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Nei pazienti con grave compromissione epatica, deve essere eseguita una attenta valutazione caso per caso del rapporto rischio-beneficio da parte del medico prescrittore.
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Un induttore del CYP3A4, appear la rifampicina, ha ridotto del 90% la distribuzione del tadalafil, con possibile riduzione della sua efficacia. Altri induttori del CYP3A4, occur fenobarbital, fenitoina e carbamazepina potrebbero ridurre le concentrazioni plasmatiche di tadalafil.
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Esistono dati clinici limitati sulla sicurezza del tadalafil somministrato in dose singola in pazienti sahte cialis 100 mg con compromissione epatica grave (classe C secondo la classificazione di Child-Pugh).
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