Tamsulosin Tadalafil

Selective ala-blockers (such as 0.4 mg tamsulosin every day) are appropriate in combination with tadalafil. 

Flypersensitivity to any component of the tablet administration with nitrates (either regularly and/or intermittently) and nitric oxide donors because of the potentiation of hypotension (see Drug Interactions) coadministration with alpha-blockers (vardenafil only) coadministration with alpha-blockers other than 0.4 mg/day tamsulosin (tadalafil only). 

Tadalafil has also been extensively evaluated in patients with cardiovascular disease and has a similar safety and efficacy profile to sildenafil (45). Studies have shown no adverse effects on cardiac contraction, ventricular repolarization, or ischemic threshold. A similar hypotensive effect has been recorded with a dose of doxazosin 8 mg so caution is needed. As hypotension does not occur in the supine position and as tadalafil has a long half-life it is suggested that tadalafil is taken in the morning and doxazosin in the evening. There is no interaction of tadalafil with the selective a-adrenoceptor antagonist tamsulosin, which can, therefore, be prescribed as an alternative to doxazosin for symptomatic benign prostate hypertrophy (46). 

Kloner RA, Jackson G, EmmickJT, et al, Interaction between phosphodiesterase 5 inhibitor, tadalafil, and two alpha blockers, doxazosin and tamsulosin in healthy normotensive men. J Urol 2004 172 1935-1940. 

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