From the Guidelines
Trazodone and tadalafil should not be taken together due to potential interactions and increased side effect risk, as recommended by the most recent guidelines. The combination of these medications can lead to enhanced blood pressure lowering effects, potentially causing symptoms like dizziness, lightheadedness, or fainting 1. Tadalafil, a PDE5 inhibitor used for erectile dysfunction or benign prostatic hyperplasia, and trazodone, an antidepressant sometimes used for insomnia, both affect blood vessel dilation.
Some key points to consider when evaluating the use of trazodone and tadalafil together include:
- The mechanism by which trazodone exerts its effect on erectile function may be related to its antagonism of alpha2-adrenergic receptors, which can relax penile vascular and corporal smooth muscle, enhancing arterial inflow and producing an erection 1.
- Results of clinical trials evaluating the efficacy and safety of trazodone in the treatment of erectile dysfunction have been published, but the differences in pooled results were not statistically significant 1.
- The most recent guidelines recommend against the combination of trazodone and tadalafil, particularly due to the higher side effect risk 1.
Given the potential risks and lack of significant benefits, it is recommended to avoid the combination of trazodone and tadalafil. If you need to take both medications, it's crucial to inform your healthcare provider about all medications you're taking to ensure appropriate monitoring and dosing adjustments. Be particularly careful if you have pre-existing cardiovascular conditions, are taking other blood pressure medications, or consume alcohol, which can worsen these effects 1.
From the Research
Trazodone and Tadalafil Interaction
- There is no direct evidence of a contraindication between trazodone and tadalafil in the provided studies 2, 3, 4, 5, 6.
- Trazodone has been used in combination with sildenafil, another phosphodiesterase-5 (PDE-5) inhibitor, to treat erectile dysfunction (ED) in men who initially failed to respond to sildenafil alone 3.
- The study suggests that priming patients with trazodone may be a reasonably good alternative for patients who have initial failure to oral sildenafil citrate and have no organic cause of ED 3.
- Tadalafil, like sildenafil, is a PDE-5 inhibitor used to treat ED, and there is no mention of a contraindication with trazodone in the provided studies 2, 4.
- However, it is essential to note that trazodone can have adverse effects, including orthostatic hypotension, arrhythmias, and priapism, which should be closely monitored 5, 6.
- Additionally, PDE-5 inhibitors, such as tadalafil, should be used with caution in patients taking alpha(1)-adrenoceptors antagonists for benign prostatic hyperplasia, as they can increase the hypotensive effects of these medications 4.