Can You Take Tadalafil and Diclofenac 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) in men [4]. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors, which work by relaxing the blood vessels in the penis, allowing increased blood flow when you are sexually aroused. This helps you achieve and maintain an erection suitable for sexual activity.

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 once a day [4]. Unlike some other ED treatments, tadalafil does not cause an erection on its own—sexual stimulation is still needed for it to work.

Common brand names include Cialis, but generic tadalafil is widely available and just as effective. At Cured Pharmacy, tadalafil is available from £7.95 after an online consultation with a UK-registered prescriber, who will check that it is safe and suitable for you.

What is diclofenac and why is it prescribed?

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) commonly prescribed to relieve pain and reduce inflammation in conditions such as arthritis, back pain, sprains, and strains. It works by blocking enzymes called cyclooxygenase (COX) enzymes, which produce chemicals in the body called prostaglandins that cause pain, swelling, and inflammation.

Diclofenac is available in several forms, including tablets, capsules, suppositories, and topical gels or patches. Oral diclofenac is usually taken two or three times a day with or after food to reduce the risk of stomach upset. Like all NSAIDs, diclofenac can have side effects, particularly on the stomach, kidneys, and cardiovascular system, especially when used long-term or at high doses.

Because diclofenac can increase the risk of heart attack, stroke, and high blood pressure, your doctor will consider your cardiovascular health before prescribing it. This is particularly important if you are also taking medicines for erectile dysfunction, as both your heart health and blood pressure need to be carefully managed.

Common uses of diclofenac

Diclofenac is prescribed for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gout, post-operative pain, dental pain, and musculoskeletal injuries. Topical diclofenac gel is often used for localised pain in joints or soft tissues, which may carry a lower risk of systemic side effects compared to oral forms.

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—stop tadalafil and seek urgent medical help
• Chest pain during or after sexual activity—call 999; do not take nitrate medicines
• Severe dizziness, fainting, or rapid heartbeat—sit down and call 111 or your GP
• Black or tarry stools, or vomiting blood while taking diclofenac—seek urgent medical attention

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

Is there an interaction between tadalafil and diclofenac?

No major direct drug interaction between tadalafil and diclofenac is commonly reported in clinical practice or standard drug interaction databases. This means that, for most men, taking tadalafil and diclofenac together does not cause one medicine to interfere with how the other works in the body.

However, both medicines can affect your cardiovascular system in ways that require careful consideration. Tadalafil can cause a mild reduction in blood pressure, particularly when you first start taking it or when you stand up quickly [4]. Diclofenac, on the other hand, can increase blood pressure and may increase the risk of heart attack or stroke, especially in people with existing heart disease or risk factors.

Because of these separate cardiovascular effects, your prescriber will assess your overall heart health, blood pressure, and any other medicines you are taking during your consultation. If you have high blood pressure, heart disease, or have had a stroke or heart attack, your doctor will weigh the benefits and risks of using both medicines together. It is essential to declare all your current medicines, including over-the-counter painkillers, during your online consultation at Cured Pharmacy.

What does your prescriber check before approving tadalafil and diclofenac together?

When you request tadalafil through Cured Pharmacy, a UK-registered prescriber will review your full medical history and current medicines to ensure it is safe for you. If you are already taking diclofenac or another NSAID, the prescriber will pay particular attention to your cardiovascular health, including your blood pressure, history of heart disease, stroke, or heart attack, and any other risk factors such as diabetes, high cholesterol, or smoking.

The prescriber will also check whether you are taking any medicines that are known to interact dangerously with tadalafil, such as nitrates (GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' [4]. These combinations can cause a dangerous drop in blood pressure and must never be used together. If you are on alpha-blockers for prostate problems or high blood pressure, the prescriber will ensure you are stable on that treatment and may start you on a lower dose of tadalafil.

Your prescriber will also consider whether sexual activity itself is safe for you. If you have unstable angina, severe heart failure, or have had a recent heart attack or stroke, tadalafil may not be suitable [2]. The consultation is designed to protect your health while helping you access effective treatment for erectile dysfunction.

Medicines that must not be taken with tadalafil

Do not take tadalafil if you are using nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or recreational nitrites ('poppers'). Combining these with tadalafil can cause a severe and potentially life-threatening drop in blood pressure [4]. You must also not take tadalafil alongside another PDE5 inhibitor such as sildenafil or vardenafil.

At a glance

Practical advice for taking tadalafil and diclofenac safely

If your prescriber has approved tadalafil and you are also taking diclofenac, there are several practical steps you can take to use both medicines safely. First, always take each medicine exactly as prescribed or as directed on the label. Do not exceed the recommended dose of either medicine, as this increases the risk of side effects.

Monitor your blood pressure regularly if you have been advised to do so, especially if you have a history of high blood pressure or heart disease. If you notice any new symptoms such as dizziness, light-headedness, chest pain, or shortness of breath, stop taking the medicines and seek medical advice promptly. Avoid drinking excessive alcohol, as this can worsen erectile dysfunction, increase the risk of side effects from both medicines, and add to the blood-pressure-lowering effect of tadalafil.

If you experience stomach pain, indigestion, or black stools while taking diclofenac, contact your GP, as these may be signs of a stomach ulcer or bleeding. For tadalafil, 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 [4]. Always inform any healthcare professional you see—whether your GP, a hospital doctor, or a pharmacist—that you are taking both tadalafil and diclofenac.

Other pain relief options and tadalafil interactions

If you are concerned about taking diclofenac with tadalafil, or if your doctor has advised you to avoid NSAIDs, there are alternative pain relief options you can discuss with your healthcare provider. Paracetamol is generally considered safe to take with tadalafil and does not carry the same cardiovascular risks as NSAIDs. It is often the first choice for mild to moderate pain and can be used regularly for conditions such as osteoarthritis.

Other NSAIDs, such as ibuprofen or naproxen, have similar cardiovascular considerations to diclofenac, so switching to a different NSAID does not necessarily reduce the risk. Topical NSAIDs (such as diclofenac gel applied to the skin) may be a safer option for localised pain, as they result in lower levels of the medicine in your bloodstream compared to tablets. Your GP or pharmacist can advise on the most appropriate pain relief for your individual circumstances.

If you are taking other medicines for blood pressure, heart disease, or diabetes, these will also be reviewed during your tadalafil consultation. Medicines such as alpha-blockers (for prostate problems or high blood pressure) require careful dose adjustment when starting tadalafil, and potent CYP3A4 inhibitors (such as some antibiotics or antifungal medicines) can increase tadalafil levels in your body [4]. Always declare every medicine you take, including over-the-counter products, herbal remedies, and supplements, during your consultation at Cured Pharmacy.

When to see your GP about erectile dysfunction

If you are experiencing erectile dysfunction for the first time, it is important to see your GP for a full assessment [1]. ED can be an early warning sign of underlying health conditions such as heart disease, diabetes, or high blood pressure. Your GP can arrange tests, review your medicines, and discuss lifestyle changes that may help, as well as referring you for specialist treatment if needed.

In summary

• No major direct interaction is commonly reported between tadalafil and diclofenac
• Your prescriber will review your cardiovascular health and blood pressure before approving the combination
• Both medicines can affect your heart and circulation in different ways
• Always declare all current medicines during your online consultation
• Seek urgent help for chest pain, prolonged erection, or sudden vision or hearing loss

Start Your Assessment For Erectile Dysfunction

Start your journey to better health today.

• Reviewed by UK-based prescribers
• Takes under 3 minutes
• Discreet Packaging

Faq