Tadalafil and Leuprorelin: Can They Be Taken Together?
Learn how these medicines interact and what your prescriber checks before approving tadalafil.
Takes less than 2 minutes to complete 100% online
ED Treatments We Offer
Pricing Disclaimer: Prices on some pages may not be up to date — the live pricing table below and pricing shown during consultation are official current prices and take precedence over any other figures on the site.
Tadalafil and Leuprorelin: Understanding the Interaction
Published: 22 October 2026
Many men prescribed leuprorelin for prostate cancer or other hormone-related conditions wonder whether they can safely use tadalafil and leuprorelin together to manage erectile dysfunction. The good news is that no major direct interaction between these two medicines is commonly reported, and they can often be used together under medical supervision. However, because leuprorelin itself can cause or worsen erectile dysfunction as a side effect, and because both medicines require careful prescribing, it's essential that your doctor or prescriber knows about all your current treatments before starting tadalafil.
At a glance
What is tadalafil and leuprorelin used for?
Tadalafil is a prescription medicine used to treat erectile dysfunction (ED) in men. 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 available as on-demand tablets (typically 10mg or 20mg taken at least 30 minutes before sex, with effects lasting up to 36 hours) or as a daily low-dose tablet (2.5mg or 5mg) for men who prefer spontaneity. It is the generic version of Cialis and is also sold under brand names such as Avarante.
Leuprorelin (also known as leuprolide) is a hormone therapy medicine used primarily to treat prostate cancer, endometriosis, uterine fibroids, and certain other hormone-sensitive conditions [12]. It works by reducing the production of testosterone (in men) or oestrogen (in women). In prostate cancer, lowering testosterone can slow the growth of cancer cells. Leuprorelin is usually given as an injection (depot) every few weeks or months. Because testosterone plays an important role in sexual function, one of the most common side effects of leuprorelin in men is erectile dysfunction or reduced libido.
Do tadalafil and leuprorelin interact with each other?
There is no known direct pharmacological interaction between tadalafil and leuprorelin. This means that the two medicines do not interfere with each other's breakdown in the body, and taking them together does not usually increase the risk of side effects from either drug. Many men on leuprorelin therapy are prescribed tadalafil or other PDE5 inhibitors to help manage the erectile dysfunction caused by low testosterone levels.
However, it is important to understand that leuprorelin itself is a common cause of erectile dysfunction. By suppressing testosterone production, leuprorelin reduces the hormonal drive for erections and can make it harder to achieve or maintain an erection even with the help of tadalafil [1][2]. PDE5 inhibitors like tadalafil work by improving blood flow to the penis, but they cannot fully replace the role of testosterone in sexual desire and function. Some men find that tadalafil helps to some extent, while others may need additional support or alternative treatments.
Your prescriber will review your full medical history, including your cancer treatment plan, current testosterone levels, and any other medicines you are taking, before deciding whether tadalafil is suitable and likely to be effective for you. It is essential that you declare all your current medicines, including leuprorelin, during your online consultation at Cured Pharmacy or when seeing your GP.
Why erectile dysfunction happens with leuprorelin
Leuprorelin lowers testosterone to very low levels, which is the intended effect for treating prostate cancer. Unfortunately, testosterone is crucial for libido, erectile function, and overall sexual health. Without adequate testosterone, many men experience reduced sexual desire, difficulty achieving erections, and changes in mood or energy. Tadalafil can help improve the physical ability to get an erection by enhancing blood flow, but it does not restore testosterone levels or sexual desire. Some men on long-term hormone therapy may benefit from a combination of treatments, and your specialist or GP can discuss all the options with you.
What does your prescriber check before prescribing tadalafil and leuprorelin together?
When you request tadalafil through Cured Pharmacy's online consultation, the prescriber will ask about all your current medicines, including leuprorelin, and any other health conditions. They will check that tadalafil is safe for you and that there are no contraindications. Key checks include your cardiovascular health (heart and blood pressure), whether you take any nitrate medicines (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers', as these must never be combined with tadalafil due to the risk of a dangerous drop in blood pressure [3][4].
Your prescriber will also ask about other blood pressure medicines, alpha-blockers (such as tamsulosin or doxazosin, often used for prostate symptoms), and any medicines that affect how tadalafil is broken down in the body, such as certain antibiotics, antifungals, or HIV medicines. If you are on an alpha-blocker, you should be stable on that treatment before starting tadalafil, and you will usually be started on the lowest dose of the PDE5 inhibitor to minimise the risk of dizziness or low blood pressure.
Because you are being treated for a serious condition such as prostate cancer, your prescriber may also liaise with your oncologist or urologist to ensure that tadalafil is appropriate and will not interfere with your cancer treatment. It is important to be open and honest about your diagnosis, treatment plan, and any symptoms you are experiencing.
What you need to know
- No major direct interaction exists between tadalafil and leuprorelin; they can often be used together safely.
- Leuprorelin lowers testosterone, which can cause erectile dysfunction and reduce tadalafil's effectiveness.
- Never take tadalafil with nitrates, nicorandil, riociguat, poppers, or another PDE5 inhibitor.
- Your prescriber reviews all your medicines and health conditions before approving tadalafil.
- If tadalafil doesn't work, other treatments and support are available—speak to your healthcare team.
Practical advice for taking tadalafil while on leuprorelin
If your prescriber approves tadalafil, you can take it as directed, usually at least 30 minutes before sexual activity if using the on-demand dose, or once daily at the same time each day if using the low-dose daily option. Tadalafil requires sexual stimulation to work; it will not cause an automatic erection. Because leuprorelin lowers your testosterone, you may find that your libido is reduced, and tadalafil may be less effective than it would be in men with normal testosterone levels. Managing expectations is important, and some men find that combining tadalafil with psychological support, lifestyle changes, or other treatments can improve outcomes [2][8].
Avoid drinking large amounts of alcohol, as this can make erectile dysfunction worse and increase the risk of dizziness or low blood pressure when combined with tadalafil. Grapefruit juice can raise tadalafil levels in the blood and should be avoided. Do not take tadalafil more often than prescribed, and never combine it with another PDE5 inhibitor (such as sildenafil or vardenafil) or with nitrate medicines, nicorandil, riociguat, or poppers.
Keep all your healthcare providers informed. If you experience any new symptoms, side effects, or changes in your health, contact your GP, oncologist, or the Cured Pharmacy team. Common side effects of tadalafil include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion; these are usually mild and temporary [4]. If you develop chest pain during sex, an erection lasting more than four hours, or sudden loss of vision or hearing, seek urgent medical help.
When tadalafil may not be suitable
Tadalafil is not suitable for everyone. It should not be used if you have been advised that sexual activity is inadvisable (for example, if you have had a recent heart attack or stroke, unstable angina, or severe heart failure), if you have very low blood pressure, or if you have a history of non-arteritic anterior ischaemic optic neuropathy (NAION), a rare cause of sudden vision loss [4]. Your prescriber will assess your individual circumstances and may recommend alternative treatments if tadalafil is not appropriate for you.
Other medicines and treatments for erectile dysfunction on leuprorelin
If tadalafil alone is not effective, or if you cannot take it, there are other options. Sildenafil (Viagra), vardenafil (Levitra), and avanafil (Spedra) are other PDE5 inhibitors that work in a similar way to tadalafil and may be tried [3][5][6]. However, because the underlying cause of your ED is low testosterone from leuprorelin, all PDE5 inhibitors may have limited effectiveness. Some men benefit from a vacuum erection device, which uses a pump to draw blood into the penis, or from alprostadil, a medicine that can be applied as a cream (Vitaros) or given as an injection (Caverject) directly into the penis [7].
In some cases, your oncologist may consider intermittent hormone therapy (taking breaks from leuprorelin) to allow testosterone levels to recover partially, which can improve sexual function. This approach is not suitable for everyone and depends on your cancer type, stage, and treatment goals. Psychological support, such as counselling or sex therapy, can also be very helpful, especially if anxiety, depression, or relationship issues are contributing to erectile difficulties [1][2].
Always discuss your options with your healthcare team. Erectile dysfunction is a common and distressing side effect of prostate cancer treatment, and you deserve support and effective management. Do not stop or change any prescribed medicine, including leuprorelin, without advice from your specialist.
When to get urgent help
- Erection lasting more than 4 hours (priapism)—go to A&E immediately
- Sudden loss of vision or hearing—seek urgent medical attention
- Chest pain during or after sex—call 999 or go to A&E
- Severe dizziness, fainting, or very low blood pressure—seek same-day GP or A&E advice
- Allergic reaction (rash, swelling, difficulty breathing)—call 999
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
How to access tadalafil safely through Cured Pharmacy
Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering a confidential, UK-based prescribing service for erectile dysfunction treatments. To request tadalafil, you will complete a short online consultation that asks about your medical history, current medicines (including leuprorelin), and any health conditions. A UK-registered prescriber will review your answers and, if appropriate, approve your prescription. Your medicine is then dispensed by our pharmacy team and delivered discreetly to your door.
We offer a range of tadalafil options, including generic tadalafil tablets and branded Cialis, at transparent prices. For example, generic tadalafil starts from £7.95 for a supply, or £6.36 for your first order with code Ednew. Tadalafil 20mg (Teva) is available at £9.99 (£7.99 with Ednew), and Avarante (tadalafil) 10mg costs £11.49 (£9.19 with Ednew). Branded Cialis is priced at £12.00 (£9.60 with Ednew). All prices include the prescriber review and delivery.
If tadalafil is not suitable, we also offer sildenafil (from £0.45, or £0.36 with Ednew), vardenafil (£16.95, or £13.56 with Ednew), and Spedra (avanafil) (£20.95, or £16.76 with Ednew). Our prescribers will recommend the most appropriate treatment based on your individual circumstances. If you have any questions or concerns, our pharmacy team is here to help.
Why see your GP about new erectile dysfunction
If you are experiencing erectile dysfunction for the first time, or if it is getting worse, it is important to see your GP. ED can be an early warning sign of underlying health problems such as heart disease, diabetes, or high blood pressure [1][10]. Your GP can arrange tests, review your medicines, and refer you to a specialist if needed. If you are already under the care of an oncologist or urologist for prostate cancer, they can also advise on the best approach to managing ED alongside your cancer treatment.
Declare all your medicines
Always tell your prescriber about leuprorelin and any other treatments you are taking, including over-the-counter medicines and supplements. This ensures tadalafil is safe and appropriate for you.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 22 October 2026]
- National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 22 October 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 22 October 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 22 October 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 22 October 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 22 October 2026]
- Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 22 October 2026]
- European Association of Urology. (n.d.). EAU Guidelines on Sexual and Reproductive Health. https://uroweb.org/guidelines/sexual-and-reproductive-health [accessed 22 October 2026]
- Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54–61. https://pubmed.ncbi.nlm.nih.gov/8254833/ [accessed 22 October 2026]
- Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 22 October 2026]
Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.
Trusted by thousands
Real people, real results
“Fabulous service and quick delivery”
“Felt the effects of these after about 5 days. Erections are better and can get aroused and ready easier”
“Excellent value and brilliant customer service”
“I received excellent service and everything went well. The order arrived quickly and in perfect condition. It's working very well! Thank you to the whole team for the great work!”
“Delivery was good, the product lived up to expectations.”
How Our Online Service Works
Choose your treatment
Select from our recommended UK-licensed medications.
Answer quick questions
Select safe UK treatments. Quick answers.
Get it delivered fast
We will deliver direct to you as quickly as tomorrow.
Get Discreet ED Treatment Online
Reviewed by UK-based prescribers · Takes under 3 minutes · Discreet Packaging
Your Questions Answered
Can I take tadalafil if I'm on leuprorelin for prostate cancer?
Yes, there is no direct interaction between tadalafil and leuprorelin, and they can often be used together. However, leuprorelin lowers testosterone, which can cause erectile dysfunction, so tadalafil may be less effective than in men with normal testosterone levels. Your prescriber will assess your individual situation.
Will tadalafil work if my testosterone is low from leuprorelin?
Tadalafil can help improve blood flow to the penis, but it cannot replace the role of testosterone in sexual desire and function. Some men find it helpful, while others may need additional treatments. Managing expectations and discussing all options with your healthcare team is important.
Do I need to tell my oncologist if I start taking tadalafil?
Yes, it is good practice to inform your oncologist or specialist about any new medicines, including tadalafil. They can ensure it fits safely with your overall treatment plan and advise on the best approach to managing erectile dysfunction during cancer treatment.
Are there any medicines I must not take with tadalafil?
Yes. Do not take tadalafil with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, poppers (amyl/alkyl nitrites), or another PDE5 inhibitor. These combinations can cause a dangerous drop in blood pressure. Always declare all your medicines during your consultation.
What are the common side effects of tadalafil?
Common side effects include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion. These are usually mild and temporary. If you experience chest pain during sex, an erection lasting more than four hours, or sudden vision or hearing loss, seek urgent medical help.
Can I take tadalafil every day while on leuprorelin?
Yes, tadalafil is available as a daily low-dose tablet (2.5mg or 5mg) for men who prefer spontaneity. Your prescriber will advise on the best dosing schedule for you, taking into account your leuprorelin treatment and overall health.
What if tadalafil doesn't work for me?
If tadalafil is not effective, other options include different PDE5 inhibitors (sildenafil, vardenafil, avanafil), vacuum devices, alprostadil cream or injections, or psychological support. Speak to your GP or specialist about alternative treatments and whether adjustments to your hormone therapy might help.
How do I order tadalafil from Cured Pharmacy?
Complete a short online consultation on our website. A UK-registered prescriber will review your answers and, if appropriate, approve your prescription. Your medicine is then dispensed and delivered discreetly to your door. All consultations are confidential and reviewed by qualified healthcare professionals.
Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)