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PDE5 inhibitor

Tadalafil with the birth control pill

Many women of reproductive age take a combined or progestogen-only oral contraceptive while also using a chronic medication such as Tadalafil (Tadalafil). The combination is generally fine at 20mg, 2.5mg, 5mg, 10mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.

How Tadalafil can affect contraceptive efficacy

Combined and progestogen-only contraceptives are metabolised through CYP3A4. Strong CYP3A4 inducers (some antiepileptics, rifampicin, St John's Wort) lower contraceptive plasma levels and reduce efficacy. Whether Tadalafil acts on CYP3A4 determines whether Tadalafil affects contraception. Most agents in PDE5 inhibitor have no clinically meaningful effect on the pill at 20mg, 2.5mg, 5mg, 10mg.

Practical guidance

According to the prescribing information for Tadalafil, women on hormonal contraception should review Tadalafil with the prescribing pharmacist or doctor. Where an interaction is documented, additional barrier contraception or switching to a non-oral method (IUD, implant) for the duration of Tadalafil therapy is the standard mitigation.

Frequently asked questions

Will Tadalafil make my pill less effective?

Most PDE5 inhibitor medications at 20mg, 2.5mg, 5mg, 10mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Tadalafil states whether the interaction is meaningful.

Do I need a backup contraceptive on Tadalafil?

Backup contraception is needed only when there is a documented interaction between Tadalafil and the contraceptive method. For most users at 20mg, 2.5mg, 5mg, 10mg, no backup is required. The pharmacist confirms whether Tadalafil interacts with hormonal contraception.

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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.