Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report
Abstract Background Priapism 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...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | Basic and Clinical Andrology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12610-025-00278-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Abstract Background Priapism 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. Conclusions This 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. |
|---|---|
| ISSN: | 2051-4190 |