Tadalafil and Felodipine: Can You Take Them Together?

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What is tadalafil and felodipine?

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 generic name for Cialis and is available in two forms: on-demand tablets (10mg or 20mg taken at least 30 minutes before sex, with effects lasting up to 36 hours) and daily low-dose tablets (2.5mg or 5mg taken once a day) [4].

Felodipine is a calcium channel blocker prescribed to treat high blood pressure (hypertension) and sometimes angina (chest pain). It works by relaxing and widening blood vessels, which lowers blood pressure and reduces the workload on the heart [12]. Felodipine is usually taken once daily as a modified-release tablet, often in doses ranging from 2.5mg to 10mg.

Both medicines affect blood vessels, which is why understanding their interaction is important for your safety. While they work through different mechanisms, their combined effect on blood pressure needs to be considered by your prescriber before starting treatment.

How do tadalafil and felodipine interact?

Tadalafil and felodipine can be taken together, but both medicines have the potential to lower blood pressure. When used in combination, this blood-pressure-lowering effect may be additive, meaning the overall drop in blood pressure could be greater than with either medicine alone [2][4]. For most men whose blood pressure is well controlled on felodipine, this interaction is manageable, but it requires careful assessment.

The mechanism is straightforward: felodipine relaxes the smooth muscle in artery walls by blocking calcium channels, while tadalafil increases levels of a substance called cyclic GMP, which also relaxes blood vessels. When both effects occur together, some men may experience symptoms of low blood pressure, such as dizziness, light-headedness, or feeling faint, particularly when standing up quickly [4].

It is important to note that felodipine does not significantly affect how tadalafil is broken down in the body, so the levels of tadalafil in your bloodstream should remain predictable. This is different from some other medicines that can increase or decrease tadalafil levels. Your prescriber will review your current blood pressure control, your dose of felodipine, and any symptoms you experience to decide whether tadalafil is suitable and at what dose [2].

Is this combination safe?

For most men taking felodipine with well-controlled blood pressure, tadalafil can be prescribed safely. However, your prescriber must assess your individual circumstances. They will check your current blood pressure readings, how long you have been stable on felodipine, whether you experience any dizziness or fainting, and whether you have any other heart or circulation problems [2]. Starting on a lower dose of tadalafil and monitoring how you respond is a common precautionary approach.

When to get urgent help

• Erection lasting longer 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 or after sex – stop, sit down, seek urgent help; do not take nitrates
• Severe dizziness, fainting, or feeling very unwell – contact your GP, NHS 111, or go to A&E
• Rapid or irregular heartbeat with dizziness or breathlessness – seek same-day medical advice

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

What will your prescriber check before prescribing tadalafil and felodipine together?

During your online consultation at Cured Pharmacy, the UK-registered prescriber will ask detailed questions to ensure tadalafil is safe for you while taking felodipine. They will want to know your current dose of felodipine, how long you have been taking it, and whether your blood pressure is well controlled [2]. You will also be asked about any symptoms of low blood pressure, such as dizziness, fainting, or feeling light-headed when you stand up.

Your prescriber will review your full medical history, including any heart conditions (such as angina, heart attack, heart failure, or irregular heartbeat), stroke, kidney or liver problems, and any other medicines you take [4]. They will also ask about your general fitness and whether your doctor has advised you that sexual activity is safe for you. If you have unstable or poorly controlled blood pressure, or if you have recently had a heart attack or stroke, tadalafil may not be suitable [2][4].

The prescriber may recommend starting with a lower dose of tadalafil (for example, 10mg on-demand rather than 20mg) to minimise the risk of a significant drop in blood pressure. They will also advise you on warning signs to watch for and when to seek medical help. It is essential to answer all questions honestly and to declare every medicine you take, including over-the-counter products and supplements, so the prescriber can make a safe decision.

Practical advice for taking tadalafil with felodipine

If your prescriber approves tadalafil while you are taking felodipine, follow their instructions carefully. Take tadalafil exactly as prescribed—do not take more than the recommended dose or take it more often than once a day (for on-demand tablets) [4]. If you are prescribed daily tadalafil, take it at the same time each day. Continue taking your felodipine as usual; do not stop or change the dose without speaking to your GP or pharmacist.

Be cautious when standing up from sitting or lying down, especially in the first few hours after taking tadalafil, as this is when you are most likely to feel dizzy if your blood pressure drops [4]. Avoid drinking large amounts of alcohol, as alcohol can lower blood pressure further and may make erectile dysfunction worse [1]. Grapefruit juice can increase the levels of felodipine and some other medicines in your blood, so it is best to avoid it or discuss it with your pharmacist.

If you experience dizziness, light-headedness, fainting, or a rapid heartbeat after taking tadalafil, sit or lie down and contact your GP or NHS 111 for advice. If you develop chest pain during or after sexual activity, stop immediately, sit down, and seek urgent medical help—do not take GTN spray or any nitrate medicine if you have used tadalafil, as this combination can cause a dangerous drop in blood pressure [4].

Can I take other blood pressure medicines with tadalafil?

Many men with high blood pressure take more than one medicine to control it. Tadalafil can usually be taken with other blood pressure medicines, including ACE inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, and diuretics, but the same principle applies: the prescriber must assess the combination and may start you on a lower dose [2][4]. Alpha-blockers (such as doxazosin or tamsulosin, often used for prostate symptoms) require particular caution, and you should be stable on the alpha-blocker before starting tadalafil. Always declare every medicine you take during your consultation.

Warning signs and when to seek help with tadalafil and felodipine

Most men tolerate tadalafil well, even when taking felodipine, but it is important to know the warning signs that need urgent attention. If you experience an erection that lasts longer than four hours (priapism), seek emergency medical help immediately, as this can cause permanent damage [4]. Priapism is rare but requires urgent treatment.

Sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing (sometimes with ringing in the ears or dizziness), are rare but serious side effects that require you to stop taking tadalafil and seek medical help straight away [4]. These symptoms may indicate a serious problem with blood flow to the eye or ear.

If you develop chest pain during or after sexual activity, stop immediately and seek urgent help. Do not take any nitrate medicines (such as GTN spray) if you have used tadalafil within the last 48 hours, as the combination can cause a life-threatening drop in blood pressure [4]. If you feel severely dizzy, faint, or unwell after taking tadalafil, especially if you also feel your heart racing or have difficulty breathing, contact your GP, call NHS 111, or go to A&E depending on the severity of your symptoms.

Getting tadalafil safely with felodipine at Cured Pharmacy

Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering a convenient, confidential way to access erectile dysfunction treatment. If you are taking felodipine or any other blood pressure medicine, you can complete an online consultation that will be reviewed by a UK-registered prescriber. The prescriber will assess whether tadalafil is safe and appropriate for you, taking into account your current medicines, blood pressure control, and overall health [2].

We offer a range of tadalafil products, including generic tadalafil tablets and branded Cialis, all requiring a prescription after a clinical assessment. Prices start from £7.95 for generic tadalafil (£6.36 with first-order code Ednew), with other options including Tadalafil 20mg (Teva) at £9.99 (£7.99 with code Ednew), Avarante (tadalafil) 10mg at £11.49 (£9.19 with code Ednew), and branded Cialis at £12.00 (£9.60 with code Ednew). If tadalafil is not suitable, the prescriber may suggest an alternative PDE5 inhibitor such as sildenafil, vardenafil, or avanafil.

Your medicine will be dispensed by our UK pharmacists and delivered discreetly to your door. If you have any questions about taking tadalafil with felodipine or any other medicine, our pharmacy team is available to help. Remember, erectile dysfunction can be an early warning sign of heart disease or diabetes, so if you have not already done so, it is a good idea to see your GP for a general health check [1][2].

What if I take other medicines?

During your consultation, you must declare every medicine you take, including prescription medicines, over-the-counter products, herbal remedies, and supplements. Some medicines can interact with tadalafil in ways that require dose adjustments or make tadalafil unsuitable. For example, potent CYP3A4 inhibitors (such as ritonavir, ketoconazole, itraconazole, or clarithromycin) can increase tadalafil levels, requiring a lower dose [4]. Never take tadalafil with nitrates, nicorandil, riociguat, or another PDE5 inhibitor, as these combinations are dangerous [4]. The prescriber will check every medicine you list to ensure your safety.

In summary

• Tadalafil and felodipine can usually be taken together if your blood pressure is well controlled.
• Both medicines can lower blood pressure, so your prescriber may start you on a lower tadalafil dose.
• Watch for dizziness or light-headedness, especially when standing up after taking tadalafil.
• Always declare every medicine you take during your online consultation for a safe assessment.
• Seek urgent help if you experience chest pain, an erection lasting over four hours, or sudden vision or hearing loss.

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