Tadalafil and Fesoterodine: Can You Take Them Together?

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At a glance

What is Tadalafil and How Does It Work?

Tadalafil is a prescription medicine licensed in the UK for treating erectile dysfunction (ED). It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused [3][4].

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 at the same time. Both forms require sexual stimulation to work—tadalafil does not cause an erection on its own [4].

At Cured Pharmacy, tadalafil is available after an online consultation reviewed by a UK prescriber. Generic tadalafil starts from £7.95, with first orders discounted to £6.36 using code Ednew. Branded Cialis is also available at £12.00 (£9.60 with code Ednew). The prescriber will check your medical history, current medicines, and whether tadalafil is suitable for you before approving any prescription.

What is Fesoterodine and Why is It Prescribed?

Fesoterodine (brand name Toviaz) is a prescription medicine used to treat overactive bladder syndrome. It helps reduce symptoms such as sudden urges to urinate, frequent trips to the toilet, and urge incontinence (leaking urine when you feel a sudden need to go). Fesoterodine belongs to a class of medicines called antimuscarinics or anticholinergics.

Fesoterodine works by blocking certain receptors in the bladder muscle, helping the bladder relax and hold more urine. This reduces the frequency and urgency of urination. It is usually taken once daily, with or without food, and the dose may be adjusted by your doctor depending on how well it works and whether you experience side effects.

Common side effects of fesoterodine include dry mouth, constipation, blurred vision, and difficulty emptying the bladder completely. Because fesoterodine can cause dizziness or blurred vision, it may affect your ability to drive or operate machinery, especially when you first start taking it or if the dose is increased.

Do Tadalafil and Fesoterodine Interact?

No major interaction between tadalafil and fesoterodine is commonly reported in clinical practice or major drug interaction databases. These medicines work through different mechanisms in different parts of the body: tadalafil acts on blood vessels in the penis, while fesoterodine acts on receptors in the bladder muscle. There is no known pharmacological reason why they would interfere with each other's effectiveness or significantly increase side effects when used together.

However, both medicines can occasionally cause dizziness or low blood pressure as side effects. If you experience dizziness when standing up, or feel lightheaded, it is worth mentioning to your prescriber. They may advise starting on a lower dose of tadalafil or monitoring how you respond to the combination.

It is important to remember that every person's medical situation is unique. Your prescriber will review your full medication list, medical history, heart health, blood pressure, and any other conditions during your consultation. Even when no major interaction is expected, individual factors such as kidney or liver function, age, and other medicines you take can influence whether a combination is suitable for you personally.

What Your Prescriber Will Check

During your online consultation at Cured Pharmacy, the prescriber will ask about all medicines you currently take, including fesoterodine, to check for any interactions or contraindications. They will also review your cardiovascular health, blood pressure, and any history of heart disease, stroke, or other conditions that might affect the safety of tadalafil [2][4].

If you are taking other medicines that lower blood pressure (such as alpha-blockers for prostate symptoms, or medicines for high blood pressure), the prescriber will assess whether tadalafil is safe and may recommend starting on a lower dose. You should never take tadalafil with nitrates (GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, or recreational drugs called 'poppers', as this combination can cause a dangerous drop in blood pressure [4].

What you need to know

• No major interaction between tadalafil and fesoterodine is commonly reported in clinical practice.
• Your prescriber reviews your full medication list and medical history to ensure the combination is safe for you.
• Both medicines can occasionally cause dizziness; report any troublesome side effects to your prescriber.
• Never take tadalafil with nitrates, nicorandil, riociguat, or poppers—this combination is dangerous.
• Seek urgent help for an erection lasting over four hours or sudden vision or hearing loss.

Practical Advice for Taking Tadalafil and Fesoterodine Together

If your prescriber approves tadalafil while you are taking fesoterodine, take each medicine exactly as directed. Fesoterodine is usually taken once daily at the same time each day, while on-demand tadalafil is taken at least 30 minutes before sexual activity (or daily tadalafil is taken once a day at the same time). You can take them at different times of day if that suits your routine better.

Both medicines can cause dry mouth as a side effect. Staying well hydrated, sipping water regularly, and using sugar-free gum or lozenges can help. If you experience dizziness, avoid standing up quickly from sitting or lying down, especially when you first start taking tadalafil or if your dose is increased.

Avoid drinking large amounts of alcohol, as this can worsen erectile dysfunction, increase the risk of dizziness and low blood pressure, and reduce the effectiveness of tadalafil. Grapefruit juice can raise tadalafil levels in your blood, so it is best to avoid it while taking this medicine [4]. If you develop any new or troublesome side effects, contact your prescriber or pharmacist for advice.

Other Medicines That May Interact with Tadalafil

While tadalafil and fesoterodine do not have a major interaction, it is important to be aware of other medicines that can interact with tadalafil. Never take tadalafil with nitrates (used for angina), nicorandil, riociguat (for pulmonary hypertension), or recreational drugs called 'poppers'—this combination can cause a dangerous fall in blood pressure and is absolutely contraindicated [4].

Alpha-blockers (such as tamsulosin, doxazosin, or alfuzosin) used for prostate symptoms or high blood pressure can also lower blood pressure when combined with tadalafil. If you take an alpha-blocker, you should be stable on that medicine before starting tadalafil, and your prescriber will usually recommend starting on the lowest dose of tadalafil [3][4].

Certain medicines that affect liver enzymes (such as ritonavir, cobicistat, ketoconazole, itraconazole, clarithromycin, or rifampicin) can alter tadalafil levels in your blood, requiring dose adjustments or making tadalafil unsuitable. Always tell your prescriber about every medicine you take, including over-the-counter medicines, herbal remedies (especially St John's wort), and supplements, so they can check for interactions [4][12].

When Tadalafil is Not Suitable

Tadalafil is not suitable for everyone. It should not be used if you have been advised by your doctor to avoid sexual activity (for example, if you have had a recent heart attack or stroke, unstable angina, severe heart failure, or very low blood pressure). It is also not suitable if you have had a previous episode of non-arteritic anterior ischaemic optic neuropathy (NAION), a rare condition causing sudden vision loss, or certain inherited retinal disorders [4][12].

If you have severe kidney or liver disease, tadalafil may not be suitable or may require a lower dose. Your prescriber will assess your medical history and current health during the consultation to determine whether tadalafil is safe for you.

When to get urgent help

• Erection lasting more than four hours (priapism)—call 999 or go to A&E immediately
• Sudden loss of vision in one or both eyes—stop tadalafil and seek urgent medical advice
• Sudden decrease or loss of hearing, possibly with ringing in the ears or dizziness
• Chest pain during or after sexual activity—seek medical help; do not use GTN spray if you have taken tadalafil
• Severe dizziness, fainting, or signs of allergic reaction (swelling of face, lips, tongue, throat, difficulty breathing)

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

When to Seek Medical Help While Taking Tadalafil and Fesoterodine

Most people tolerate tadalafil and fesoterodine well, but it is important to know when to seek help. If you experience an erection lasting more than four hours (priapism), seek urgent medical attention immediately by calling 999 or going to A&E. Priapism is a medical emergency that requires prompt treatment to prevent permanent damage [4][12].

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 of PDE5 inhibitors. Stop taking tadalafil and seek urgent medical advice if this happens. If you develop chest pain during or after sexual activity, stop and seek medical help—do not take nitrate medicines (GTN spray) if you have used tadalafil within the last 48 hours, as this can cause a dangerous drop in blood pressure [4].

If you experience severe dizziness, fainting, or signs of an allergic reaction (such as swelling of the face, lips, tongue or throat, difficulty breathing, or a severe rash), seek urgent medical help. For less urgent concerns, such as troublesome side effects or questions about your treatment, contact your prescriber, pharmacist, or GP for advice. Never stop taking a prescribed medicine like fesoterodine without discussing it with your doctor first.

Ongoing Monitoring and Support

Erectile dysfunction can be an early warning sign of underlying health conditions such as heart disease, diabetes, or high blood pressure [1][2]. If you are experiencing ED for the first time, it is important to see your GP for a full assessment, even if you are also seeking treatment through an online pharmacy. Your GP can check for underlying causes and ensure you receive appropriate care.

At Cured Pharmacy, our UK-registered prescribers review every consultation individually and can provide ongoing support and advice about your treatment. If your circumstances change—for example, if you start a new medicine, develop a new health condition, or experience side effects—you can contact us for a review of your treatment. We are here to help you access safe, effective treatment for erectile dysfunction with the convenience of online prescribing and discreet home delivery.

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