Sildenafil and Trandolapril: Can You Take Them Together?
Learn how these medicines interact and what your prescriber checks before treatment.
Takes less than 2 minutes to complete 100% online
Trusted by thousands
Real people, real results
“Fabulous service and quick delivery”
“Felt the effects of these after about 5 days. Erections are better and can get aroused and ready easier”
“Excellent value and brilliant customer service”
“I received excellent service and everything went well. The order arrived quickly and in perfect condition. It's working very well! Thank you to the whole team for the great work!”
“Delivery was good, the product lived up to expectations.”
How Our Online Service Works
Sildenafil and Trandolapril: Understanding the Interaction
Published: 18 October 2026
Many men wonder whether sildenafil and trandolapril can be taken together safely. The good news is that sildenafil (Viagra) and trandolapril—an ACE inhibitor used to treat high blood pressure and heart failure—are not contraindicated, meaning they can usually be prescribed together under medical supervision. However, because both medicines can lower blood pressure, your prescriber will carefully assess your individual circumstances to ensure the combination is appropriate for you.
At a glance
What Is Trandolapril and Why Is It Prescribed?
Trandolapril belongs to a group of medicines called ACE inhibitors (angiotensin-converting enzyme inhibitors). It works by relaxing and widening your blood vessels, which lowers blood pressure and makes it easier for your heart to pump blood around your body. Doctors commonly prescribe trandolapril to treat high blood pressure (hypertension), heart failure, and to protect the heart after a heart attack.
ACE inhibitors like trandolapril are among the most widely used cardiovascular medicines in the UK. They help reduce the risk of serious complications such as stroke, heart attack, and kidney problems in people with high blood pressure or heart conditions. Trandolapril is usually taken once or twice daily, and it may take several weeks to show its full effect on blood pressure.
If you have been prescribed trandolapril, it is important to take it regularly as directed, even if you feel well. High blood pressure often has no symptoms, but controlling it is essential for long-term health. Many men with cardiovascular conditions also experience erectile dysfunction, which is why understanding how trandolapril interacts with ED treatments like sildenafil is so important.
What Is Sildenafil and How Does It Work?
Sildenafil is a medicine used to treat erectile dysfunction (ED). It is the active ingredient in Viagra and is also available as a generic medicine at a lower cost. Sildenafil belongs to a class of drugs called PDE5 inhibitors (phosphodiesterase type 5 inhibitors), which work by increasing blood flow to the penis when you are sexually aroused, making it easier to get and keep an erection [3].
Sildenafil is typically taken about one hour before sexual activity, and its effects can last for up to four hours. It comes in three strengths: 25mg, 50mg, and 100mg. The usual starting dose is 50mg, but your prescriber may adjust this depending on how well it works for you and whether you experience any side effects. Sildenafil only works when you are sexually stimulated—it does not cause an automatic erection [1].
ED is a common condition that affects many men, particularly as they get older or if they have conditions such as diabetes, high blood pressure, or heart disease [10]. Sildenafil has been proven effective in clinical trials and is a safe, well-established treatment when used appropriately under medical supervision [9].
How Do Sildenafil and Trandolapril Interact?
Sildenafil and trandolapril can both lower blood pressure, so when taken together, there is a potential for an additive effect—meaning your blood pressure may drop more than it would with either medicine alone. This can occasionally cause symptoms such as dizziness, light-headedness, or fainting, particularly when you stand up quickly. However, this interaction is usually manageable and does not mean the two medicines cannot be used together [3].
The mechanism behind this interaction is straightforward: trandolapril lowers blood pressure by widening blood vessels, while sildenafil also has a mild blood-pressure-lowering effect as it increases blood flow. For most men whose blood pressure is well controlled on trandolapril, the additional drop caused by sildenafil is small and not clinically significant. Your prescriber will review your blood pressure readings, overall cardiovascular health, and any symptoms you have experienced to decide whether sildenafil is safe for you.
It is important to note that trandolapril is not in the same category as medicines that are absolutely contraindicated with sildenafil. Nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, and riociguat must never be taken with sildenafil because the combination can cause a dangerous, life-threatening drop in blood pressure. Trandolapril does not carry this risk, but caution and medical oversight are still essential.
What Your Prescriber Will Check
Before prescribing sildenafil to someone taking trandolapril, a UK prescriber will assess several factors. They will check your current blood pressure, ask about any symptoms of low blood pressure (such as dizziness or fainting), and review your full medication list to identify any other drugs that might interact. They will also consider your cardiovascular health, including whether you have had a recent heart attack, stroke, or unstable angina, as these conditions may make sexual activity inadvisable [2].
Your prescriber may recommend starting on a lower dose of sildenafil (such as 25mg) to minimise the risk of side effects. They will also advise you to monitor how you feel when you first take sildenafil, particularly if you experience any dizziness or light-headedness. If you have any concerns or notice unusual symptoms, you should contact your GP or pharmacist for advice.
What you need to know
- Sildenafil and trandolapril can usually be taken together under medical supervision.
- Both medicines can lower blood pressure, so your prescriber will assess your individual risk.
- Never take sildenafil with nitrates, nicorandil, or riociguat—this is dangerous.
- Seek urgent help for chest pain during sex or an erection lasting over four hours.
- All ED treatments at Cured Pharmacy require a UK prescriber consultation.
Practical Advice for Taking Sildenafil and Trandolapril Together
If your prescriber has confirmed that it is safe for you to take sildenafil and trandolapril together, there are a few practical steps you can take to minimise the risk of side effects. First, take sildenafil exactly as prescribed—do not take more than the recommended dose or use it more than once in 24 hours. Taking a higher dose will not make it work better and may increase the risk of side effects such as dizziness, headache, or flushing.
Be mindful of how you feel when you stand up, particularly in the first few hours after taking sildenafil. If you feel dizzy or light-headed, sit or lie down until the feeling passes. Avoid drinking large amounts of alcohol when taking sildenafil, as alcohol can also lower blood pressure and make side effects more likely. Heavy drinking can also make erectile dysfunction worse and reduce the effectiveness of the treatment.
Continue taking your trandolapril as prescribed—do not stop or change the dose without speaking to your doctor. If you experience persistent dizziness, fainting, chest pain during sex, or any other concerning symptoms, seek medical advice promptly. Most men tolerate the combination of sildenafil and trandolapril well, but individual responses can vary, so it is important to stay alert to how your body reacts.
Other Blood Pressure Medicines and Sildenafil
Trandolapril is just one of many blood pressure medicines, and it is worth understanding how other types interact with sildenafil. ACE inhibitors (like trandolapril, ramipril, and lisinopril) and angiotensin receptor blockers (ARBs, such as losartan and candesartan) have a similar interaction profile with sildenafil—they can add to the blood-pressure-lowering effect, but the combination is usually safe with appropriate monitoring.
Alpha-blockers (such as doxazosin, tamsulosin, and alfuzosin), which are often used to treat high blood pressure or prostate problems, carry a higher risk of low blood pressure when combined with sildenafil. If you take an alpha-blocker, your prescriber will ensure you are stable on that medicine before starting sildenafil, and they will usually recommend the lowest dose of sildenafil to begin with [3].
Calcium channel blockers (such as amlodipine and diltiazem) and diuretics (such as bendroflumethiazide and furosemide) can also add to the blood-pressure-lowering effect of sildenafil, but again, the combination is generally manageable. The key is to declare all your current medicines during your consultation so that your prescriber can make a fully informed decision about whether sildenafil is suitable for you.
Medicines You Must Never Take with Sildenafil
While sildenafil can usually be taken with trandolapril and many other blood pressure medicines, there are some drugs that you must never take with sildenafil. These include nitrates (such as GTN spray, isosorbide mononitrate, and isosorbide dinitrate), nicorandil, riociguat, and amyl or alkyl nitrites (poppers). The combination of sildenafil with any of these medicines can cause a sudden, severe, and potentially life-threatening drop in blood pressure [3].
If you use a nitrate medicine for angina or chest pain, do not take sildenafil. Similarly, if you take nicorandil (another angina medicine) or riociguat (used for pulmonary hypertension), sildenafil is contraindicated. Always tell your prescriber about every medicine you take, including those bought over the counter, herbal remedies, and recreational drugs, to ensure your safety.
When to get urgent help
- Chest pain during or after sexual activity—call 999 immediately
- Erection lasting more than four hours (priapism)—go to A&E
- Sudden loss of vision or hearing—seek urgent medical assessment
- Severe dizziness, fainting, or feeling very unwell after taking sildenafil
- Rapid heartbeat or shortness of breath with dizziness—contact your GP or call 111
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
When to Seek Urgent Medical Help
Most men who take sildenafil and trandolapril together do so without serious problems, but it is important to know the warning signs that require urgent medical attention. If you develop chest pain during or after sexual activity, stop what you are doing and seek immediate help. Chest pain could be a sign of a heart problem, and you should call 999 or go to A&E. Do not take nitrate medicines (such as GTN spray) if you have used sildenafil in the past 24 hours, as this can cause a dangerous drop in blood pressure.
Another rare but serious side effect of sildenafil is priapism—a painful erection that lasts for more than four hours. This is a medical emergency and requires immediate treatment to prevent permanent damage to the penis. If you experience an erection lasting longer than four hours, go to A&E straight away. Sudden loss of vision or hearing is also a rare but serious side effect that requires urgent medical assessment [3].
If you feel very dizzy, faint, or unwell after taking sildenafil, particularly if you also feel short of breath or have a rapid heartbeat, seek medical advice promptly. These symptoms could indicate that your blood pressure has dropped too low. Most side effects of sildenafil are mild and temporary, but it is always better to err on the side of caution and get checked if you are concerned.
How Cured Pharmacy Can Help
Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering a confidential, convenient service for men seeking treatment for erectile dysfunction. All ED medicines are prescription-only and are supplied only after an online consultation reviewed by a UK-registered prescriber. During the consultation, you will be asked about your medical history, current medicines (including trandolapril), and any symptoms you have experienced, so that the prescriber can assess whether sildenafil or another ED treatment is safe and appropriate for you.
Cured Pharmacy offers a range of ED treatments, including sildenafil (generic Viagra) from £0.45, tadalafil (generic Cialis) from £7.95, vardenafil (generic Levitra) from £16.95, and Spedra (avanafil) from £20.95. First-time customers can use the code Ednew for a discount on their first order. All medicines are dispensed by UK pharmacists and delivered discreetly to your door. If you have any questions about taking sildenafil with trandolapril or any other medicine, the pharmacy team is available to provide advice and support.
Start Low, Go Slow
If you take trandolapril or another blood pressure medicine, your prescriber may recommend starting with a lower dose of sildenafil (such as 25mg) to minimise the risk of dizziness or low blood pressure. Always take sildenafil exactly as prescribed and monitor how you feel.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 18 October 2026]
- National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 18 October 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 18 October 2026]
- Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998). Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338(20), 1397–1404. https://pubmed.ncbi.nlm.nih.gov/9580646/ [accessed 18 October 2026]
- Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54–61. https://pubmed.ncbi.nlm.nih.gov/8254833/ [accessed 18 October 2026]
Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.
ED Treatments We Offer
Pricing Disclaimer: Prices on some pages may not be up to date — the live pricing table below and pricing shown during consultation are official current prices and take precedence over any other figures on the site.
Get Discreet ED Treatment Online
Start your journey to better health today.
- Reviewed by UK-based prescribers
- Takes under 3 minutes
- Discreet Packaging
Start Your Journey To Better Health Today
Once you complete a short online assessment you will be able to choose your preferred treatment from safe medically approved options tailored to you.
Start My Assessment Log in to Your AccountYour Questions Answered
Can I take sildenafil if I am on trandolapril?
Yes, sildenafil and trandolapril can usually be taken together, but only after a prescriber has reviewed your blood pressure, cardiovascular health, and full medication list to ensure it is safe for you.
Will taking sildenafil with trandolapril make my blood pressure too low?
Both medicines can lower blood pressure, so there is a potential for an additive effect. Most men tolerate the combination well, but your prescriber will monitor you and may start you on a lower dose of sildenafil.
Do I need to stop taking trandolapril before using sildenafil?
No, you should not stop taking trandolapril without medical advice. Your prescriber will assess whether sildenafil is safe to add to your current treatment.
What should I do if I feel dizzy after taking sildenafil and trandolapril together?
Sit or lie down until the dizziness passes, and avoid standing up quickly. If dizziness is severe or persistent, contact your GP or pharmacist for advice.
Are there any blood pressure medicines I must not take with sildenafil?
Yes, you must never take sildenafil with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, or riociguat, as this can cause a dangerous drop in blood pressure.
Can I drink alcohol while taking sildenafil and trandolapril?
Moderate alcohol is usually fine, but heavy drinking can lower blood pressure further, worsen erectile dysfunction, and increase the risk of side effects such as dizziness.
How do I get sildenafil if I take trandolapril?
You need a prescription from a UK prescriber. Cured Pharmacy offers an online consultation service where a prescriber will review your medical history and current medicines to decide if sildenafil is suitable for you.
What are the warning signs that I should seek urgent help?
Seek urgent help if you experience chest pain during sex, an erection lasting more than four hours, sudden loss of vision or hearing, or severe dizziness and fainting.
Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)