- Liver disease
- Retinitis pigmentosa
- Seizure disorders
PDE5 inhibitors (applies to Adcirca) cardiovascular disease
Major Potential Hazard, Moderate plausibility. Applicable conditions: Hypotension, Cerebral Vascular Disorder, History - Cerebrovascular Disease, History - Myocardial Infarction
The use of phosphodiesterase-5 (PDE5) inhibitors is not recommended in patients with preexisting cardiovascular disease for whom sexual activity is inadvisable due to the potential cardiac risk. Physicians should also consider the vasodilatory effect of these drugs and whether they may adversely affect patients with underlying cardio- and/or cerebrovascular conditions, in particular those who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; those with resting hypotension (BP < 90/50) or hypertension (BP > 170/110); and those with unstable angina associated with cardiac failure or coronary artery disease. There are no controlled clinical data on the safety or efficacy in such patients. Other adverse cardiovascular effects reported include angina pectoris, myocardial infarction, AV block, ventricular arrhythmia, tachycardia, palpitation, hypotension, postural hypotension, syncope, cerebral thrombosis, cerebrovascular hemorrhage, transient ischemic attack, cardiac arrest, heart failure, and hypertension. Many of these events occurred in patients with cardiovascular risk factors and during or shortly after sexual activity.
References
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals PROD (2001):
- Feenstra J, vanDriePierik RJHM, Lacle CF, Stricker BHC "Acute myocardial infarction associated with sildenafil." Lancet 352 (1998): 957-8
- Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction." Clin Ther 20 (1998): 1033-48
- Zusman RM "Cardiovascular data on sildenafil citrate - Introduction." Am J Cardiol 83 (1999): c1-2
- Conti CR, Pepine CJ, Sweeney M "Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease." Am J Cardiol 83 (1999): c29-34
- Zusman RM, Morales A, Glasser DB, Osterloh IH "Overall cardiovascular profile of sildenafil citrate." Am J Cardiol 83 (1999): c35-44
- Montorsi F, McDermott TED, Morgan R, Olsson A, Schultz A, Kirkeby HJ, Osterloh IH "Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies." Urology 53 (1999): 1011-8
- Kloner RA, Zusman RM "Cardiovascular effects of sildenafil citrate and recommendations for its use." Am J Cardiol 84 (1999): n11-7
- Awan GM, Calderon E, Dawood G, Alpert MA "Acute, symptomatic atrial fibrillation after sildenafil citrate therapy in a patient with hypertrophic obstructive cardiomyopathy." Am J Med Sci 320 (2000): 69-71
- Kloner RA "Cardiovascular risk and sildenafil." Am J Cardiol 86 (2000): f57-61
- Moreira SG, Brannigan RE, Spitz A, Orejuela FJ, Lipshultz LI, Kim ED "Side-effect profile of sildenafil citrate (Viagra) in clinical practice." Urology 56 (2000): 474-6
- McMahon CG, Smali R, Johnson H "Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction." J Urol 164 (2000): 1192-6
- Malozowski S, Sahlroot JT "Hemodynamic effects of sildenafil." N Engl J Med 343 (2000): 967-8
- Dunn N "Cardiovascular events in users of sildenafil - Paper does not provide any reassurance." Br Med J 323 (2001): 50-1
- "Product Information. Levitra (vardenafil)." Bayer (2003):
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- Curran M, Keating G "Tadalafil." Drugs 63 (2003): 2203-12; discussion 2213-4
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- "Product Information. Stendra (avanafil)." Vivus Inc (2012):
- "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
- "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
PDE5 inhibitors (applies to Adcirca) renal dysfunction
Major Potential Hazard, High plausibility.
The plasma clearance of phosphodiesterase-5 (PDE5) inhibitors may be decreased in patients with severe renal impairment, resulting in drug accumulation. Therapy with these agents should be avoided in patients with severe renal disease or on renal dialysis. Dose adjustments might be needed based on individual renal assessment and tolerability if used in these patients.
References
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals PROD (2001):
- "Product Information. Levitra (vardenafil)." Bayer (2003):
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2005):
- "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
- "Product Information. Stendra (avanafil)." Vivus Inc (2012):
- "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
Tadalafil (applies to Adcirca) pulmonary disease
Major Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Heart or Vascular Disease, Pulmonary Edema
Tadalafil tablet for the treatment of pulmonary arterial hypertension (PAH) should not be used in patients with pulmonary veno-occlusive disease (PVOD) as it may significantly worsen the cardiovascular status of these patients. If signs of pulmonary edema develop during therapy, the possibility of associated PVOD should be considered.
References
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
PDE 5 inhibitors (applies to Adcirca) priapism
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Myeloproliferative Disorder, Sickle Cell Anemia, Peyronie's Disease, Cavernosal/Penile Tissue Abnormalities
Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours) have been reported during treatment with phosphodiesterase-5 (PDE 5) inhibitors. Priapism may result in penile tissue damage and permanent loss of potency if not treated promptly. These agents should be used cautiously in patients with conditions that may predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia, and those with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie's disease). If an erection persists longer than 4 hours, the patient should seek immediate medical assistance.
References
- Kassim AA, Fabry ME, Nagel RL "Acute priapism associated with the use of sildenafil in a patient with sickle cell trait." Blood 95 (2000): 1878-9
- "Product Information. Levitra (vardenafil)." Bayer (2003):
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
- "Product Information. Stendra (avanafil)." Vivus Inc (2012):
- "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
- "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
- "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
PDE5 inhibitors (applies to Adcirca) alcoholism
Moderate Potential Hazard, Moderate plausibility.
Alcohol consumption may intensify the pressure-lowering effects of mild vasodilators, such as phosphodiesterase 5 (PDE5) inhibitors. Therefore, patients that consume alcohol should be warned to limit alcohol intake while receiving these agents.
References
- "Product Information. Levitra (vardenafil)." Bayer (2003):
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
- "Product Information. Stendra (avanafil)." Vivus Inc (2012):
- "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
- "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
- "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
PDE5 inhibitors (applies to Adcirca) hearing loss
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Tinnitus
Use of phosphodiesterase-5 (PDE5) inhibitors has been associated with sudden decrease or loss of hearing, which may be accompanied by tinnitus or dizziness. Patients with hearing problems should stop taking these agents and seek prompt medical care.
References
- "Product Information. Levitra (vardenafil)." Bayer (2003):
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
- "Product Information. Stendra (avanafil)." Vivus Inc (2012):
- "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
- "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
- "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
PDE5 inhibitors (applies to Adcirca) liver disease
Moderate Potential Hazard, High plausibility.
Phosphodiesterase 5 (PDE-5) inhibitors are cleared predominantly by hepatic metabolism. The pharmacokinetic disposition of these agents has not been assessed in patients with severe hepatic impairment. No dosage modification is recommended for patients with mild to moderate hepatic impairment, however, therapy with these agents should not be administered to patients with severe hepatic impairment. In patients with mild hepatic impairment a lower dose of these agents should be used as initial therapy.
References
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
- "Product Information. Stendra (avanafil)." Vivus Inc (2012):
- "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
- "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
PDE5 inhibitors (applies to Adcirca) retinitis pigmentosa
Moderate Potential Hazard, Moderate plausibility.
Phosphodiesterase-5 (PDE5) inhibitors have been associated with transient impairment of color discrimination (blue/green) and blue- or color-tinged vision. These agents also inhibit phosphodiesterase-6 (PDE6), to a much lesser extent, which is involved in phototransduction in the retina. There are no controlled clinical data on the safety in patients with retinitis pigmentosa, a minority of whom may have genetic disorders of retinal phosphodiesterases. Therapy with these agents should be avoided in such patients.
References
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals PROD (2001):
- Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA "Oral sildenafil in the treatment of erectile dysfunction." N Engl J Med 338 (1998): 1397-404
- Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction." Clin Ther 20 (1998): 1033-48
- Zrenner E "No cause for alarm over retinal side-effects of sildenafil." Lancet 353 (1999): 340-1
- Vobig MA, Klotz T, Staak M, BartzSchmidt KU, Engelmann U, Walter P "Retinal side-effects of sildenafil." Lancet 353 (1999): 375
- Marmor MF "Sildenafil (Viagra) and ophthalmology." Arch Ophthalmol 117 (1999): 518-9
- Montorsi F, McDermott TED, Morgan R, Olsson A, Schultz A, Kirkeby HJ, Osterloh IH "Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies." Urology 53 (1999): 1011-8
- Vobig MA "Retinal side-effects of sildenafil." Lancet 353 (1999): 1442
- McMahon CG, Smali R, Johnson H "Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction." J Urol 164 (2000): 1192-6
- "Product Information. Levitra (vardenafil)." Bayer (2003):
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
- "Product Information. Stendra (avanafil)." Vivus Inc (2012):
- "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
PDE5 inhibitors (applies to Adcirca) seizure disorders
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Seizures
The use of phosphodiesterase 5 (PDE-5) inhibitors has been associated with seizures. Therapy with these agents should be administered cautiously in patients with preexisting seizure disorders.
References
- "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals PROD (2001):
- "Product Information. Levitra (vardenafil)." Bayer (2003):
- "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
- "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2005):
- "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
- "Product Information. Stendra (avanafil)." Vivus Inc (2012):
- "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
Adcirca drug interactions
There are 307 drug interactions with Adcirca (tadalafil).
Adcirca alcohol/food interactions
There is 1 alcohol/food interaction with Adcirca (tadalafil).
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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