Tadalafil is mainly metabolized with the participation of isoenzyme . Selective inhibitor of isozyme ketoconazole (400 mg daily) increases the exposure of a single dose of tadalafil , and ketoconazole (200 mg daily) increases the exposure of a single dose of tadalafil relative to the values for only one tadalafil.
Ritonavir (200 mg twice daily), an inhibitor of nzofermentov , increases the exposure of a single dose of tadalafil parabolan dosage without changing . Despite the fact that the specific interactions has not been studied, it is possible to assume that other protease inhibitors such as saquinavir, as well as inhibitors isoenzyme , such as erythromycin and itraconazole, increase the activity of tadalafil
Selective inductor isoenzyme, rifampicin (600 mg per day), it reduces the exposure of a single dose of tadalafil and , relative values one tadalafil. We can assume that the simultaneous use of other inducers of should also reduce the concentration of tadalafil in plasma.
Simultaneous treatment with an antacid (magnesium hydroxide / aluminum hydroxide) and tadalafil reduced the rate of absorption of tadalafil without altering the area under the concentration-time curve for tadalafil.
Increasing the pH of the stomach as a result of receiving blocker histamine receptors nizatidine had no effect on tadalafil farmakokinetnku.
Safety and efficacy of combinations of Cialis with other treatments for erectile dysfunction have not been studied, so the use of such combinations is not recommended.
tadalafil did not potentiate the increase in bleeding time caused by taking aspirin.
Effect of tadalafil on other drugs
known that tadalafil enhances the hypotensive effect of nitrates. This is due to the additive effect of nitrates and tadalafil on the metabolism of nitric oxide. Therefore, the use of tadalafil to patients receiving nitrates is contraindicated.
Tadalafil has no clinically significant effect on clearance of drugs, the metabolism of which proceeds with the participation of cytochrome parabolan dosage. Studies have confirmed that tadalafil does not nngibiruet or induce isozymes .
Tadalafil has no clinically significant effect on farmakokinstnku S-warfarin or R-varfarnna. Tadalafil did not affect the action of warfarin on prothrombin time.
Tadalafil does not increase the duration of bleeding caused by acetylsalicylic acid.
Cialis has a systemic vasodilating properties and may exacerbate the effects of antihypertensive drugs aimed at lowering blood pressure.
In addition, patients taking multiple antihypertensive agents whose poorly controlled hypertension, there was a somewhat larger reduction in blood pressure. The vast majority of patients, this reduction was not associated with hypotensive symptoms. Patients receiving treatment with antihypertensive drugs and receiving tadalafil, should be given appropriate clinical recommendations.
There was no significant reduction in blood pressure when using Cialis makers selective alpha 1A adrenoblokator tamsulosin.
Concomitant use of tadalafil with doxazosin is contraindicated. When using tadalafil in healthy volunteers who took doxazosin parabolan dosage an alpha 1 adrenoblokator, were increased hypotensive action doksazoziia. Some patients have experienced dizziness. Syncope was observed. The use of doxazosin in lower doses has not been studied.
Tadalafil did not affect the concentration of alcohol, as well as alcohol does not affect the concentration of tadalafil. At high doses of alcohol did not cause reception tadalafil statistically significant reduction in the average blood pressure value. Some patients experienced postural dizziness and orthostatic pshotsnziya. At the reception of tadalafil in combination with lower doses of alcohol (0.6 g / kg) decrease in blood pressure were observed, and dizziness occurred with the same frequency that the admission of alcohol.
Tadalafil has no clinically meaningful effect on the pharmacokinetics of parabolan dosage pharmacodynamics of theophylline.