Tadalafil and Linagliptin: Can You Take Them Together?

Tadalafil and Linagliptin: Understanding the Interaction

Published: 22 October 2026

Tadalafil and linagliptin are commonly prescribed together, and no major interaction between these two medicines is reported in clinical practice. Tadalafil is a PDE5 inhibitor used to treat erectile dysfunction (ED), while linagliptin is a DPP-4 inhibitor used to manage type 2 diabetes. Because diabetes is a common cause of ED, many men take both medicines at the same time. This page explains what each medicine does, how they work in the body, what your prescriber will check, and practical advice for using them safely together.

What is tadalafil and how does it work?

Tadalafil is a prescription medicine licensed in the UK to treat erectile dysfunction. It belongs to a group of medicines called PDE5 inhibitors, which work by relaxing blood vessels in the penis, allowing more blood to flow in when you are sexually aroused [3][4]. Tadalafil does not cause an erection on its own—sexual stimulation is still needed for it to work.

Tadalafil is available in two forms: on-demand tablets (usually 10 mg or 20 mg taken at least 30 minutes before sex, with effects lasting up to 36 hours) and daily tablets (2.5 mg or 5 mg taken once a day) [4]. The branded version is called Cialis, but generic tadalafil is widely available and works in exactly the same way. At Cured Pharmacy, generic tadalafil is available from £7.95 after an online consultation with a UK prescriber.

Common side effects of tadalafil include headache, indigestion, back pain, muscle aches, flushing, and a blocked or runny nose [4]. These are usually mild and short-lived. Tadalafil must not be taken with nitrates (such as GTN spray), nicorandil, riociguat, or recreational drugs called poppers, because the combination can cause a dangerous drop in blood pressure [3][4].

What is linagliptin and how does it work?

Linagliptin is a prescription medicine used to treat type 2 diabetes. It belongs to a class of medicines called DPP-4 inhibitors (also known as gliptins), which help to control blood sugar levels by increasing the release of insulin after meals and reducing the amount of glucose produced by the liver. Linagliptin is usually taken once a day, with or without food, and is often prescribed alongside other diabetes medicines or on its own.

Unlike some diabetes medicines, linagliptin does not usually cause low blood sugar (hypoglycaemia) when used alone, although the risk increases if it is combined with insulin or sulphonylureas such as gliclazide. Common side effects of linagliptin include inflammation of the nose or throat (nasopharyngitis) and cough. Rarely, it can cause pancreatitis (inflammation of the pancreas), so you should seek medical advice if you develop severe, persistent stomach pain.

Linagliptin is processed differently in the body compared to many other medicines. Most of it is removed unchanged through the gut rather than being broken down by liver enzymes, which means it has fewer drug interactions than some other diabetes treatments. This is one reason why it can often be used safely alongside other medicines, including tadalafil.

Can you take tadalafil and linagliptin together?

Yes, tadalafil and linagliptin can usually be taken together. No significant interaction between these two medicines is commonly reported, and they work on completely different systems in the body. Tadalafil acts on blood vessels in the penis to help achieve an erection, while linagliptin works on hormones that control blood sugar levels. Because linagliptin is not broken down by the same liver enzymes (CYP3A4) that process tadalafil, it does not affect how much tadalafil stays in your system or how long it works.

Many men with type 2 diabetes experience erectile dysfunction, so it is quite common for doctors to prescribe both medicines at the same time [1][2]. Diabetes can damage blood vessels and nerves over time, which can make it harder to get or keep an erection. Treating diabetes well with medicines like linagliptin may help to protect your blood vessels, while tadalafil can help to manage the symptoms of ED.

However, every person's medical history is different, and your prescriber will still need to check all your current medicines, health conditions, and blood pressure before prescribing tadalafil. This is why an online consultation is required before you can be supplied with tadalafil from Cured Pharmacy. During the consultation, you will be asked about your diabetes, any other medicines you take, and whether you have any heart or blood pressure problems.

What your prescriber will check

Before prescribing tadalafil, your prescriber will review your full medical history and current medicines to make sure it is safe for you. They will check whether you take any medicines that must not be combined with tadalafil, such as nitrates, nicorandil, or riociguat [3][4]. They will also ask about your blood pressure, heart health, and whether you have had a recent heart attack, stroke, or problems with your vision.

If you take other blood-pressure-lowering medicines (such as amlodipine, ramipril, or an alpha-blocker like tamsulosin), your prescriber will consider whether tadalafil might add to the blood-pressure-lowering effect and cause dizziness. In most cases, this is manageable, but you may be advised to start on a lower dose of tadalafil. Your prescriber will also check that sexual activity is safe for you, as it does place extra demand on your heart.

Practical advice for taking tadalafil and linagliptin

If you are prescribed both tadalafil and linagliptin, you can take them at the same time of day or at different times—there is no need to separate the doses. Linagliptin is usually taken once a day at the same time each day, while on-demand tadalafil is taken only when you plan to have sex (at least 30 minutes before). If you are taking daily tadalafil (2.5 mg or 5 mg), you should take it at the same time every day, and you can take it alongside your linagliptin dose if that is more convenient.

Keep your diabetes well controlled. Good blood sugar control can help to protect your blood vessels and nerves, which may improve erectile function over time [1][2]. Continue to take your linagliptin and any other diabetes medicines exactly as prescribed, and attend your regular diabetes check-ups. If your blood sugar levels are poorly controlled, tadalafil may be less effective.

Avoid heavy alcohol when using tadalafil, as alcohol can make it harder to get an erection and can add to the blood-pressure-lowering effect of tadalafil, increasing the risk of dizziness or fainting. Grapefruit juice can raise tadalafil levels in the blood, so it is best to avoid large amounts. If you experience side effects such as severe headache, dizziness, or chest pain during sex, stop and seek medical advice.

Other diabetes medicines and tadalafil

Linagliptin is just one of many medicines used to treat type 2 diabetes, and you may be wondering whether other diabetes treatments can be taken with tadalafil. In general, most diabetes medicines do not interact directly with tadalafil. Metformin, the most commonly prescribed diabetes medicine, does not interact with tadalafil and the two can be taken together safely. The same applies to other DPP-4 inhibitors (such as sitagliptin, saxagliptin, and alogliptin), SGLT2 inhibitors (such as dapagliflozin, empagliflozin, and canagliflozin), and GLP-1 receptor agonists (such as semaglutide and liraglutide).

Sulphonylureas (such as gliclazide) and insulin do not interact with tadalafil either, but they can cause low blood sugar (hypoglycaemia), which may make you feel dizzy or unwell. If you experience symptoms of low blood sugar, treat it promptly and do not take tadalafil until you feel better. If you are on insulin or a sulphonylurea, make sure your diabetes is stable before starting ED treatment.

Your prescriber will always check your full list of medicines during the consultation, including all diabetes treatments, blood pressure medicines, and any over-the-counter or herbal products. Never stop or change a prescribed medicine without speaking to your doctor or pharmacist first.

Tadalafil and linagliptin: what the evidence shows

No major clinical studies have specifically looked at the combination of tadalafil and linagliptin, but both medicines have been used together in clinical practice for many years without reports of significant problems. Linagliptin's unique metabolism (it is not broken down by CYP3A4 enzymes) means it is unlikely to affect tadalafil levels in the blood. Tadalafil does not affect blood sugar control or interfere with how linagliptin works.

If you have any concerns about taking these medicines together, discuss them with your prescriber during your consultation. They can review your individual circumstances and provide personalised advice based on your medical history and current health.

When to seek medical help and warning signs

Most men can take tadalafil and linagliptin together without problems, but you should be aware of warning signs that need urgent medical attention. If you develop an erection that lasts longer than four hours (priapism), go to A&E immediately or call 999. Priapism is a medical emergency and can cause permanent damage to the penis if not treated quickly [3][4].

Seek urgent help if you experience sudden loss of vision in one or both eyes, as this may be a sign of a rare condition called non-arteritic anterior ischaemic optic neuropathy (NAION). Sudden loss of hearing or ringing in the ears also requires prompt medical assessment. If you develop chest pain during or after sex, stop and seek medical advice—do not take any nitrate medicines (such as GTN spray) if you have used tadalafil in the past 48 hours, as this can cause a dangerous drop in blood pressure.

If you experience severe stomach pain while taking linagliptin, contact your GP or call 111, as this could be a sign of pancreatitis. If you feel dizzy, faint, or unwell after taking tadalafil, sit or lie down until you feel better, and speak to your pharmacist or doctor before taking another dose. Always report any new or worsening symptoms to a healthcare professional.

How Cured Pharmacy can help

Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering discreet, convenient access to ED treatment after an online consultation with a UK prescriber. If you are taking linagliptin or any other diabetes medicine and would like to try tadalafil, you can complete a short medical questionnaire on our website. A UK prescriber will review your answers and, if appropriate, issue a prescription. Your medicine is then dispensed by our pharmacy team and delivered discreetly to your door.

We offer a range of ED treatments, including generic tadalafil from £7.95 (or £6.36 for your first order with code Ednew). Our team is here to answer any questions you have about your treatment, and you can contact us at any time for advice. If you have not seen a GP about your erectile dysfunction yet, we encourage you to do so, as ED can be an early warning sign of heart disease or poorly controlled diabetes [1][2].

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 22 October 2026]
2. 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]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 22 October 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [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.

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