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Tadalafil and nitrates — GPhC CRA MCQ

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HardDrug InteractionsTadalafil and nitratesGPhC CRA

A 64-year-old man with stable angina uses GTN spray and is prescribed tadalafil 5mg daily for urinary symptoms. He also takes doxazosin at night and reports dizziness on standing. What is the most important interaction to flag?

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Correct answer: D — Tadalafil with nitrates can cause severe hypotension and needs prescriber review

PDE5 inhibitors such as tadalafil are contraindicated with nitrates because of severe hypotension risk. The patient's use of doxazosin and orthostatic symptoms add further concern. This requires prescriber review before supply. The interaction is pharmacodynamic and not solved by routine timing advice in a patient using nitrate rescue therapy.

Reference: BNF