Tadalafil and Celecoxib: Can You Take Them Together?

Available Treatments

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.

Tadalafil and Celecoxib: Understanding the Interaction

Published: 19 October 2026

Many men wonder whether tadalafil and celecoxib can be taken together safely. The good news is that there is no major direct interaction between tadalafil (a medicine for erectile dysfunction) and celecoxib (a non-steroidal anti-inflammatory drug, or NSAID, used for pain and inflammation). However, both medicines can affect your cardiovascular system in different ways, so your prescriber will carefully review your overall health and other medicines before approving treatment.

What Is Tadalafil and How Does It Work?

Tadalafil is a prescription medicine used to treat erectile dysfunction (ED). 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 [4]. Tadalafil is the active ingredient in branded Cialis and is also available as a generic medicine.

Tadalafil comes in two forms: on-demand tablets (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 once a day [4]. Both forms require sexual stimulation to work—they do not cause an automatic erection.

Common side effects include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion [4]. Tadalafil is not suitable for everyone, particularly men taking nitrates, nicorandil, riociguat, or those for whom sexual activity is inadvisable due to heart problems.

How Tadalafil Affects Blood Pressure

Tadalafil causes a mild reduction in blood pressure by relaxing blood vessels throughout the body, not just in the penis [4]. This effect is usually small and well-tolerated, but it becomes important when tadalafil is combined with other medicines that also lower blood pressure, such as some blood pressure tablets or alpha-blockers used for prostate symptoms. Your prescriber will check your current medicines and blood pressure to ensure tadalafil is safe for you.

What Is Celecoxib and Why Is It Prescribed?

Celecoxib is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain and reduce inflammation in conditions such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It is also sometimes prescribed for short-term pain relief after surgery or injury. Celecoxib belongs to a subgroup of NSAIDs called COX-2 inhibitors, which are designed to cause fewer stomach side effects than traditional NSAIDs like ibuprofen or naproxen.

Like all NSAIDs, celecoxib works by blocking enzymes (cyclooxygenase enzymes) that produce chemicals called prostaglandins, which cause pain, inflammation, and fever. However, NSAIDs—including celecoxib—can have cardiovascular effects, particularly when used long-term or at high doses. They may slightly increase blood pressure and, in some people, raise the risk of heart attack or stroke, especially in those with existing heart disease or risk factors.

Common side effects of celecoxib include indigestion, stomach pain, diarrhoea, wind, swelling in the legs or ankles, dizziness, and headache. Your doctor will prescribe the lowest effective dose for the shortest time needed and will consider your heart and kidney health before starting treatment.

The Interaction Between Tadalafil and Celecoxib

There is no major direct pharmacological interaction between tadalafil and celecoxib—they work through different mechanisms and do not significantly affect each other's levels in the body. This means that, in most cases, the two medicines can be taken together if both are clinically appropriate for you.

However, both medicines can have cardiovascular effects that your prescriber must consider. Tadalafil causes a mild lowering of blood pressure, while celecoxib (like other NSAIDs) may cause a small increase in blood pressure or fluid retention in some people, and can slightly increase cardiovascular risk, particularly with long-term use or in people with existing heart disease [4].

Your prescriber will review your full medical history, including any heart conditions, high blood pressure, kidney problems, or other cardiovascular risk factors, before approving tadalafil. If you are taking celecoxib regularly, this will be part of the assessment. The combination is not contraindicated, but your overall cardiovascular health is the key factor in deciding whether tadalafil is safe for you.

What Your Prescriber Will Check

During your online consultation, your prescriber will ask about all your current medicines, including celecoxib and any other NSAIDs, as well as blood pressure tablets, heart medicines, and treatments for prostate symptoms. They will also ask about your cardiovascular health, including any history of heart attack, stroke, angina, heart failure, high or low blood pressure, and whether you have any kidney or liver problems. This comprehensive review ensures that tadalafil is safe and appropriate for you, taking into account the combined effects of all your medicines on your heart and circulation.

Practical Advice for Taking Tadalafil and Celecoxib Together

If your prescriber approves tadalafil and you are also taking celecoxib, there are some practical steps you can take to use both medicines safely. First, always take each medicine exactly as prescribed—do not increase the dose or frequency without consulting your doctor or pharmacist. If you experience any new symptoms such as dizziness, light-headedness, chest pain, or swelling in your legs, contact your GP or pharmacist promptly.

Monitor your blood pressure if you have been advised to do so, particularly if you have high blood pressure or are taking blood pressure medicines. NSAIDs like celecoxib can sometimes cause a small rise in blood pressure or reduce the effectiveness of blood pressure tablets, so regular monitoring helps ensure your treatment remains safe and effective.

Avoid taking additional over-the-counter NSAIDs (such as ibuprofen or naproxen) while you are on celecoxib, as combining NSAIDs increases the risk of side effects, including stomach ulcers and cardiovascular problems. If you need pain relief, speak to your pharmacist about safer alternatives such as paracetamol. Limit alcohol intake, as heavy drinking can worsen erectile dysfunction, increase the risk of side effects from both medicines, and add to the blood-pressure-lowering effect of tadalafil.

Other Medicines That Interact With Tadalafil

While tadalafil and celecoxib can usually be taken together, there are some medicines that must never be combined with tadalafil because they can cause a dangerous drop in blood pressure. These include nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, and recreational drugs called 'poppers' (amyl or alkyl nitrites). Do not take tadalafil with another PDE5 inhibitor such as sildenafil, vardenafil, or avanafil [4].

Alpha-blockers used for prostate symptoms (such as tamsulosin, doxazosin, alfuzosin, or terazosin) can also interact with tadalafil, increasing the risk of dizziness or fainting due to low blood pressure. If you take an alpha-blocker, your prescriber will ensure you are stable on it and will usually start you on the lowest dose of tadalafil [4].

Some medicines can raise the level of tadalafil in your blood by slowing its breakdown. These include potent CYP3A4 inhibitors such as ritonavir, cobicistat (found in some HIV medicines), Paxlovid (used for COVID-19), and antifungals like ketoconazole or itraconazole. If you take any of these, your prescriber may reduce your tadalafil dose or advise against using it [4]. Conversely, medicines that speed up the breakdown of tadalafil—such as rifampicin, carbamazepine, phenytoin, or St John's wort—can make it less effective.

Declaring All Your Medicines

It is essential to list all your current medicines during your online consultation, including prescription medicines, over-the-counter treatments, herbal remedies, and supplements. This allows your prescriber to check for interactions and ensure tadalafil is safe for you. Never stop or change a prescribed medicine without speaking to your doctor or pharmacist first.

When to Seek Medical Help

Most men tolerate tadalafil well, but you should seek urgent medical help in certain situations. If you develop an erection that lasts longer than four hours (priapism), go to A&E immediately, as this can cause permanent damage to the penis if not treated promptly [4]. 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), also requires urgent medical attention.

If you experience chest pain during or after sexual activity, stop and seek medical help. Do not take nitrates (such as GTN spray) if you have used tadalafil in the past 48 hours, as the combination can cause a dangerous drop in blood pressure [4]. If you develop severe dizziness, fainting, or signs of an allergic reaction (such as swelling of the face, lips, tongue, or throat, or difficulty breathing), call 999 or go to A&E.

If you notice new or worsening symptoms while taking celecoxib and tadalafil together—such as persistent swelling in your legs, unexplained shortness of breath, or significant changes in your blood pressure—contact your GP or pharmacist for advice. Erectile dysfunction can be an early warning sign of heart disease or diabetes, so if you are experiencing ED for the first time, it is important to see your GP for a full health check [1][2].

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 19 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 19 October 2026]
3. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 19 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.