Tadalafil, Alcohol and Blood Pressure: What to Know

Tadalafil affects blood pressure, and alcohol also influences cardiovascular function. Understanding how these substances interact helps ensure safe use. This guide explains what’s known about tadalafil, alcohol, and blood pressure, and what doctors advise.

How Tadalafil Affects Blood Pressure

Normal Blood Pressure Effects

Tadalafil causes mild to moderate blood pressure lowering in most people:

• Typically decreases systolic blood pressure by 1-4 mmHg
• May decrease diastolic pressure by 1-2 mmHg
• Effects are usually modest and not problematic
• Duration mirrors tadalafil’s overall effects (up to 36 hours for on-demand doses)

For most healthy individuals, these changes cause no symptoms or issues.

Why Tadalafil Lowers Blood Pressure

Tadalafil works by inhibiting PDE5, which leads to:

• Relaxation of smooth muscle in blood vessels
• Improved blood flow (the desired effect for ED)
• General vasodilation throughout the body
• Modest overall blood pressure reduction

This mechanism explains both tadalafil’s therapeutic effects and its blood pressure impact.

Alcohol’s Effects on Blood Pressure

How Alcohol Affects Blood Pressure

Alcohol consumption has complex cardiovascular effects:

Acute effects (whilst drinking):

• Initially may cause blood pressure to drop
• Vasodilation (blood vessel widening)
• Reduced vascular resistance
• Potential for dizziness or lightheadedness

Chronic heavy drinking:

• Can raise blood pressure over time
• Increases cardiovascular disease risk
• May worsen erectile dysfunction

Tadalafil and Alcohol: The Interaction

Combined Blood Pressure Effects

When tadalafil and alcohol are used together:

• Both substances can lower blood pressure
• Effects may be additive
• Risk of symptomatic hypotension (excessively low blood pressure) increases
• Symptoms might include dizziness, lightheadedness, or fainting

Official Guidance on Alcohol

Medical advice regarding tadalafil and alcohol generally states:

• Moderate alcohol (1-2 drinks) is typically acceptable
• Excessive alcohol should be avoided
• Individual tolerance varies
• Caution is warranted, especially when first using tadalafil

What “Moderate” Means

NHS guidelines define moderate drinking as:

• Up to 14 units per week
• Spread over 3+ days
• Not saving up units for one occasion

For reference:

• One pint of standard beer = approximately 2 units
• Standard glass of wine (175ml) = approximately 2 units
• Single measure of spirits = approximately 1 unit

Risks of Heavy Drinking with Tadalafil

Combining tadalafil with excessive alcohol can:

• Increase risk of dangerous blood pressure drops
• Cause dizziness, fainting, or falls
• Impair judgment about sexual health and safety
• Reduce tadalafil’s effectiveness (alcohol alone can cause ED)
• Increase likelihood of side effects like headache

Symptoms of Low Blood Pressure

Recognising Hypotension

Signs that blood pressure has dropped too low include:

• Dizziness or lightheadedness, especially when standing
• Feeling faint or actually fainting
• Blurred vision
• Nausea
• Fatigue or weakness
• Rapid heartbeat
• Confusion

What to Do

If you experience these symptoms:

1. Sit or lie down immediately
2. Avoid sudden position changes
3. Drink water
4. Don’t drive or operate machinery
5. Seek medical attention if symptoms persist or worsen
6. Contact emergency services if you faint or have chest pain

Tadalafil for People with Blood Pressure Conditions

High Blood Pressure (Hypertension)

Many men with ED also have hypertension:

Well-controlled hypertension:

• Tadalafil is often safe with proper medical supervision
• Blood pressure medications may interact
• Close monitoring ensures safety
• Benefits of treating ED often outweigh small risks

Uncontrolled hypertension:

• Should be addressed before starting ED treatment
• Very high blood pressure needs management first
• Doctor will assess appropriateness of tadalafil

Blood Pressure Medications

Several types of blood pressure medications require consideration with tadalafil:

Alpha-blockers (e.g., doxazosin, tamsulosin):

• Significant interaction risk
• Both lower blood pressure
• May require dose adjustment or timing separation
• Close medical monitoring essential

Other antihypertensives:

• Generally compatible but require assessment
• May need blood pressure monitoring
• Dose adjustments sometimes necessary

Nitrates (for angina):

• ABSOLUTE CONTRAINDICATION
• Never combine with tadalafil
• Can cause life-threatening blood pressure drop
• This includes recreational “poppers” (alkyl nitrites)

Low Blood Pressure (Hypotension)

People with baseline low blood pressure need careful assessment:

• Tadalafil may worsen symptoms
• Risk of fainting or dizziness increases
• Doctor will weigh risks and benefits
• May recommend against tadalafil if hypotension is significant

Practical Advice for Tadalafil and Alcohol

Safe Approach

To minimise risks when using tadalafil:

1. Limit alcohol intake to 1-2 drinks
2. Pace your drinking - avoid rapid consumption
3. Stay hydrated with water
4. Eat food - don’t drink on an empty stomach
5. Be aware of symptoms of low blood pressure
6. Avoid binge drinking entirely
7. Don’t mix with other substances that lower blood pressure

First-Time Users

When using tadalafil for the first time:

• Be especially cautious with alcohol
• Try tadalafil without alcohol first to gauge your response
• If combining, use minimal alcohol initially
• Be aware of how you feel
• Have a safe environment and responsible company

Special Occasions

For events involving more drinking:

• Consider whether it’s wise to use tadalafil that day
• Remember that alcohol itself impairs erectile function
• Plan ahead for safety
• Don’t let social pressure override medical judgment

Alcohol and Erectile Function

Direct Effects of Alcohol on ED

Alcohol affects sexual function independently:

Short-term:

• Small amounts may reduce anxiety
• Moderate amounts can impair erectile function
• Heavy consumption significantly impairs performance
• Alcohol is itself a cause of erectile difficulties

Long-term heavy use:

• Damages blood vessels
• Affects nerve function
• Reduces testosterone
• Can cause permanent ED

The Paradox

Many men drink alcohol to reduce performance anxiety, but:

• Alcohol itself impairs erections
• Combined with tadalafil, effectiveness may actually decrease
• Better strategies for anxiety include proper communication with partners or addressing psychological factors

Cardiovascular Health and Lifestyle

Broader Context

For men using tadalafil long-term:

Cardiovascular health matters:

• Regular exercise improves blood pressure
• Healthy diet supports vascular health
• Maintaining healthy weight helps both ED and blood pressure
• Managing stress benefits overall cardiovascular function

Lifestyle modifications:

• May reduce both blood pressure medication needs and ED severity
• Support tadalafil effectiveness
• Improve overall quality of life
• Often recommended alongside medication

For more information, see our guide on lifestyle factors and ED.

Alcohol Reduction Benefits

Reducing heavy alcohol consumption can:

• Improve blood pressure
• Enhance erectile function
• Reduce medication interaction risks
• Improve overall health
• Potentially reduce need for ED treatment

When to Seek Medical Advice

Before Using Tadalafil

Inform your doctor about:

• Your typical alcohol consumption
• Any blood pressure conditions
• All medications you take
• History of fainting or dizziness
• Cardiovascular problems

Contact Your Doctor If:

• You experience frequent dizziness with tadalafil
• Blood pressure symptoms concern you
• You want to adjust your treatment
• You’re starting new blood pressure medications
• Your alcohol consumption changes significantly
• You have questions about interactions

Emergency Situations

Seek immediate medical help if you experience:

• Chest pain
• Severe dizziness or fainting
• Suspected overdose
• Severe allergic reaction
• Prolonged erection (over 4 hours)

Monitoring Blood Pressure

Self-Monitoring

Some men benefit from home blood pressure monitoring:

• Provides useful data for doctors
• Helps track treatment effects
• Can identify problematic patterns
• Relatively inexpensive and straightforward

When to Check

Consider checking blood pressure:

• Before starting tadalafil
• After starting treatment
• When changing doses
• If experiencing symptoms
• Regularly if you have hypertension

Discuss monitoring strategy with your healthcare provider.

Frequently Asked Questions

Can I have any alcohol with tadalafil?

Moderate alcohol consumption (1-2 standard drinks) is typically considered acceptable for most men using tadalafil. However, individual tolerance varies, and excessive drinking should be avoided due to increased risk of low blood pressure and reduced medication effectiveness.

Will tadalafil make my blood pressure medication less effective?

Tadalafil doesn’t make blood pressure medication less effective. However, the combined effect can lower blood pressure more than either medication alone. Your doctor will monitor this and adjust dosing if needed to ensure both safety and effectiveness of both treatments.

Can I take tadalafil if I have high blood pressure?

Many men with well-controlled high blood pressure safely use tadalafil under medical supervision. The key is that blood pressure should be adequately managed with medication and monitoring. Uncontrolled very high blood pressure should be addressed before starting ED treatment.

What should I do if I feel dizzy after taking tadalafil?

Sit or lie down immediately to prevent falling. Avoid sudden position changes. Stay hydrated. The feeling typically passes within a short time. If dizziness is severe, persistent, or accompanied by other concerning symptoms, seek medical attention.

Is it safer to use tadalafil without alcohol?

Yes, using tadalafil without alcohol reduces the risk of blood pressure-related side effects and ensures maximum medication effectiveness. If you choose to drink, limiting consumption to 1-2 drinks minimises risks whilst allowing some social flexibility.

Can tadalafil affect my blood pressure long-term?

Tadalafil’s blood pressure effects are related to when you take it and last only whilst the medication is active. It doesn’t permanently lower blood pressure. However, men taking daily tadalafil experience continuous mild blood pressure lowering, which is monitored by healthcare providers.

Related Information

For additional context about tadalafil safety and usage:

• Tadalafil Side Effects - Comprehensive safety guide
• Tadalafil Long-Term Use and Safety - Extended treatment considerations
• How Does Tadalafil Work? - Understanding the mechanism
• Lifestyle Factors and ED - Beyond medication approaches