Tadalafil and Nirmatrelvir/Ritonavir Interaction

Drug interaction information between Tadalafil and Nirmatrelvir/Ritonavir.

Tadalafil and Nirmatrelvir/Ritonavir have a documented moderate interaction in FDA labeling.

FDA drug labeling documents a moderate-severity interaction between Tadalafil and Nirmatrelvir/Ritonavir. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.

Drug A

Tadalafil

PDE5 Inhibitor

Drug B

Nirmatrelvir/Ritonavir

Antiviral (Protease Inhibitor Combination)

How They Interact

This combination prevents the body from clearing tadalafil, leading to much higher levels of the drug in your system.

FDA Label Information

Pulmonary hypertension agents (PDE5 inhibitors) tadalafil (Adcirca ® ) ↑ tadalafil Avoid concomitant use of tadalafil with PAXLOVID for pulmonary hypertension. sildenafil, tadalafil, vardenafil ↑ sildenafil ↑ tadalafil ↑ vardenafil Dosage adjustment is recommended for use of sildenafil, tadalafil or vardenafil with PAXLOVID when used for erectile dysfunction.

Frequently Asked Questions

What SPL severity band is on file for Tadalafil + Nirmatrelvir/Ritonavir?

Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.

Which drug in this pair has the larger labeled-interaction portfolio?

Nirmatrelvir/Ritonavir has 86 labeled pairs on file vs Tadalafil's 25. In the moderate band specifically: Tadalafil has 2 (also Clarithromycin); Nirmatrelvir/Ritonavir has 30 (also Amlodipine, Tamsulosin, Fluticasone, Apixaban).

What mechanism field is on file for Tadalafil and Nirmatrelvir/Ritonavir?

This combination prevents the body from clearing tadalafil, leading to much higher levels of the drug in your system.

Nirmatrelvir/Ritonavir carries more major-labeled pairs than Tadalafil

SPL source-record counts only. This page's band is moderate · classes on file: Tadalafil (PDE5 Inhibitor); Nirmatrelvir/Ritonavir (Antiviral (Protease Inhibitor Combination)).

Nirmatrelvir/Ritonavir has 23 major-labeled pairs vs Tadalafil's 1. This page itself is in the moderate band, not the major band.

Tadalafil

1 major · 2 moderate · 22 minor · 25 total

Nirmatrelvir/Ritonavir

23 major · 30 moderate · 33 minor · 86 total

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.