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A Guide on Tadalafil Interactions

Julian Carter


tadalafil interactions

Tadalafil is a medicine that can treat Erectile Dysfunction, the inability to get or maintain erections.

It’s a Phosphodiesterase type 5 (PDE5) inhibitor that keeps your blood vessels dilated. 

Tadalafil increases blood flow to your penis’ soft tissue, leading to an erection. 

It has a longer duration of effectiveness than other PDE5 Inhibitors. 

However, just like the majority of other medicines, Tadalafil also might have some unfavorable interactions. 

Tadalafil may interact with other pills, vitamins, herbs, diseases, or food items you may be consuming. 

These interactions can change the way Tadalafil work. This, in turn, leads to specific side effects.

Thus, it is recommended that you inform your doctor about all prescription, over-the-counter medications you are taking before taking Tadalafil for Erectile Dysfunction.

In this article, you will learn about Tadalafil interactions in detail.

Tadalafil interactions with other medicines

Tadalafil oral pills (also known by their brand-name Cialis) may interact with other medications, vitamins, or herbal supplements. 

Nitrates, GC stimulators, Alpha-blockers, and other medications can all interact with Tadalafil. 

Doctors may not recommend Tadalafil in combination with the following medicines due to the possibility of side effects.

Guanylate Cyclase (GC) Stimulators

The medications used to treat Pulmonary Arterial Hypertension are known as Guanylate Cyclase (GC) stimulators, such as Vericiguat and Riociguat. 

Both GC stimulants and Cialis have the potential to lower blood pressure

Taking Tadalafil along with a GC stimulator may result in even lower blood pressure. 

As a result, doctors are unlikely to prescribe Tadalafil in conjunction with GC stimulants.


can viagra cause a heart attackSource: pixabay
Heart attack

Nitrate is a vasodilator used to treat or prevent anal fissures, Angina, heart failure, and Hypertension. 

If you use Tadalafil with Nitrates, your blood pressure may decrease significantly. 

Fainting and lightheadedness can result from a sudden drop in blood pressure. 

In extreme circumstances, it might result in a heart attack or stroke.

Learn what happens when you combine a PDE5 inhibitor with Nitrates. Read: Why Viagra and Nitroglycerin Shouldn’t be Taken Together?

Consult your doctor before using Tadalafil if you take a Nitrate to avoid side effects.


According to studies, Alpha-blockers like are used to treat Benign Prostate Hyperplasia (BPH) or high blood pressure. 

Like Cialis and Viagra, Alpha-blockers like Tamsulosin work by reducing blood pressure.

Using Tadalafil with Alpha-blockers may lead to a dangerous drop in blood pressure.

This might cause fainting or dizziness.

Other medications

Tadalafil’s working can be impacted by other medications, which may change how Tadalafil functions. 

Examples include:

  • HIV Protease inhibitors like Fosamprenavir
  • Azole antifungals like Itraconazole and Ketoconazole
  • Macrolide antibiotics like Clarithromycin and Erythromycin.
According to a report published in National Library of Medicine, Tadalafil can be effective for up to 36 hours after only one dose.

Other PDE5 inhibitors

Tadalafil belongs to a group of medications known as PDE5 inhibitors, which help treat the symptoms of Erectile Dysfunction.

Tadalafil and other Erectile Dysfunction pills from this group can reduce blood pressure. 

Combining Tadalafil with other medicines in the same family, such as Sildenafil (Viagra), Vardenafil (Levitra), and Avanafil (Stendra), might increase the risk of low blood pressure even more. 

As a result, serious side effects may occur.

Do not take Tadalafil with other PDE5 Inhibitors, as it can significantly drop your blood pressure.


Certain antibiotics, such as Erythromycin and Rifampin, may stop your body from metabolizing Tadalafil

As a result, your body may have more Tadalafil than usual. 

Your chance of experiencing adverse side effects from Tadalafil may rise if you have a high concentration of Tadalafil in your body.

Antiseizure medicines

Your body may break down Tadalafil faster than usual if you use particular antiseizure medications like Carbamazepine and Phenobarbital. 

As a consequence, your body may have less Tadalafil than usual. This might reduce the ability of Tadalafil to treat your Erectile Dysfunction effectively.

Recommended Read: Learn about Tadalafil’s duration in this informative article – How Long Does Tadalafil Last? Exploring the Duration of Tadalafil’s Effects

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  • Tadalafil interactions with food

    Reduce Alcohol IntakeSource: D-Kiene_from_Getty_Images
    Avoid alcohol

    Consuming Tadalafil, along with alcohol and grapefruit or grape juice, can lead to serious side effects. 

    Dizziness, fainting, lightheadedness, flushing, headaches, and palpitations are some symptoms you may encounter more frequently after combining Tadalafil with alcohol or grapefruit.


    Avoid drinking alcohol when taking Tadalafil.

    Tadalafil raises the risk of extremely low blood pressure when alcohol is consumed along with it. 

    Call your doctor immediately if you experience dizziness, lightheadedness, or blurred vision.

    Recommended read: Explore the article on Cialis and alcohol interactions for informed and safe usage – Do Cialis and Alcohol Interact?

    Grapefruit or Grape Juice

    According to a research paper published in NCBI, grapefruit juice may enhance the body’s plasma exposure to Tadalafil. 

    This may prevent Tadalafil from being metabolized. 

    Consequently, Tadalafil’s adverse effects will increase.

    Tadalafil interaction with diseases

    The risk of interactions with Tadalafil may rise due to several diseases and other circumstances. 

    If you have a history of heart diseases, blood-related disorders, kidney or liver disease, etc., consult your doctor before using Tadalafil. 

    The following health issues or conditions might affect how Tadalafil works:

    Heart disease or stroke

     If you have a heart condition or have recently suffered a stroke, doctors usually won’t prescribe Tadalafil.

    Additionally, Tadalafil is not advised for those who have issues like these:

    • Untreated high or low blood pressure
    • Chest discomfort 
    • Untreated and irregular heart rhythm 

    Blood cancers or problems with blood cells

    If you have Blood Cancer (such as Leukaemia and Multiple Myeloma), inform your doctor before using Tadalafil. 

    Also, tell them if you suffer from blood cell conditions, such as Sickle Cell Anemia. 

    Your risk of Priapism might rise as a result of these situations.

    Plasma exposure is the body’s actual exposure to a medication after the intake of the prescribed amount of the medicine.
    Priapism: It is a condition in which the penis maintains an erection for an extended time without suitable stimulation.

    Kidney or liver diseases

    Before using Tadalafil, let your doctor know if you have a liver or renal condition. 

    Failures of the kidneys and the liver are two such diseases that may interact with Tadalafil.


    Tadalafil is a safe and effective treatment for Erectile Dysfunction and may be the best option for you. 

    Additional factors must also be considered, such as potential side effects and medication interactions. 

    Tadalafil causes side effects when it interacts with a number of different medications and food items.

    Tadalafil tablet’s label might have colored stickers on the label that describe an interaction. 

    Ask your doctor to explain this information if you need clarification.

    Frequently Asked Questions

    What can you not take with Tadalafil?

    When using Tadalafil, avoid drinking large amounts of alcohol. Additionally, avoid consuming grapefruit or grapefruit juice while taking this medication.

    What drugs should not be taken with Tadalafil?

    Tadalafil and other medications, such as Nitrates, Azole antifungals, Alpha-blockers, Macrolide antibiotics, other PDE5 inhibitors, and others, should not be consumed together.

    Can you drink alcohol with Tadalafil?

    No. When using Tadalafil, restrict the consumption of alcohol. 

    Alcohol consumption in excess can raise your risk of experiencing headaches or dizziness, speed up your heartbeat, or reduce your blood pressure.

    Should I avoid certain foods while taking Tadalafil?

    Yes. While using Tadalafil, avoid eating grapefruit or drinking grapefruit juice. 

    Grapefruit and grapefruit juice may affect how much Tadalafil is absorbed in your body.

    Is taking Tadalafil harmful to your heart?

    Yes. People with cardiac issues may face substantial adverse effects while consuming Tadalafil. 

    Do not use Tadalafil if you also take Riociguat or any Nitrate medication frequently prescribed to treat Angina (chest pain).

    Is Tadalafil affected by food?

    Yes. Tadalafil may be taken before or after meals. 

    For quick results, it is better to take Tadalafil on an empty stomach. 

    A high-fat meal could slow down tadalafil’s effects.

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