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Tadalafil is an inhibitor of phosphodiesterase type 5 PDE5the enzyme responsible for the degradation of cyclic guanosine monophosphate cGMP. Pulmonary arterial hypertension is with impaired release of nitric oxide by the vascular endothelium and consequent reduction of cGMP concentrations in the pulmonary vascular smooth muscle. PDE5 is the predominant phosphodiesterase in the pulmonary vasculature.

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Phenylephrine: Moderate The therapeutic effect of phenylephrine may be decreased in patients receiving phosphodiesterase inhibitors. Phenylephrine; Promethazine: Moderate The therapeutic effect of phenylephrine may be decreased in patients receiving phosphodiesterase inhibitors.

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Both atorvastatin and leflunomide can increase the risk of hepatotoxicity. Leflunomide is predicted to increase the exposure to atorvastatin.

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This medicine is not recommended for patients of kidney disease. Speak to your doctor before you go ahead, in any case.

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Accessed August 29, IPP Procedure No. Pharmacotherapeutic advances in the treatment of erectile dysfunction.

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