Tadalafil and Amisulpride: Can They Be Taken Together?
Understand the interaction, what your prescriber checks, and how to use both medicines safely.
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Tadalafil and Amisulpride: Understanding the Interaction
Published: 18 October 2026
Many men prescribed amisulpride for mental health conditions wonder whether tadalafil and amisulpride 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, both medicines can affect blood pressure and heart rhythm, so your prescriber will carefully review your individual circumstances, current health, and all medications during your consultation before deciding whether tadalafil is suitable for you.
Stand Up Slowly
Both tadalafil and amisulpride can lower blood pressure. To reduce the risk of dizziness or fainting, always stand up slowly from sitting or lying down, especially in the first few hours after taking tadalafil.
What Is Tadalafil and How Does It Work?
Tadalafil is a prescription medicine used to treat erectile dysfunction (ED) in men [4]. It belongs to a group of medicines called PDE5 inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused. Tadalafil does not cause an erection on its own—sexual stimulation is still needed for it to work.
Tadalafil is available in two forms: on-demand tablets (usually 10mg or 20mg) taken at least 30 minutes before sexual activity, with effects lasting up to 36 hours, and daily low-dose tablets (2.5mg or 5mg) taken every day at the same time [4]. The long duration of action has earned tadalafil the nickname 'the weekend pill'. At Cured Pharmacy, tadalafil is available after an online consultation reviewed by a UK-registered prescriber.
Common side effects of tadalafil include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion [4]. These are usually mild and temporary. Tadalafil can also lower blood pressure slightly, which is why your prescriber needs to know about all your current medicines and health conditions before prescribing it.
What Is Amisulpride and Why Is It Prescribed?
Amisulpride is an antipsychotic medicine used to treat schizophrenia and, at lower doses, certain mood disorders. It works by blocking dopamine receptors in the brain, which helps to reduce symptoms such as hallucinations, delusions, and disordered thinking. Amisulpride is usually taken once or twice daily, and the dose varies depending on the condition being treated and individual response.
Like many antipsychotic medicines, amisulpride can cause side effects that affect sexual function. These may include reduced libido, difficulty achieving or maintaining an erection, and delayed ejaculation. Some men also experience weight gain, drowsiness, and changes in blood pressure. Amisulpride can prolong the QT interval on an electrocardiogram (ECG), which is a measure of the heart's electrical activity, and this effect is important when considering other medicines.
If you are experiencing sexual difficulties while taking amisulpride, it is important not to stop or reduce your dose without speaking to the doctor who prescribed it. Stopping antipsychotic medication suddenly can be harmful. Instead, discuss your concerns with your GP or psychiatrist, who may be able to adjust your treatment or refer you for ED assessment.
Sexual Side Effects of Antipsychotic Medicines
Sexual dysfunction is a common but often under-discussed side effect of many antipsychotic medicines, including amisulpride. This can include reduced desire, difficulty with erections, and problems with orgasm or ejaculation. These effects can significantly impact quality of life and relationships, and may lead some men to stop taking their medication without medical advice, which can be dangerous. If you are experiencing these issues, speak openly with your healthcare team—there are often solutions, including switching medicines, adjusting doses, or adding treatment for ED.
How Do Tadalafil and Amisulpride Interact?
There is no major direct pharmacological interaction between tadalafil and amisulpride that would make the combination unsafe in most cases. They work through different mechanisms in the body: tadalafil affects blood flow to the penis by inhibiting the PDE5 enzyme, while amisulpride blocks dopamine receptors in the brain. Neither medicine significantly affects the breakdown or levels of the other in the bloodstream.
However, both medicines can lower blood pressure, and taking them together may add to this effect, potentially causing dizziness, light-headedness, or fainting, especially when standing up quickly. Amisulpride can also prolong the QT interval on an ECG, and while tadalafil is not known to do this significantly, your prescriber will consider your overall heart health and any other medicines that might affect heart rhythm.
Your prescriber will review your full medical history, current medicines, and recent blood pressure readings during your consultation. They may recommend starting tadalafil at a lower dose to see how you respond, and they will advise you to watch for any unusual symptoms such as dizziness or palpitations. It is essential to declare amisulpride and all other medicines you take during your online consultation so that the prescriber can make a safe, informed decision.
Understanding Blood Pressure Effects
Both tadalafil and amisulpride can cause a modest drop in blood pressure. When you take them together, this effect may be more noticeable, particularly in the first few hours after taking tadalafil. You might feel dizzy when you stand up, especially if you also take other medicines for blood pressure or if you drink alcohol. To minimise this risk, stand up slowly from sitting or lying down, stay well hydrated, and avoid heavy alcohol. If you feel faint, sit or lie down immediately and contact your GP or pharmacist for advice.
What you need to know
- No major direct interaction is commonly reported between tadalafil and amisulpride in clinical practice.
- Both medicines can lower blood pressure, so your prescriber will check your heart health and current medicines carefully.
- Watch for dizziness or fainting when standing up, and contact your GP if these symptoms occur.
- Always declare amisulpride and all other medicines during your online consultation for safe prescribing.
- Do not stop amisulpride without medical advice, even if you experience sexual side effects.
What Your Prescriber Will Check Before Prescribing Tadalafil
Before prescribing tadalafil to someone taking amisulpride, a UK prescriber will carry out a thorough assessment. This includes asking about your current mental health treatment, who prescribes your amisulpride, and whether your condition is stable. They will also ask about your cardiovascular health, including any history of heart disease, stroke, high or low blood pressure, and whether you have had any recent ECG tests.
You will be asked to list all your current medicines, including over-the-counter products, herbal supplements, and recreational drugs. This is because some medicines can interact dangerously with tadalafil—for example, nitrates (used for angina), nicorandil, riociguat, and poppers (alkyl nitrites) must never be taken with tadalafil, as the combination can cause a life-threatening drop in blood pressure. The prescriber will also check for other medicines that might affect tadalafil levels or increase the risk of side effects.
If you have any concerns about how tadalafil might affect your mental health or interact with amisulpride, raise them during your consultation. The prescriber may contact your GP or psychiatrist for further information if needed. Remember, the online consultation is a clinical assessment, not just a form to fill in—honest, complete answers help ensure your safety.
Practical Advice for Taking Tadalafil and Amisulpride Together
If your prescriber approves tadalafil while you are taking amisulpride, follow their instructions carefully. Take tadalafil exactly as prescribed—do not take more than the recommended dose or take it more often than once a day (for on-demand tablets). If you are prescribed daily tadalafil, take it at the same time each day, and remember that it may take a few days to build up in your system before you notice the full benefit.
Monitor yourself for any new or worsening symptoms, especially dizziness, light-headedness, palpitations, or fainting. If you experience any of these, stop taking tadalafil and contact your GP or pharmacist the same day. Do not stop taking amisulpride without advice from the doctor who prescribed it. Avoid drinking large amounts of alcohol, as this can worsen ED, increase the risk of side effects, and add to the blood-pressure-lowering effect of both medicines.
Keep all your healthcare professionals informed. If you see your GP, psychiatrist, or another specialist, tell them you are taking tadalafil. Similarly, if your amisulpride dose changes or you start any new medicine, inform the prescriber at Cured Pharmacy through your account or by contacting the pharmacy directly. This ensures that your treatment remains safe and effective.
When to Seek Medical Advice
Seek urgent medical help if you develop an erection lasting more than four hours (priapism), sudden loss of vision or hearing, or chest pain during sexual activity. Contact your GP the same day if you experience severe dizziness, fainting, fast or irregular heartbeat, or any other symptom that worries you. If you feel that tadalafil is not working or is causing troublesome side effects, do not simply stop taking it or increase the dose yourself—speak to the prescriber who can review your treatment and suggest alternatives.
When to get urgent help
- Erection lasting more than 4 hours (priapism)—go to A&E immediately
- Sudden loss of vision or hearing—stop tadalafil and seek urgent medical help
- Chest pain during or after sexual activity—stop and call 999
- Severe dizziness, fainting, or fast/irregular heartbeat—contact your GP the same day or call 111
- Any symptoms that worry you or do not improve—speak to your GP or pharmacist promptly
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
Other Erectile Dysfunction Treatments and Amisulpride
If tadalafil is not suitable for you, or if you would prefer to try a different ED treatment, there are several alternatives available. Sildenafil (generic Viagra) is another PDE5 inhibitor that works in a similar way to tadalafil but has a shorter duration of action—around four to six hours [3]. Vardenafil (generic Levitra) and avanafil (Spedra) are also PDE5 inhibitors with slightly different profiles [5][6]. The same considerations about blood pressure and heart health apply to all PDE5 inhibitors when taken with amisulpride.
For men who cannot take PDE5 inhibitors, other options include alprostadil, which can be given as a cream applied to the tip of the penis (Vitaros) or as an injection into the side of the penis (Caverject) [7]. These treatments work locally rather than affecting the whole body, so they may be suitable for some men taking amisulpride, but they require a specialist assessment and training in how to use them safely.
Lifestyle changes can also help improve erectile function. Losing weight if you are overweight, stopping smoking, reducing alcohol intake, exercising regularly, and managing stress can all make a difference [1]. If your ED is related to the side effects of amisulpride, your psychiatrist may be able to adjust your dose or switch you to a different antipsychotic with fewer sexual side effects, though this decision must be made carefully to avoid destabilising your mental health.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-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]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 18 October 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 18 October 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 18 October 2026]
- Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [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.
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Your Questions Answered
Can I take tadalafil if I'm on amisulpride?
In most cases, yes—there is no major direct interaction between tadalafil and amisulpride. However, both medicines can affect blood pressure and heart rhythm, so your prescriber will review your individual health and all current medicines before deciding whether tadalafil is safe for you.
Will tadalafil affect my mental health or amisulpride treatment?
Tadalafil does not interfere with how amisulpride works and is not known to worsen mental health conditions. If you have any concerns, discuss them with your prescriber during your consultation.
What side effects should I watch for when taking tadalafil and amisulpride together?
Watch for dizziness, light-headedness, fainting, or palpitations, especially when standing up. If you experience any of these, stop taking tadalafil and contact your GP or pharmacist the same day.
Do I need to tell my psychiatrist I'm taking tadalafil?
Yes, it is good practice to keep all your healthcare professionals informed about every medicine you take, including tadalafil. This helps them monitor your overall treatment safely.
Can amisulpride cause erectile dysfunction?
Yes, amisulpride and other antipsychotic medicines can cause sexual side effects, including reduced libido and difficulty with erections. Speak to your GP or psychiatrist if this is affecting you—do not stop amisulpride without medical advice.
Is it safe to drink alcohol while taking tadalafil and amisulpride?
Heavy alcohol can worsen erectile dysfunction and add to the blood-pressure-lowering effects of both medicines, increasing the risk of dizziness and fainting. It is best to limit alcohol intake.
What if tadalafil doesn't work for me while I'm on amisulpride?
If tadalafil is not effective, speak to your prescriber—they may suggest trying a different dose, a different PDE5 inhibitor, or referring you to a specialist for further assessment and alternative treatments.
Can I take sildenafil (Viagra) instead of tadalafil if I'm on amisulpride?
Yes, sildenafil is another PDE5 inhibitor and the same considerations apply. Your prescriber will assess whether sildenafil is suitable for you based on your health and current medicines.
Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)