Yes, I’m aware of the CYP3A4 amlodipine interaction – I check the CYP3A4 lists for everything – and plan to stop the GFJ while I experiment with the amlodipine when it arrives (mail order pharm). LD tadalafil doesn’t seem to be contraindicated, but perhaps no GFJ is advisable. Thank you for your input.
I should have mentioned this URL which specifically addresses amlodipine and GFJ: pubmed.ncbi.nlm.nih.gov
It’s true that a low dose won’t be affected as much as a higher dose, but it’s metabolized by CYP3A4.
Keep in mind some people like @CronosTempi are very mindful even of drug-to-drug interactions that even can’t be seen on the regular drug interaction websites (that everyone should use).
From that perspective adding GFJ that changes CYP3A4 might be like throwing fuel on the fire.
If it’s $1 per mg, doubling the dose from 5 mg is just $5 every other week, or $10 a month. Add the cost of the grapefruit and it’s maybe $9 a month.
So the monetary cost could be $9/month for polypharmacy on steroids, and grapefruit consumption could be associated with higher ACM.
While direct targeting of the PDE5A protein demonstrated no elevated risk for LBD (OR 0.99 CI:0.92-1.08), the phenotype of lifelong hypoperfusion mediated by blood pressure was strongly associated with a 23%–32% (P<0.001) higher LBD risk and significant atrophy in deep brain gray matter.
There is no single trial demonstrating MACE reduction.
