Tadalafil and Darolutamide: Can They Be Taken Together?

Takes less than 2 minutes to complete 100% online

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 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 as the branded medicine Cialis or as a generic. It can be taken on-demand (10 mg or 20 mg at least 30 minutes before sex, with effects lasting up to 36 hours) or as a lower daily dose (2.5 mg or 5 mg) [4]. The long duration of action is why tadalafil is sometimes called the 'weekend pill'.

Common side effects include headache, indigestion, back pain, muscle aches, flushing, and a blocked or runny nose [4]. Most side effects are mild and short-lived. Tadalafil is not suitable for everyone, particularly men taking nitrates, nicorandil, riociguat, or those for whom sexual activity is inadvisable due to heart problems [4].

What is darolutamide and why is it prescribed?

Darolutamide (brand name Nubeqa) is a prescription medicine used to treat prostate cancer. It is an androgen receptor inhibitor, which means it blocks the effects of male hormones (androgens) that can fuel the growth of prostate cancer cells [12]. Darolutamide is typically prescribed for men with non-metastatic castration-resistant prostate cancer (nmCRPC) or metastatic hormone-sensitive prostate cancer (mHSPC), often alongside other treatments such as androgen deprivation therapy (ADT).

Darolutamide is taken as tablets, usually twice a day with food. Common side effects include fatigue, pain in the arms or legs, rash, and changes in liver function tests [12]. Because darolutamide is used to treat a serious condition, it is important never to stop or change your dose without speaking to your cancer specialist.

Men taking darolutamide may experience erectile dysfunction as a result of the cancer itself, the hormonal treatment, or the psychological impact of a cancer diagnosis. This is why some men on darolutamide seek treatment for ED to help maintain quality of life and intimate relationships.

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 sex—stop activity, use your GTN spray if prescribed, and call 999 if pain does not resolve
• Severe dizziness or fainting after taking tadalafil—seek same-day medical advice
• New or worsening erectile dysfunction—see your GP, as it can be an early sign of heart disease or diabetes

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

Do tadalafil and darolutamide interact with each other?

There is no well-documented major direct interaction between tadalafil and darolutamide reported in standard UK prescribing references [3][4][12]. This means that, in general, the two medicines are not known to interfere with each other's effectiveness or to cause a dangerous reaction when taken together.

However, darolutamide is metabolised (broken down) in the liver by enzymes including CYP3A4, and tadalafil is also partly metabolised by CYP3A4 [4][12]. While darolutamide is not classified as a strong inhibitor or inducer of CYP3A4, there is a theoretical possibility of minor changes in how the body processes tadalafil. In practice, this is not usually clinically significant, but your prescriber will take your full medication list into account.

It is also important to remember that men with prostate cancer may be taking other medicines (such as hormone therapies, blood pressure tablets, or medicines for other conditions) that can interact with tadalafil. Your prescriber will check every medicine you are taking during your consultation to ensure tadalafil is safe and appropriate for you.

Why your prescriber reviews all your medicines

Even though tadalafil and darolutamide do not have a major known interaction, your prescriber must review your full medical history and all current medicines. This is because some medicines commonly used alongside darolutamide—such as alpha-blockers for urinary symptoms, blood pressure medicines, or other cancer treatments—can interact with tadalafil [3][4]. Your prescriber will also check that your heart health is suitable for sexual activity, as this is an important safety consideration for all PDE5 inhibitors [1][2].

What does your prescriber check before prescribing tadalafil?

Before prescribing tadalafil, your doctor or pharmacist prescriber will ask about your medical history, current medicines, and any symptoms you are experiencing. They will check that you are not taking any medicines that must not be combined with tadalafil, such as nitrates (GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, or amyl/alkyl nitrites (poppers) [3][4]. Taking tadalafil with any of these can cause a dangerous drop in blood pressure.

Your prescriber will also ask about heart conditions, blood pressure, liver or kidney problems, and any history of stroke, priapism (prolonged erection), or sudden vision or hearing loss [4]. If you are taking alpha-blockers (such as tamsulosin or doxazosin) for urinary symptoms related to prostate enlargement, your 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 or low blood pressure [3][4].

If you are taking other medicines that affect liver enzymes (such as potent CYP3A4 inhibitors like ritonavir, ketoconazole, or clarithromycin), your prescriber may need to adjust the dose of tadalafil or choose a different ED treatment [4]. Always tell your prescriber about every medicine, supplement, or herbal product you are taking, including those bought over the counter.

Declaring your cancer treatment

It is essential to tell your prescriber that you are taking darolutamide and any other cancer treatments, including hormone therapy. This allows them to check for any potential interactions and to ensure that tadalafil is suitable given your overall health. Your cancer specialist should also be aware of any new medicines you start, so good communication between your healthcare team is important.

Practical advice for taking tadalafil with darolutamide

If your prescriber decides that tadalafil is safe and appropriate for you, take it exactly as directed. For on-demand tadalafil (10 mg or 20 mg), take the 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 time it precisely [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 [4].

You can take tadalafil with or without food, though a very large, high-fat meal may slightly delay how quickly it works [4]. Avoid drinking large amounts of alcohol, as this can make erectile dysfunction worse and increase the risk of side effects such as dizziness or low blood pressure [4]. Grapefruit juice can raise the level of tadalafil in your blood, so it is best to avoid it [4].

If you experience side effects such as headache, indigestion, or muscle aches, these are usually mild and temporary. However, if you develop 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 [4]. Always keep your cancer specialist and your GP informed about any new medicines or symptoms.

How to get tadalafil safely from Cured Pharmacy

Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering a range of ED treatments, including tadalafil, after a confidential online consultation. Every request is reviewed by a UK-registered prescriber who will check your medical history, current medicines (including darolutamide), and overall suitability for treatment [1][2].

We offer both generic and branded tadalafil at transparent prices. Generic tadalafil is available from £7.95 (first order with code Ednew: £6.36), and branded Cialis from £12.00 (first order with code Ednew: £9.60). We also stock other ED medicines such as sildenafil (generic Viagra), vardenafil (generic Levitra), and Spedra (avanafil), so your prescriber can recommend the most suitable option for you.

Your medicine is dispensed by our UK pharmacists and delivered discreetly to your door. If you have any questions about your treatment or experience any side effects, our pharmacy team is here to help. Remember, if you have new or worsening erectile dysfunction, it is important to see your GP, as ED can be an early sign of heart disease or diabetes [1][2].

Why choose Cured Pharmacy?

Cured Pharmacy combines convenience with clinical safety. Our online consultation is thorough, confidential, and reviewed by experienced UK prescribers. We are committed to providing genuine, licensed medicines at fair prices, with clear information and professional support every step of the way. Your health and safety are our top priorities.

In summary

• No major direct interaction between tadalafil and darolutamide is commonly reported
• Your prescriber will review all your medicines, including cancer treatments and blood pressure tablets
• Never take tadalafil with nitrates, nicorandil, riociguat, or poppers—this is dangerous
• Tell your cancer specialist and GP about any new medicines you start
• Cured Pharmacy offers safe, confidential online consultations with UK prescribers

Faq