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...
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| Language: | English |
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BMC
2025-08-01
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| Series: | Basic and Clinical Andrology |
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| Online Access: | https://doi.org/10.1186/s12610-025-00278-x |
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| author | Can Arici Mert Basaranoglu Selahittin Cayan Murat Bozlu Erdem Akbay |
| author_facet | Can Arici Mert Basaranoglu Selahittin Cayan Murat Bozlu Erdem Akbay |
| author_sort | Can Arici |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-8e8663f1ae7f46d4bb32d80410947e8f |
| institution | DOAJ |
| issn | 2051-4190 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Basic and Clinical Andrology |
| spelling | doaj-art-8e8663f1ae7f46d4bb32d80410947e8f2025-08-20T03:04:26ZengBMCBasic and Clinical Andrology2051-41902025-08-013511610.1186/s12610-025-00278-xChlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case reportCan Arici0Mert Basaranoglu1Selahittin Cayan2Murat Bozlu3Erdem Akbay4Department of Urology, School of Medicine, Mersin UniversityDepartment of Urology, School of Medicine, Mersin UniversityDepartment of Urology, School of Medicine, Mersin UniversityDepartment of Urology, School of Medicine, Mersin UniversityDepartment of Urology, School of Medicine, Mersin UniversityAbstract 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.https://doi.org/10.1186/s12610-025-00278-xPriapismChlorpromazineTadalafilDrug interactionPenile prosthesisIschemic priapism |
| spellingShingle | Can Arici Mert Basaranoglu Selahittin Cayan Murat Bozlu Erdem Akbay Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report Basic and Clinical Andrology Priapism Chlorpromazine Tadalafil Drug interaction Penile prosthesis Ischemic priapism |
| title | Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report |
| title_full | Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report |
| title_fullStr | Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report |
| title_full_unstemmed | Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report |
| title_short | Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report |
| title_sort | chlorpromazine tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation a case report |
| topic | Priapism Chlorpromazine Tadalafil Drug interaction Penile prosthesis Ischemic priapism |
| url | https://doi.org/10.1186/s12610-025-00278-x |
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