ArticleBasic and clinical andrology2025
Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report.
Article in Basic and clinical andrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPriapism represents a rare urological emergency characterized by persistent penile erection unrelated to sexual stimulation. Although chlorpromazine-induced priapism has been documented, the synergistic interaction with phosphodiesterase type 5 inhibitors resulting in refractory cases necessitating penile prosthesis implantation constitutes a novel clinical scenario requiring comprehensive documentation. CASE PRESENTATION: We report a 56-year-old male who developed refractory ischemic priapism following self-administration of oral chlorpromazine for hiccups, taken 24 h after tadalafil 20 mg for erectile dysfunction. The patient had previously experienced a transient priapism episode 10 years earlier following isolated chlorpromazine use, establishing chlorpromazine as the primary etiological agent. Despite comprehensive management including corporal aspiration, intracavernosal sympathomimetic injection, and distal T-shunt creation, the patient developed recurrent priapism requiring penile prosthesis implantation.
conclusionsThis case demonstrates compelling evidence of a dangerous chlorpromazine-tadalafil interaction resulting in treatment-refractory priapism. The synergistic pharmacological effects of alpha-adrenergic blockade and phosphodiesterase type 5 inhibition created a severe clinical presentation necessitating immediate penile prosthesis implantation. Healthcare practitioners must recognize this potentially devastating drug interaction and implement preventive measures through comprehensive medication reconciliation and patient counseling.
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