Tadalafil and Hydralazine/Isosorbide Dinitrate Interaction
Drug interaction information between Tadalafil and Hydralazine/Isosorbide Dinitrate.
Tadalafil and Hydralazine/Isosorbide Dinitrate have a documented major interaction in FDA labeling.
FDA drug labeling documents a major-severity interaction between Tadalafil and Hydralazine/Isosorbide Dinitrate. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
These medicines both lower blood pressure in a similar way, and using them at the same time can cause a severe and unsafe drop in blood pressure.
What To Do
You should not use these drugs together as it is strictly advised against.
FDA Label Information
7 DRUG INTERACTIONS 7.1 Phosphodiesterase Inhibitors BiDil is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), PDE5 inhibitors such as avanafil, sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates.
Tadalafil Also Interacts With
- Clarithromycin moderate
- Nirmatrelvir/Ritonavir moderate
- Amlodipine minor
- Metoprolol minor
- Tamsulosin minor
Hydralazine/Isosorbide Dinitrate Also Interacts With
- Sildenafil major
Frequently Asked Questions
Can I take Tadalafil and Hydralazine/Isosorbide Dinitrate together?
This is a major interaction. You should not use these drugs together as it is strictly advised against.
How serious is the interaction between Tadalafil and Hydralazine/Isosorbide Dinitrate?
This interaction is classified as "major" severity by the FDA. Major interactions may be life-threatening or cause serious side effects.
Why do Tadalafil and Hydralazine/Isosorbide Dinitrate interact?
These medicines both lower blood pressure in a similar way, and using them at the same time can cause a severe and unsafe drop in blood pressure.
Understanding the Tadalafil and Hydralazine/Isosorbide Dinitrate Interaction
FDA-approved prescribing information for these two drugs flags their combination as a major-severity interaction. Tadalafil belongs to the PDE5 Inhibitor class and Hydralazine/Isosorbide Dinitrate belongs to the Vasodilator / Nitrate Combination class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: These medicines both lower blood pressure in a similar way, and using them at the same time can cause a severe and unsafe drop in blood pressure. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Tadalafil has 25 total documented interactions on file in this dataset, and Hydralazine/Isosorbide Dinitrate has 2. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: You should not use these drugs together as it is strictly advised against. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Tadalafil or Hydralazine/Isosorbide Dinitrate based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.