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Cialis (tadalafil) Disease Interactions

There are 9 disease interactions with Cialis (tadalafil):

Major

Pde5 Inhibitors (Includes Cialis) ↔ Cardiovascular Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Hypotension, Cardiovascular Disease, 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

  1. Kloner RA, Zusman RM "Cardiovascular effects of sildenafil citrate and recommendations for its use." Am J Cardiol 84 (1999): n11-7
  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
  3. Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction." Clin Ther 20 (1998): 1033-48
View all 14 references
Major

Pde5 Inhibitors (Includes Cialis) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

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

  1. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.
Major

Tadalafil (Includes Cialis) ↔ Pulmonary Disease

Severe Potential Hazard, Moderate plausibility

Applies to: 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.

Moderate

Pde5 Inhibitors (Includes Cialis) ↔ Alcoholism

Moderate Potential Hazard, Moderate plausibility

Applies to: Alcoholism, Acute Alcohol Intoxication

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.

Moderate

Pde5 Inhibitors (Includes Cialis) ↔ Hearing Loss

Moderate Potential Hazard, Moderate plausibility

Applies to: Hearing Loss, 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.

Moderate

Pde5 Inhibitors (Includes Cialis) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

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.

Moderate

Pde5 Inhibitors (Includes Cialis) ↔ Priapism

Moderate Potential Hazard, Moderate plausibility

Applies to: Leukemia, Myeloproliferative Disorders, Sickle Cell Anemia, Multiple Myeloma, Peyronie's Disease

Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours) have been reported during treatment with phosphodiesterase-5 (PDE5) 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

  1. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.
  2. 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
Moderate

Pde5 Inhibitors (Includes Cialis) ↔ Retinitis Pigmentosa

Moderate Potential Hazard, Moderate plausibility

Applies to: Retinitis Pigmentosa

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

  1. 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
  2. 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
  3. Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction." Clin Ther 20 (1998): 1033-48
View all 9 references
Moderate

Pde5 Inhibitors (Includes Cialis) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: 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

  1. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.

Cialis (tadalafil) drug Interactions

There are 325 drug interactions with Cialis (tadalafil)

Cialis (tadalafil) alcohol/food Interactions

There is 1 alcohol/food interaction with Cialis (tadalafil)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.

Do not stop taking any medications without consulting your healthcare provider.

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