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The reduced exposure of tadalafil with the co-administration of rifampin or other CYP3A4 inducers can be anticipated decrease the efficacy of Sildenafil for once-daily use; the magnitude of decreased efficacy is unknown. Aspirin : Tadalafil did not potentiate the increase in bleeding time caused by aspirin.

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Conversely, patients already receiving an optimized dose of tadalafil should be started on the lowest dose of the alpha-blocker; increases in the alpha-blocker dose should be done in stepwise fashion. When tadalafil is used for benign prostatic hypertrophy BPHdiscontinue alpha-blocker therapy least 1 day prior to initiating therapy. Other variables, such as intravascular volume depletion, concurrent antihypertensive therapy, or evidence of hemodynamic instability with alpha-blocker monotherapy, may affect the safety of concomitant use of tadalafil and an alpha-blocker.

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Increased systemic exposure to tadalafil may result in an increase in tadalafil-induced adverse effects, including hypotension, syncope, visual changes, and prolonged erection. Lesinurad: Moderate Lesinurad may decrease the systemic exposure and therapeutic efficacy of symptoms monitor for potential reduction in efficacy. Lesinurad; Allopurinol: Moderate Lesinurad may decrease the systemic exposure and therapeutic efficacy of tadalafil; monitor for potential reduction in efficacy.

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