Is it safe to take Fexofenadine with Tadalafil (Cialis) and Minoxidil (Rogaine)?

From the Guidelines

It is not recommended to take fexofenadine with tadalafil and minoxidil without consulting a healthcare provider, especially considering the potential risks associated with combining medications that affect blood vessels and blood pressure. The combination of tadalafil and minoxidil may increase the risk of hypotension, as both medications have vasodilatory effects 1. Additionally, the use of tadalafil with other medications that affect blood pressure, such as minoxidil, should be guided by the need for continued therapy versus alternative options available to the treating clinician 1. Fexofenadine, an antihistamine, does not have significant known interactions with tadalafil or minoxidil, but it is still important to evaluate the complete medical history and current medication list to ensure safety.

Some key points to consider when taking these medications together include:

• The potential for additive blood pressure-lowering effects, which could be problematic for some individuals
• The need to avoid concomitant use of phosphodiesterase type 5 inhibitors, such as tadalafil, with nitrate medications, due to the risk of severe hypotension 1
• The importance of consulting with a healthcare provider before combining these medications, especially if you have underlying health conditions like cardiovascular disease, liver problems, or kidney issues
• The need to report any unusual side effects to your doctor immediately, such as dizziness, lightheadedness, or changes in blood pressure.

The most recent guideline on the management of patients with chronic coronary disease recommends that phosphodiesterase type 5 inhibitors, such as tadalafil, should not be used concomitantly with nitrate medications, and that patients on long-acting nitrate therapy who want to use a phosphodiesterase type 5 inhibitor should be guided by the need for continued nitrate therapy versus other alternative options available to the treating clinician 1. In contrast, the management of lower urinary tract symptoms attributed to benign prostatic hyperplasia recommends against the combination of low-dose daily tadalafil with other medications, due to the higher side effect risk 1.

From the Research

Interaction between Fexofenadine, Tadalafil, and Minoxidil

• There is no direct evidence of interactions between Fexofenadine, Tadalafil, and Minoxidil in the provided studies.
• Tadalafil, a phosphodiesterase type 5 inhibitor, is used to treat erectile dysfunction 2.
• Minoxidil is a vasodilator used to treat hypertension and promote hair growth 3, 4.
• Fexofenadine is an antihistamine, and its interaction with Tadalafil and Minoxidil is not explicitly mentioned in the studies.

Safety of Concomitant Medications with PDE5 Inhibitors

• The use of nitrates is contraindicated with PDE5 inhibitors like Tadalafil 5.
• Caution is advised when using alpha-blockers and potent CYP3A inhibitors with PDE5 inhibitors 5.
• Statins and testosterone may have synergistic effects with PDE5 inhibitors on sexual activity 5.

Orthostatic Hypotension and Minoxidil

• Minoxidil can cause orthostatic hypotension, especially when discontinued after long-term use 3, 6.
• Orthostatic hypotension is a common cardiovascular disorder that can be diagnosed with an orthostatic challenge 6.