Tadalafil and Bempedoic Acid: Can You Take Them Together?

Tadalafil and Bempedoic Acid: What You Need to Know

Published: 18 October 2026

If you're taking bempedoic acid for high cholesterol and considering tadalafil for erectile dysfunction, you may wonder whether tadalafil and bempedoic acid can be used together safely. The good news is that no major interaction between these two medicines is commonly reported in UK prescribing guidance. However, every person's medical situation is unique, and your prescriber will review all your current medicines, heart health, and blood pressure during your consultation to ensure tadalafil is suitable for you.

What is tadalafil and bempedoic acid used for?

Tadalafil is a prescription medicine used to treat erectile dysfunction (ED) in men. 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 is the active ingredient in Cialis and is available as on-demand tablets (10mg or 20mg, taken at least 30 minutes before sex, with effects lasting up to 36 hours) or as a daily low-dose tablet (2.5mg or 5mg). It requires sexual stimulation to work and does not increase sexual desire on its own [4].

Bempedoic acid is a prescription medicine used to lower cholesterol levels in adults with high cholesterol (hypercholesterolaemia) or mixed dyslipidaemia. It is often prescribed alongside statins or when statins are not tolerated. Bempedoic acid works by reducing the production of cholesterol in the liver. It is taken once daily and is part of a treatment plan that includes a healthy diet and lifestyle changes to reduce the risk of heart disease and stroke [12].

Both medicines address different health concerns—tadalafil improves erectile function, while bempedoic acid helps manage cholesterol—and many men may need treatment for both conditions, particularly as cardiovascular risk factors and ED often occur together [1][2].

Is there an interaction between tadalafil and bempedoic acid?

No major interaction between tadalafil and bempedoic acid is commonly reported in UK prescribing resources such as the British National Formulary or Summaries of Product Characteristics [4][12]. This means that, based on current evidence, taking these two medicines together is not expected to cause a significant problem for most people. Bempedoic acid does not belong to the groups of medicines that are known to interact dangerously with tadalafil, such as nitrates, nicorandil, riociguat, or potent CYP3A4 inhibitors.

However, the absence of a major reported interaction does not mean that no precautions are needed. Tadalafil can lower blood pressure slightly, and if you are taking other medicines that also affect blood pressure or heart function, the combined effect needs to be considered. Bempedoic acid itself is not primarily a blood-pressure-lowering medicine, but it is often prescribed to people with cardiovascular risk factors who may also be on other heart or blood-pressure medicines.

Your prescriber will review your full medical history, current medicines (including bempedoic acid), blood pressure, and cardiovascular health during your consultation. This ensures that tadalafil is safe and appropriate for you. You should always declare every medicine you take, including over-the-counter products and supplements, so that your prescriber can make an informed decision [2][4].

How tadalafil works in your body

Tadalafil works by blocking an enzyme called phosphodiesterase type 5 (PDE5). When you are sexually aroused, your body releases a chemical called nitric oxide, which increases levels of a substance called cyclic GMP in the smooth muscle of the penis. Cyclic GMP relaxes the blood vessels, allowing more blood to flow in and produce an erection. PDE5 breaks down cyclic GMP, so by blocking PDE5, tadalafil helps cyclic GMP levels stay higher for longer, making it easier to get and keep an erection when you are sexually stimulated [4][9]. Tadalafil also has a mild blood-pressure-lowering effect, which is why interactions with other blood-pressure medicines or heart conditions must be checked.

What does your prescriber check before prescribing tadalafil and bempedoic acid together?

When you request tadalafil through an online consultation at Cured Pharmacy, a UK-registered prescriber will review your answers to a detailed health questionnaire. If you are already taking bempedoic acid, the prescriber will want to know why it was prescribed (usually for high cholesterol), what other medicines you take, and whether you have any heart or blood-vessel conditions. This is because ED can be an early warning sign of cardiovascular disease, and some heart conditions make sexual activity or PDE5 inhibitors unsuitable [1][2].

The prescriber will check your blood pressure, as tadalafil can cause a small drop in blood pressure. If you are on other medicines that lower blood pressure (such as ACE inhibitors, angiotensin receptor blockers, calcium-channel blockers, or beta-blockers), the prescriber will assess whether the combination is safe and whether you should start on a lower dose of tadalafil. They will also check that you are not taking any medicines that must never be combined with tadalafil, such as nitrates (GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, or another PDE5 inhibitor [3][4].

If you take an alpha-blocker for prostate symptoms (such as tamsulosin or doxazosin), special care is needed because the combination with tadalafil can increase the risk of dizziness or fainting due to low blood pressure. In such cases, you should be stable on the alpha-blocker, and the prescriber will start you on the lowest dose of tadalafil. The prescriber will also ask about any recent heart attack, stroke, unstable angina, severe heart failure, or very low blood pressure, as these conditions may mean tadalafil is not safe for you [2][4].

Practical advice for taking tadalafil and bempedoic acid safely

If your prescriber approves tadalafil for you and you are already taking bempedoic acid, here are some practical tips to use both medicines safely. Take each medicine exactly as prescribed: bempedoic acid is usually taken once daily, and tadalafil is taken either on-demand (at least 30 minutes before sex, with effects lasting up to 36 hours) or as a daily low dose. Do not take more tadalafil than prescribed, and never take it more than once in 24 hours [4].

Monitor how you feel, especially when you first start tadalafil. Some men experience mild side effects such as headache, flushing, indigestion, or a stuffy nose. Dizziness or light-headedness can occur, particularly if you are on other blood-pressure medicines. If you feel dizzy, sit or lie down until it passes, and avoid driving or operating machinery. Do not drink large amounts of alcohol when taking tadalafil, as alcohol can worsen ED, increase the risk of side effects, and add to the blood-pressure-lowering effect [3][4].

Continue taking your bempedoic acid as prescribed by your doctor. Do not stop or change the dose of any medicine without speaking to your GP or prescriber first. If you develop any new symptoms, such as chest pain during sex, an erection lasting more than four hours, or sudden loss of vision or hearing, stop taking tadalafil and seek urgent medical help. Keep your GP informed that you are using tadalafil, especially if your heart or cholesterol treatment changes [1][2][4].

What to avoid when taking tadalafil

Never take tadalafil with nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or recreational drugs called 'poppers' (amyl or alkyl nitrites). This combination can cause a dangerous drop in blood pressure that may be life-threatening. Do not take tadalafil with another PDE5 inhibitor (such as sildenafil, vardenafil, or avanafil) at the same time. Grapefruit juice may increase tadalafil levels in your blood and should be avoided. If you are prescribed a new medicine by your GP or another doctor, always tell them you are taking tadalafil so they can check for interactions [3][4][12].

Other medicines for high cholesterol and tadalafil

Bempedoic acid is one of several medicines used to manage high cholesterol. Many men taking tadalafil will also be on statins (such as atorvastatin, simvastatin, or rosuvastatin), ezetimibe, fibrates, or PCSK9 inhibitors. No major interaction is commonly reported between tadalafil and statins or ezetimibe, and these combinations are widely used in clinical practice [4][12].

However, some statins and other medicines are metabolised by the same liver enzyme system (CYP3A4) as tadalafil. If you are also taking a potent CYP3A4 inhibitor (such as certain antifungals like ketoconazole or itraconazole, some antibiotics like clarithromycin, or HIV medicines like ritonavir or cobicistat), your prescriber may need to reduce the maximum dose of tadalafil or choose a different ED treatment. Always declare every medicine, supplement, and herbal product you use during your consultation [3][4].

If you are on multiple medicines for heart disease, high blood pressure, or cholesterol, your prescriber will take extra care to ensure that tadalafil is safe and that the overall effect on your blood pressure is manageable. This is why a thorough medication review is an essential part of every consultation at Cured Pharmacy. If you have any concerns about your cholesterol treatment or ED, speak to your GP, who can review your overall cardiovascular risk and treatment plan [2][12].

When to seek medical advice about tadalafil and bempedoic acid

You should seek urgent medical help if you experience chest pain or discomfort during or after sex, an erection that lasts more than four hours (priapism), sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing, which may be accompanied by ringing in the ears or dizziness. These are rare but serious side effects of tadalafil that require immediate attention. Call 999 or go to A&E [4][12].

Contact your GP or prescriber if you develop new or worsening symptoms such as severe dizziness, fainting, unexplained muscle pain or weakness (which could be related to your cholesterol medicine), or if tadalafil stops working as well as it did before. If you are started on a new medicine by another doctor or if your bempedoic acid dose changes, let your ED prescriber know so they can review whether any adjustment to your tadalafil is needed [2][4].

Remember that erectile dysfunction can be an early sign of heart disease, diabetes, or other health problems. If you have not already done so, see your GP for a full health check, including blood pressure, cholesterol, and blood sugar tests. Treating the underlying cause, alongside ED treatment, can improve your overall health and quality of life. At Cured Pharmacy, our online consultation is reviewed by a UK-registered prescriber, but it is not a substitute for ongoing care from your GP [1][2].

How to get tadalafil from Cured Pharmacy

Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering a convenient, confidential service for erectile dysfunction treatment. To request tadalafil, complete a short online consultation that asks about your medical history, current medicines (including bempedoic acid), and any heart or blood-pressure conditions. A UK-registered prescriber will review your answers, and if tadalafil is suitable, your medicine will be dispensed by our pharmacy and delivered discreetly to your door. Prescription treatments are only supplied after clinical assessment, ensuring your safety. If you have any questions, our pharmacy team is here to help.

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. 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]
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.