Tadalafil and Cabergoline: Can You Take Them Together?

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At a glance

What Is Tadalafil and How Does It Work?

Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor licensed in the UK to treat erectile dysfunction. It works by relaxing the 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 [4].

Tadalafil is available as an on-demand treatment (usually 10 mg or 20 mg taken at least 30 minutes before sexual activity, with effects lasting up to 36 hours) or as a daily low-dose tablet (2.5 mg or 5 mg) for men who prefer spontaneity. Because of its long duration of action, tadalafil is sometimes called the 'weekend pill' [1][4].

Common brand names include Cialis, and generic versions are widely available. At Cured Pharmacy, tadalafil is supplied after an online consultation reviewed by a UK-registered prescriber to ensure it is safe and suitable for you.

What Is Cabergoline and Why Is It Prescribed?

Cabergoline is a dopamine agonist, meaning it mimics the action of dopamine in the brain. It is most commonly prescribed to treat high levels of the hormone prolactin (hyperprolactinaemia), which can cause symptoms such as reduced libido, erectile dysfunction, and infertility in men. Cabergoline is also used in the management of Parkinson's disease and certain pituitary tumours [12].

By lowering prolactin levels, cabergoline can sometimes improve sexual function and libido in men whose erectile difficulties are linked to hormonal imbalance. However, it is not a treatment for erectile dysfunction itself—it addresses an underlying cause rather than the symptom directly.

Cabergoline is taken as a tablet, usually once or twice a week, and the dose is carefully adjusted by your doctor. Because it affects dopamine pathways and can lower blood pressure, your prescriber will monitor you closely, especially if you are taking other medicines that also affect blood pressure or heart function.

Do Tadalafil and Cabergoline Interact?

There is no major direct pharmacological interaction between tadalafil and cabergoline reported in UK prescribing references. They work through different mechanisms: tadalafil acts on blood vessels in the penis via PDE5 inhibition, while cabergoline acts on dopamine receptors in the brain to lower prolactin [4][12].

However, both medicines can lower blood pressure. Tadalafil causes mild vasodilation (widening of blood vessels), and cabergoline can also reduce blood pressure, particularly when you first start treatment or when the dose is increased. Taking them together may add to this blood-pressure-lowering effect, which could cause dizziness, light-headedness, or fainting, especially when standing up quickly.

For this reason, your prescriber will carefully review your full medical history, current medicines, and blood pressure during your consultation. If you are already stable on cabergoline and your blood pressure is well controlled, tadalafil may be prescribed at an appropriate dose. You should never start, stop, or adjust either medicine without professional advice.

How the Interaction Works in Plain English

Think of your blood pressure as water pressure in a hose. Tadalafil gently widens the hose (your blood vessels) to help blood flow to the penis. Cabergoline can also reduce the pressure in the system by acting on the brain's control centres. When both medicines are working at once, the combined effect on pressure needs to be monitored to avoid it dropping too low, which would make you feel dizzy or faint.

What you need to know

• No major direct interaction is commonly reported between tadalafil and cabergoline
• Both medicines can lower blood pressure, so your prescriber monitors this carefully
• Start tadalafil at the lowest dose and watch for dizziness or light-headedness
• Always declare cabergoline and all other medicines during your online consultation
• Never take tadalafil with nitrates, nicorandil, riociguat, or poppers

What Your Prescriber Checks Before Approving Tadalafil and Cabergoline Together

When you request tadalafil through Cured Pharmacy's online consultation, a UK-registered prescriber reviews every medicine you are currently taking, including cabergoline. They will check your blood pressure, cardiovascular history, and any symptoms you have experienced, such as dizziness or fainting [2][4].

If you are taking cabergoline for high prolactin, your prescriber may ask about your most recent prolactin levels and whether your dose has been stable. They will also confirm that you are not taking any medicines that are contraindicated with tadalafil, such as nitrates (GTN spray, isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites). These combinations can cause a dangerous drop in blood pressure and must never be used together [3][4].

Your prescriber will also consider whether you are on any alpha-blockers (such as tamsulosin or doxazosin) or potent CYP3A4 inhibitors (such as ritonavir, ketoconazole, or clarithromycin), as these require dose adjustments or additional caution. The consultation is designed to ensure that tadalafil is safe and appropriate for your individual circumstances.

Practical Advice for Taking Tadalafil and Cabergoline Safely

If your prescriber approves tadalafil while you are on cabergoline, start with the lowest effective dose of tadalafil and take it exactly as directed. For on-demand tadalafil, this is usually 10 mg at least 30 minutes before sexual activity. Do not take more than one dose in 24 hours [4].

Be especially cautious when standing up from sitting or lying down, particularly in the first few hours after taking tadalafil, as this is when the blood-pressure-lowering effect is most noticeable. If you feel dizzy, sit or lie down until the feeling passes. Avoid heavy alcohol, as it can worsen dizziness and make erectile dysfunction worse [1][4].

Keep all your doctors and pharmacists informed about both medicines. If your cabergoline dose changes, or if you start any new medicine (including over-the-counter or herbal products), let your prescriber know before your next tadalafil order. Do not stop taking cabergoline without your doctor's advice, as this can cause prolactin levels to rise again and may worsen symptoms.

When to Seek Medical Advice

Contact your GP or prescriber if you experience persistent dizziness, fainting, or a significant drop in blood pressure after taking tadalafil and cabergoline together. Seek urgent medical help (call 999 or go to A&E) if you have an erection lasting more than four hours (priapism), sudden loss of vision or hearing, or chest pain during sexual activity. These are rare but serious side effects that require immediate attention [1][4].

When to get urgent help

• Erection lasting more than 4 hours (priapism)—call 999 or go to A&E immediately
• Sudden loss of vision or hearing—seek urgent medical help
• Chest pain during or after sexual activity—stop and call 999
• Severe dizziness, fainting, or collapse—call 999 or go to A&E
• Persistent or worsening symptoms after starting tadalafil—contact your GP or prescriber the same day

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.

Other Medicines and Lifestyle Factors to Consider with Tadalafil and Cabergoline

Beyond cabergoline, several other medicines and lifestyle factors can affect how tadalafil works or increase the risk of side effects. Alpha-blockers (used for prostate symptoms or high blood pressure) can add to the blood-pressure-lowering effect of tadalafil, so you should be stable on the alpha-blocker before starting tadalafil, and your prescriber will usually recommend the lowest dose [3][4].

Potent CYP3A4 inhibitors, such as ritonavir (used in HIV treatment and in Paxlovid for COVID-19), ketoconazole, itraconazole, and clarithromycin, can raise tadalafil levels in your blood, increasing the risk of side effects. Your prescriber may reduce the maximum dose of tadalafil or advise avoiding it altogether, depending on the specific medicine [4][12].

Grapefruit juice can also raise tadalafil levels and should be avoided. Heavy alcohol can worsen erectile dysfunction and add to dizziness. If you are taking any other blood-pressure medicines, herbal supplements (such as St John's wort), or recreational drugs, declare them during your consultation. Your prescriber and pharmacist check every current medicine to ensure tadalafil is safe for you, and you should never stop or change a prescribed medicine without professional advice [2][4].

Why Seeing Your GP Matters

Erectile dysfunction can be an early warning sign of heart disease, diabetes, or hormonal problems such as low testosterone or high prolactin. If you have not already done so, see your GP for a full assessment, including blood tests and a cardiovascular check. Treating the underlying cause—such as adjusting your cabergoline dose if prolactin is still high—may improve your erections and overall health [1][2].