Tadalafil and Metoclopramide: Can You Take Them Together?

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Tadalafil and Metoclopramide: Understanding the Interaction

Published: 23 October 2026

Many men taking tadalafil and metoclopramide together wonder whether these medicines are safe to combine. The good news is that no major direct interaction between tadalafil (used for erectile dysfunction) and metoclopramide (used for nausea and digestive problems) is commonly reported in clinical practice. However, every medicine you take matters when starting ED treatment, and your prescriber will check your full medication list during your consultation to ensure tadalafil is suitable for you.

What is tadalafil and how does it work?

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 the branded medicine Cialis or as a generic version. It comes in two forms: on-demand tablets (10mg or 20mg taken at least 30 minutes before sexual activity, with effects lasting up to 36 hours) and daily tablets (2.5mg or 5mg taken once a day) [4]. Unlike some other ED treatments, tadalafil's long duration of action means you don't need to time it as precisely before sex.

It's important to understand that tadalafil only works when you are sexually stimulated—it does not cause an automatic erection. The medicine needs to be prescribed after a consultation with a UK-registered prescriber, who will check your medical history, current medicines, and whether tadalafil is safe and suitable for you [2].

What is metoclopramide and why is it prescribed?

Metoclopramide is a prescription medicine commonly used to treat nausea and vomiting, particularly when caused by migraines, chemotherapy, or after surgery. It also helps with symptoms of gastroparesis (delayed stomach emptying) and gastro-oesophageal reflux disease (GORD) in some cases.

Metoclopramide works by blocking dopamine receptors in the brain and gut, which helps to reduce feelings of sickness and speeds up the movement of food through the stomach. It is usually taken as a 10mg tablet up to three times a day, though it is typically prescribed for short-term use (usually no longer than five days) due to the risk of side effects with prolonged use.

Common side effects of metoclopramide include drowsiness, diarrhoea, and feeling tired. Rarely, it can cause movement disorders (such as uncontrolled muscle spasms or tremors), particularly in young adults and with longer-term use. Because metoclopramide affects dopamine, it is not suitable for everyone, and your doctor will consider your full medical history before prescribing it.

How metoclopramide affects the body

Metoclopramide primarily acts on the digestive system and the part of the brain that controls nausea. It does not directly affect blood pressure or the cardiovascular system in the same way that some other medicines do. This is one reason why it does not have a known major interaction with tadalafil, which works mainly on blood vessels.

Do tadalafil and metoclopramide interact with each other?

There is no commonly reported major interaction between tadalafil and metoclopramide. These two medicines work through different mechanisms in the body: tadalafil affects blood flow to the penis by inhibiting the PDE5 enzyme, while metoclopramide acts on dopamine receptors in the gut and brain to control nausea and stomach emptying.

Because they do not share the same metabolic pathways or have overlapping effects on blood pressure or heart function, taking tadalafil and metoclopramide together is not expected to cause significant problems for most men. However, this does not mean the combination is automatically safe for everyone—individual health conditions, other medicines you take, and your overall medical history all play a role.

Your prescriber will review your complete medication list during your online consultation, including metoclopramide and any other prescription or over-the-counter medicines, supplements, or herbal remedies you use. This careful check ensures that tadalafil is appropriate for you and that no hidden risks exist based on your unique circumstances [2][4].

Why your full medication list matters

Even when two medicines do not interact directly, the bigger picture matters. For example, if you are taking metoclopramide for a condition that affects your heart or digestive system, your prescriber needs to know about it. Some underlying health conditions may make ED treatment less suitable, regardless of the specific medicines involved.

What does your prescriber check before approving tadalafil?

When you request tadalafil through an online consultation at Cured Pharmacy, a UK-registered prescriber will review your medical questionnaire carefully. They will check for any medicines or health conditions that could make tadalafil unsafe or less effective [2][4].

The prescriber will specifically look for medicines that must never be taken with tadalafil, including nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, and amyl or alkyl nitrites (poppers). Combining tadalafil with any of these can cause a dangerous drop in blood pressure [3][4]. They will also check for alpha-blockers (such as tamsulosin or doxazosin), which can increase the risk of dizziness or low blood pressure when taken with tadalafil.

Other important checks include medicines that affect how tadalafil is broken down in the body, such as potent CYP3A4 inhibitors (for example, ritonavir, ketoconazole, or clarithromycin), which can raise tadalafil levels and require dose adjustments [4]. Your prescriber will also ask about your heart health, blood pressure, and any history of stroke, severe liver or kidney problems, or eye conditions such as non-arteritic anterior ischaemic optic neuropathy (NAION). If you are taking metoclopramide, the prescriber will note it and consider whether the reason you need it affects your suitability for ED treatment.

Practical advice for taking tadalafil safely with other medicines

If you are prescribed tadalafil while taking metoclopramide, follow the dosing instructions for both medicines exactly as directed. Take tadalafil on-demand tablets at least 30 minutes before sexual activity (effects can last up to 36 hours), or take daily tadalafil at the same time each day [4]. Take metoclopramide as prescribed by your doctor, usually before meals and at bedtime if needed.

Avoid drinking large amounts of alcohol when taking tadalafil, as alcohol can worsen erectile dysfunction and increase the risk of dizziness or low blood pressure. Grapefruit juice can raise tadalafil levels in your blood, so it is best to avoid it while using this medicine [4]. If you feel dizzy or light-headed after taking tadalafil, sit or lie down until the feeling passes, and avoid driving or operating machinery.

Do not take tadalafil more often than once a day if you are using on-demand tablets, and never take more than one PDE5 inhibitor at the same time. If you experience side effects such as headache, indigestion, back pain, or a blocked nose, these are usually mild and temporary. However, 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 immediately [4].

When to speak to your doctor or pharmacist

If you start a new medicine while taking tadalafil, or if your doctor changes the dose of metoclopramide or any other medicine, let your prescriber or pharmacist know. Do not stop taking any prescribed medicine without medical advice, even if you are concerned about interactions—your healthcare team can help you find the safest solution.

Getting tadalafil through Cured Pharmacy: how it works

Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering convenient access to erectile dysfunction treatments, including tadalafil, after a clinical consultation. You start by completing a confidential online questionnaire about your health, current medicines (including metoclopramide), and any medical conditions. A UK-registered prescriber reviews your answers to ensure tadalafil is safe and appropriate for you.

If approved, your medicine is dispensed by our pharmacy team and delivered discreetly to your door. Tadalafil (generic Cialis) is available from £7.95, or £6.36 for first orders using code Ednew. We also offer branded Cialis from £12.00 (£9.60 with code Ednew), Tadalafil 20mg (Teva) from £9.99 (£7.99 with code Ednew), and Avarante (tadalafil) 10mg from £11.49 (£9.19 with code Ednew). Other ED treatments such as sildenafil, vardenafil, and avanafil are also available after consultation.

If you have not seen a GP about your erectile dysfunction yet, we encourage you to do so. ED can be an early warning sign of underlying health conditions such as heart disease or diabetes, and your GP can arrange tests and address any contributing factors [1][2]. Our service is designed to complement NHS care, offering a convenient option for men who have already discussed ED with their doctor or who need ongoing treatment.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 23 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 23 October 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 23 October 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 23 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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