Tadalafil and Lercanidipine: Can They Be Taken Together?

Takes less than 2 minutes to complete 100% online

Key takeaways

• Tadalafil and lercanidipine can usually be taken together safely with prescriber review
• Both medicines lower blood pressure, so effects can add together causing dizziness
• Your prescriber checks blood pressure control and cardiovascular health before approving tadalafil
• Space doses apart and stand up slowly to reduce the risk of dizziness
• Never take tadalafil with nitrates, nicorandil, or another PDE5 inhibitor

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 [3][4]. Tadalafil is the generic version of 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].

Tadalafil does not cause an erection on its own—you still need sexual stimulation for it to work [1]. Because it relaxes blood vessels throughout the body, not just in the penis, tadalafil can cause a small drop in blood pressure in most men [4]. This effect is usually mild and well-tolerated, but it becomes important when tadalafil is combined with other medicines that also lower blood pressure, such as lercanidipine.

What Is Lercanidipine and Why Is It Prescribed?

Lercanidipine is a calcium channel blocker prescribed to treat high blood pressure (hypertension). It works by relaxing and widening blood vessels, which makes it easier for the heart to pump blood around the body and helps to lower blood pressure. Lercanidipine is usually taken once a day, at least 15 minutes before food, and is often chosen because it tends to cause fewer side effects such as ankle swelling compared to some other calcium channel blockers.

Like tadalafil, lercanidipine lowers blood pressure by relaxing blood vessels. When you take both medicines together, their blood-pressure-lowering effects can add up, which may increase the risk of symptoms such as dizziness, light-headedness, or fainting, especially when you stand up quickly. This does not mean the combination is unsafe, but it does mean your prescriber needs to assess your overall cardiovascular health and current blood pressure control before approving tadalafil.

How Lercanidipine Affects Blood Pressure

Calcium channel blockers like lercanidipine block calcium from entering the muscle cells of blood vessel walls and the heart. This causes the blood vessels to relax and widen, reducing the resistance against which the heart has to pump. The result is lower blood pressure and reduced strain on the heart. Because this mechanism is different from how tadalafil works, there is no direct pharmacological clash between the two medicines, but the combined effect on blood pressure must be monitored.

At a glance

Can You Take Tadalafil and Lercanidipine Together?

Yes, tadalafil and lercanidipine can be taken together, and this combination is commonly prescribed in the UK. There is no absolute contraindication, meaning they are not medicines that must never be used at the same time [4]. However, because both medicines lower blood pressure, there is a potential for an additive effect that could cause symptoms such as dizziness, light-headedness, headache, or a feeling of faintness, particularly when standing up from sitting or lying down.

Your prescriber will review your blood pressure readings, your current dose of lercanidipine, and any other medicines you take before deciding whether tadalafil is suitable for you. If your blood pressure is well controlled and you do not experience frequent dizziness or postural hypotension (a drop in blood pressure when you stand), tadalafil is usually safe to use. Most men tolerate the combination well, especially if they start on a lower dose of tadalafil and avoid taking it at the same time as their lercanidipine dose.

What Your Prescriber Will Check Before Approving Tadalafil

During your online consultation at Cured Pharmacy, the prescriber will ask about your current blood pressure control, any symptoms of low blood pressure (such as dizziness or fainting), and your full list of medicines. They will want to know the dose of lercanidipine you take, how long you have been on it, and whether your blood pressure is stable. If you have recently started lercanidipine or your dose has been increased, the prescriber may advise waiting until your blood pressure is stable before starting tadalafil.

The prescriber will also check for other cardiovascular risk factors, such as a history of heart attack, stroke, angina, or heart failure, because sexual activity itself places extra demand on the heart [2]. If you have unstable angina, very low blood pressure, or severe heart failure, tadalafil may not be suitable. The prescriber may recommend starting with a lower dose (such as tadalafil 10mg on-demand or 2.5mg daily) to minimise the risk of blood pressure dropping too much [4].

Why Your Blood Pressure History Matters

Men with well-controlled blood pressure on lercanidipine are generally good candidates for tadalafil, but those with poorly controlled or very low blood pressure may need further assessment by their GP or cardiologist before starting ED treatment. If your systolic blood pressure (the top number) is regularly below 90 mmHg, or if you experience frequent dizziness, the prescriber may advise against tadalafil or suggest a different approach to managing your ED.

Practical Advice for Taking Tadalafil and Lercanidipine Safely

If you are prescribed tadalafil while taking lercanidipine, there are several practical steps you can take to reduce the risk of side effects. First, avoid taking both medicines at exactly the same time of day. For example, if you take lercanidipine in the morning, consider taking on-demand tadalafil in the evening (at least 30 minutes before sexual activity). This spacing can help reduce the peak blood-pressure-lowering effect.

Stand up slowly from sitting or lying positions, especially in the first few hours after taking tadalafil, to avoid dizziness or light-headedness. Avoid drinking large amounts of alcohol, as alcohol can lower blood pressure further and make ED worse [1]. Grapefruit juice can increase tadalafil levels in the blood, so it is best to avoid it while using this medicine. If you experience persistent dizziness, fainting, or a rapid heartbeat, contact your GP or pharmacist for advice.

Do not stop or change the dose of lercanidipine without speaking to your doctor, even if you feel well. High blood pressure often has no symptoms, and stopping your blood pressure medicine can increase your risk of stroke or heart attack. If you have any concerns about how your medicines are working together, your GP or pharmacist can review your treatment and adjust doses if needed.

Warning Signs and When to Seek Urgent Help

Most men tolerate tadalafil and lercanidipine together without serious problems, but you should be aware of warning signs that need urgent medical attention. If you develop chest pain or discomfort during or after sexual activity, stop what you are doing and seek immediate medical help—call 999 or go to A&E. Do not take any nitrate medicines (such as GTN spray) if you have used tadalafil in the past 48 hours, as this combination can cause a dangerous drop in blood pressure [3][4].

If you experience an erection lasting more than four hours (priapism), seek emergency help immediately, as this can cause permanent damage to the penis. 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 urgent medical assessment [4]. If you feel severely dizzy, faint, or experience a very rapid or irregular heartbeat, contact your GP or call 111 for advice.

What to Do If You Feel Dizzy or Faint

Mild dizziness when standing up is not uncommon when taking tadalafil and lercanidipine together, and it usually settles within a few minutes. Sit or lie down until the feeling passes, and drink some water. If dizziness is frequent, severe, or accompanied by chest pain, shortness of breath, or fainting, contact your GP the same day. Your doctor may need to adjust the dose of one or both medicines, or check your blood pressure more closely.

When to get urgent help

• Chest pain or discomfort during or after sexual activity—call 999 immediately
• Erection lasting more than 4 hours (priapism)—go to A&E straight away
• Sudden loss of vision or hearing—seek urgent medical assessment
• Severe dizziness, fainting, or very rapid heartbeat—contact your GP or call 111
• Do not take nitrates (GTN spray) if you have used tadalafil in the past 48 hours

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