Macitentan and Tadalafil
PDE5 inhibitors enhance cellular cyclic GMP levels by inhibiting cGMP degradation in cavernosal smooth muscle and pulmonary vascular endothelium.
Kitchen Food, Drink & Dietary Conflicts
Biochemical interactions with common foods, beverages & cooking ingredientsGrapefruit / Pomelo (Citrus paradisi / Citrus maxima)
Destroys enterocyte CYP3A4 enzymes, collapsing first-pass drug metabolism and causing up to 12-fold spikes in bioavailability for oral CYP3A4 substrates (statins, calcium channel blockers, immunosuppressants, PDE5 inhibitors).
Alcoholic Beverages (Beer, Wine, Spirits)
Multiplies respiratory depression and profound sedation with opioids and sedatives; blocks hepatic lactate uptake with metformin (lactic acidosis); triggers acute disulfiram-like vomiting and tachycardia with metronidazole; and accelerates dose-dumping in extended-release capsules.
Prescription & OTC Drug Interactions (DDI)
Documented pharmacological conflicts & contraindicated co-prescriptionsDietary Supplements, Herbs & Minerals (DNI)
Interactions with over-the-counter vitamins, minerals, and herbal preparationsChronotherapy & Meal Administration Protocols
Optimal absorption, meal-timing rules & GI tolerability protocolsFrequently Researched Drug-Substance Combinations
Explore pairwise interaction dossiers and laboratory safety analysesTaking Macitentan and Tadalafil alongside daily coffee, supplements, or other medications?
Add all your daily medications, foods (Dairy, Spinach, Coffee, Grapefruit), and botanicals (Ashwagandha, Curcumin, Melatonin) into the SafeStack interactive engine to run full multi-way synergy collision analysis in real time.
Data on this clinical monograph is compiled from the U.S. National Library of Medicine (MedlinePlus), openFDA Structured Product Labeling (SPL Section 7 Drug Interactions), the NIH Office of Dietary Supplements (ODS), and Krause and Mahan's Food & Nutrition Care Process.