Compatibility «Tadalafil» and «Amiodarone»

• Interactions Tadalafil with Amiodarone

  • Negative interactions
    • ⓘ Ritonavir (500 or 600 mg 2 times a day at steady state), which is an inhibitor of CYP3A4, CYP2C9, CYP2C19 and CYP2D6, increased the exposure (AUC) of a single dose of tadalafil 20 mg by 32% with a decrease in max'>C_max by 30% relative to values when taking only tadalafil at a dose of 20 mg.
    • ⓘ Studies have shown that drugs that induce CYP3A4 can reduce tadalafil exposure.
    • ⓘ Rifampicin (600 mg daily), which is an inducer of CYP3A4, reduced the exposure (AUC) of a single dose of tadalafil 10 mg by 88% and max'>C_max by 46% compared with values when taking only tadalafil at a dose of 10 mg.
    • ⓘ It can be expected that a decrease in tadalafil exposure when used concomitantly with rifampicin or other CYP3A4 inducers will reduce the effectiveness of tadalafil with daily use; the degree of decrease in effectiveness is unknown.
    • ⓘ Studies have shown that tadalafil does not inhibit or induce cytochrome P450 isoenzymes CYP1A2, CYP3A4, CYP2C9, CYP2C19, CYP2D6 and CYP2E1.
  • No interactions
    • ⓘ Although the specific interaction has not been studied, it is assumed that other CYP3A4 inducers, such as carbamazepine, phenytoin and phenobarbital, may reduce tadalafil exposure.
  • Positive interactions
    • ⓘ Although the specific interaction has not been studied, it can be assumed that other CYP3A4 inhibitors, such as erythromycin, itraconazole and grapefruit juice, may increase tadalafil exposure.
  • Unclear interactions
    • ⓘ Tadalafil is a substrate and is predominantly metabolized by the CYP3A4 isoenzyme.
    • ⓘ Studies have shown that drugs inhibiting CYP3A4 can increase the exposure of tadalafil.
    • ⓘ CYP3A4 inhibitors (e.g. ketoconazole).
    • ⓘ Ketoconazole (400 mg daily), a selective and strong CYP3A4 inhibitor, increased the exposure (AUC) of a single dose of tadalafil 20 mg by 312% and max'>C_max by 22% compared with values when taking only tadalafil at a dose of 20 mg.
    • ⓘ CYP3A4 inducers (e.g. rifampicin).
    • ⓘ CYP3A4 substrates (e.g., midazolam or lovastatin).

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine