Tadalafil and Acitretin: Can They Be Taken Together?

Tadalafil and Acitretin: Understanding the Interaction

Published: 18 October 2026

If you're prescribed acitretin for a skin condition such as severe psoriasis and are considering tadalafil for erectile dysfunction, you may be wondering whether tadalafil and acitretin can be taken together safely. The good news is that no major direct interaction between these two medicines is commonly reported in clinical practice. However, every medicine you take—prescription, over-the-counter, or herbal—must be declared during your consultation, so your prescriber can review your full medication list and check for any individual risk factors.

What Is Tadalafil and How Does It Work?

Tadalafil is a prescription medicine used to treat erectile dysfunction (ED) in men [1]. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors, which work by relaxing the blood vessels in the penis, allowing more blood to flow in when you are sexually aroused [3][4]. Tadalafil does not cause an erection on its own—sexual stimulation is still needed.

Tadalafil is available in two forms: on-demand tablets (usually 10 mg or 20 mg, taken at least 30 minutes before sexual activity, with effects lasting up to 36 hours) and daily low-dose tablets (2.5 mg or 5 mg, taken once a day to allow for spontaneity) [4]. The long duration of action has earned tadalafil the nickname 'the weekend pill'. It is the generic version of the branded medicine Cialis and is available at Cured Pharmacy following an online consultation with a UK-registered prescriber.

What Is Acitretin and Why Is It Prescribed?

Acitretin is a prescription medicine called a retinoid, which is a form of vitamin A. It is used to treat severe skin conditions, most commonly severe psoriasis that has not responded to other treatments [12]. Acitretin works by slowing down the rate at which skin cells grow and shed, helping to reduce the thickening, scaling, and inflammation seen in psoriasis.

Because acitretin is a powerful medicine with significant side effects—including a very high risk of serious birth defects if taken during pregnancy—it is only prescribed under specialist supervision, usually by a dermatologist. Treatment requires careful monitoring with regular blood tests to check liver function, cholesterol, and triglyceride levels. Acitretin can also cause dry skin, dry lips, hair thinning, and changes in liver enzymes and blood fats. Women of childbearing potential must use highly effective contraception during treatment and for three years after stopping acitretin [12].

Common Side Effects of Acitretin

The most common side effects of acitretin include dry and peeling skin, dry lips and mouth, nosebleeds, dry eyes, hair thinning, and increased sensitivity to sunlight. Many people also experience raised cholesterol and triglyceride levels, which is why regular blood tests are essential. Less commonly, acitretin can affect mood, cause headaches, or lead to muscle and joint pain. If you experience any new or worsening symptoms while taking acitretin, speak to your dermatologist or GP.

Is There an Interaction Between Tadalafil and Acitretin?

No major direct interaction between tadalafil and acitretin is commonly reported in the medical literature or standard drug-interaction databases. Acitretin is not known to significantly affect the way tadalafil is broken down in the body, and tadalafil does not interfere with the way acitretin works on the skin. This means that, in general, the two medicines can be prescribed together if both are clinically appropriate for you.

However, it is important to understand that 'no major interaction reported' does not mean the combination is automatically safe for everyone. Your prescriber will still need to review your full medical history, all current medicines (including acitretin), and any other health conditions before deciding whether tadalafil is suitable. For example, acitretin can raise cholesterol and triglyceride levels, which are risk factors for cardiovascular disease—and cardiovascular health is a key consideration when prescribing any PDE5 inhibitor for ED [1][2].

During your online consultation at Cured Pharmacy, you will be asked to list every medicine you take, including acitretin. The prescriber will check for any potential interactions, review your blood pressure and heart health, and ensure that tadalafil is safe and appropriate for you. Never stop or change your acitretin treatment without consulting your dermatologist, as this could cause your skin condition to flare up.

What Your Prescriber Will Check Before Approving Tadalafil and Acitretin

When you request tadalafil and are already taking acitretin, your prescriber will carry out a thorough clinical assessment. They will ask about your cardiovascular health, including blood pressure, any history of heart attack, stroke, angina, or heart failure, and whether you have diabetes or high cholesterol [2]. Because acitretin can raise cholesterol and triglyceride levels, your prescriber may want to know your most recent blood test results or whether you are under regular monitoring by your dermatologist.

The prescriber will also check that you are not taking any medicines that are contraindicated with tadalafil. These include nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites)—all of which can cause a dangerous drop in blood pressure when combined with PDE5 inhibitors [3][4]. If you take an alpha-blocker for prostate symptoms (such as tamsulosin or doxazosin), the prescriber will ensure you are stable on that medicine and may start you on a lower dose of tadalafil to reduce the risk of dizziness.

You will also be asked about any other prescription or over-the-counter medicines, herbal supplements, and recreational drugs. This comprehensive review ensures that tadalafil is safe for you and that there are no hidden interactions with acitretin or any other treatment you are using.

Cardiovascular Considerations

Erectile dysfunction can be an early warning sign of cardiovascular disease, as the blood vessels in the penis are smaller and may show damage earlier than those in the heart [1][10]. If you have not seen a GP about your ED, it is a good idea to do so, especially if you are already taking acitretin for a long-term condition and may have other cardiovascular risk factors such as high cholesterol. Your GP can arrange blood tests, check your blood pressure, and assess your overall heart health before you start treatment for ED.

Practical Advice for Taking Tadalafil with Acitretin

If your prescriber approves tadalafil while you are taking acitretin, follow the dosing instructions carefully. For on-demand tadalafil (10 mg or 20 mg), take one tablet at least 30 minutes before you plan to have sex; the effect can last up to 36 hours, so you do not need to take it every day [4]. For daily tadalafil (2.5 mg or 5 mg), take one tablet at the same time each day, regardless of when you plan to have sex. Do not take more than one dose in 24 hours, and do not combine tadalafil with any other ED medicine.

Continue taking your acitretin exactly as prescribed by your dermatologist. Do not stop or reduce your dose without medical advice, as this could cause your psoriasis or other skin condition to worsen. Attend all scheduled blood tests and follow-up appointments so your dermatologist can monitor your liver function, cholesterol, and triglyceride levels. If you notice any new symptoms—such as chest pain, dizziness, or sudden changes in vision—while taking tadalafil, stop the medicine and seek medical advice immediately.

Avoid drinking large amounts of alcohol, as heavy drinking can worsen erectile dysfunction and increase the risk of side effects such as dizziness and low blood pressure when taking tadalafil [3][4]. Grapefruit juice can raise the level of tadalafil in your blood, so it is best to avoid it. If you develop any side effects from either medicine, or if your ED does not improve, speak to your prescriber or GP for further advice.

When to Seek Urgent Medical Help with Tadalafil and Acitretin

Although serious side effects from tadalafil are uncommon, you should know the warning signs that require urgent medical attention. If you experience an erection lasting more than four hours (priapism), go to A&E immediately, as this can cause permanent damage to the penis if not treated promptly [3][4]. Sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing (sometimes with ringing in the ears or dizziness), are rare but serious side effects—stop taking tadalafil and seek medical help straight away.

If you develop chest pain during or after sex, do not use nitrate medicines (such as GTN spray) to relieve it, as the combination with tadalafil can cause a dangerous drop in blood pressure. Instead, call 999 and tell the paramedics that you have taken tadalafil. If you experience severe dizziness, fainting, or an allergic reaction (such as swelling of the face, lips, or throat, or difficulty breathing), seek emergency help immediately.

While taking acitretin, be alert for signs of serious side effects such as severe stomach pain, yellowing of the skin or eyes (jaundice), severe headache with vision changes, or mood changes including depression. These are not related to tadalafil but require urgent review by your dermatologist or GP. Always keep both your dermatologist and your ED prescriber informed of any new symptoms or concerns.

Reporting Side Effects

If you experience any side effect that concerns you, whether or not it is listed in the patient information leaflet, you can report it via the Yellow Card Scheme at https://yellowcard.mhra.gov.uk or by searching for 'Yellow Card' in the Google Play or Apple App Store. Reporting side effects helps the Medicines and Healthcare products Regulatory Agency (MHRA) monitor the safety of medicines and protect public health.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 18 October 2026]
2. 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]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 18 October 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 18 October 2026]
5. 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]
6. Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [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.