Tadalafil and Pregabalin: Can You Take Them Together?
Learn how these medicines interact and what your prescriber checks during your UK consultation.
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Tadalafil and Pregabalin: Understanding the Interaction
Published: 24 October 2026
Many men prescribed pregabalin for nerve pain or anxiety wonder whether they can safely take tadalafil and pregabalin together for erectile dysfunction. The good news is that no major direct interaction between these two medicines is commonly reported in clinical practice. However, both medicines can cause dizziness and affect blood pressure, so your prescriber will carefully review your individual circumstances during an online consultation to ensure the combination is appropriate for you.
Always declare pregabalin
List pregabalin and every other medicine you take on your online consultation form. This allows the prescriber to check for interactions and start you on the safest dose of tadalafil for your individual circumstances.
What is tadalafil and pregabalin used for?
Tadalafil is a PDE5 inhibitor licensed in the UK to treat erectile dysfunction (ED). It works by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused [4]. Tadalafil is available as on-demand tablets (10mg or 20mg taken at least 30 minutes before sex, with effects lasting up to 36 hours) or as a daily low-dose option (2.5mg or 5mg). It requires sexual stimulation to work and does not increase desire on its own.
Pregabalin (commonly known by the brand name Lyrica) is a prescription medicine used to treat nerve pain (neuropathic pain), generalised anxiety disorder, and epilepsy [12]. It works by calming overactive nerve signals in the brain and spinal cord. Pregabalin is usually taken two or three times daily, and the dose is tailored to your condition and response.
Both medicines are prescription-only in the UK, meaning a healthcare professional must assess your suitability before you can obtain them. At Cured Pharmacy, our UK-registered prescribers review every online consultation to ensure any combination of medicines is safe and appropriate for you.
How do tadalafil and pregabalin interact?
There is no known direct pharmacological interaction between tadalafil and pregabalin—they work on different systems in the body and are not reported to interfere with each other's effectiveness [3][4][12]. Tadalafil acts on blood vessels, while pregabalin acts on nerve signals. This means one medicine does not typically alter the blood levels or action of the other.
However, both medicines can independently cause side effects that may overlap. Tadalafil can lower blood pressure slightly and may cause dizziness, headache, or flushing [4]. Pregabalin commonly causes dizziness, drowsiness, and can occasionally affect blood pressure [12]. When taken together, these effects might add up, potentially making you feel more dizzy or lightheaded, especially when standing up quickly.
For most men, this combination is manageable and does not cause problems, but it is important that your prescriber knows about all your current medicines. During your consultation, the prescriber will check your full medication list, your medical history, and any other conditions to ensure tadalafil is safe alongside your pregabalin.
When to get urgent help
- Chest pain or discomfort during sexual activity—stop and seek emergency help; do not take nitrates
- Erection lasting more than 4 hours (priapism)—go to A&E or call 999 immediately
- Sudden loss of vision in one or both eyes—stop tadalafil and seek urgent medical advice
- Sudden decrease or loss of hearing, sometimes with ringing or dizziness—stop and contact a doctor urgently
- Severe dizziness, fainting, or signs of allergic reaction (swelling, difficulty breathing)—call 999 or go to A&E
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
What does your prescriber check before approving tadalafil and pregabalin together?
When you request tadalafil through Cured Pharmacy's online consultation, our UK-registered prescribers review several key factors to ensure the combination with pregabalin is safe for you. They will ask about your current dose of pregabalin, how long you have been taking it, and whether you experience any side effects such as dizziness or drowsiness.
The prescriber will also check for any other medicines you take, particularly those that can interact dangerously with tadalafil. These include nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, and recreational drugs known as 'poppers' (amyl or alkyl nitrites)—you must never take tadalafil with any of these, as the combination can cause a dangerous drop in blood pressure [4]. Alpha-blockers (like tamsulosin or doxazosin) and potent CYP3A4 inhibitors (such as ritonavir, ketoconazole, or clarithromycin) also require careful dose adjustments.
Your medical history is equally important. Tadalafil is not suitable if you have had a recent heart attack or stroke, unstable angina, severe heart failure, very low blood pressure, or previous sudden vision loss (NAION) [2][4]. The prescriber will also consider whether sexual activity is safe for you. If approved, you will usually start on the lowest effective dose of tadalafil to minimise any risk of side effects.
Why your full medication list matters
Even if you only take pregabalin and tadalafil, it is essential to declare every medicine, supplement, or herbal remedy you use. Some over-the-counter products (such as St John's wort) can reduce the effectiveness of tadalafil, while others might increase side effects. The online consultation form at Cured Pharmacy asks for this information to ensure your safety, and our prescribers are trained to spot potential issues that you might not be aware of.
Practical advice for taking tadalafil and pregabalin safely
If your prescriber approves tadalafil alongside pregabalin, there are several practical steps you can take to use both medicines safely. First, take each medicine exactly as prescribed—do not adjust the dose or timing without consulting your prescriber or pharmacist. For on-demand tadalafil, take your tablet at least 30 minutes before sexual activity (effects can last up to 36 hours), and remember that sexual stimulation is needed for it to work [4].
Be mindful of dizziness, especially when you first start tadalafil or if your pregabalin dose has recently changed. Stand up slowly from sitting or lying down, and avoid driving or operating machinery if you feel drowsy or lightheaded. Limit alcohol intake, as heavy drinking can worsen erectile dysfunction and add to the blood-pressure-lowering effects of both medicines [1][4].
Avoid grapefruit juice while taking tadalafil, as it can raise the level of the medicine in your blood and increase the risk of side effects [4]. If you experience any new or worsening symptoms—such as severe dizziness, fainting, chest pain during sex, or an erection lasting more than four hours—seek medical help immediately. Never take another PDE5 inhibitor (such as sildenafil or vardenafil) at the same time as tadalafil.
What to do if you feel dizzy
If you feel dizzy after taking tadalafil and pregabalin together, sit or lie down until the feeling passes. Drink water and avoid sudden movements. If dizziness is persistent or severe, contact your GP or pharmacist for advice—your prescriber may need to review your doses or suggest an alternative approach to managing your erectile dysfunction.
At a glance
Warning signs and when to seek urgent help with tadalafil and pregabalin
Most men tolerate tadalafil and pregabalin together without serious problems, but it is important to recognise warning signs that need urgent medical attention. If you develop chest pain or discomfort during sexual activity, stop immediately and seek emergency help—do not take any nitrate medicine (such as GTN spray) if you have used tadalafil within the last 48 hours, as this combination can be life-threatening [4].
An erection lasting more than four hours (priapism) is a medical emergency that requires immediate treatment to prevent permanent damage to the penis [4]. Go to A&E or call 999 if this occurs. 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—stop taking tadalafil and seek urgent medical advice [4].
Severe dizziness, fainting, or signs of an allergic reaction (such as swelling of the face, lips, or throat, or difficulty breathing) also require immediate medical help. If you are unsure whether a symptom is serious, contact NHS 111 for advice or speak to your GP or pharmacist as soon as possible.
Other erectile dysfunction treatments and pregabalin interactions
If tadalafil is not suitable for you, or if you prefer a different option, several other PDE5 inhibitors are available in the UK. Sildenafil (generic Viagra) is taken about one hour before sex and works for up to four hours [3]. Vardenafil (generic Levitra) is taken 25–60 minutes before sex [5], and avanafil (Spedra) has a faster onset, working in as little as 15–30 minutes [6]. All of these medicines work in a similar way to tadalafil and have the same general interaction profile with pregabalin—no major direct interaction is commonly reported, but the same precautions about dizziness and blood pressure apply.
Your prescriber will help you choose the most appropriate ED treatment based on your lifestyle, medical history, and current medicines. For example, if you prefer a medicine with a shorter duration of action, sildenafil or avanafil might be better options than tadalafil. If you take other medicines that interact with PDE5 inhibitors (such as potent CYP3A4 inhibitors), your prescriber may need to adjust the dose or recommend an alternative.
Non-tablet options are also available for men who cannot take PDE5 inhibitors. Alprostadil cream (Vitaros) and alprostadil injection (Caverject) are prescription treatments that work locally on the penis [7]. Eroxon is a topical gel medical device available without prescription. If you have new or worsening erectile dysfunction, it is important to see your GP, as ED can be an early sign of underlying health conditions such as heart disease or diabetes [1][2].
Switching between ED treatments
If you are already taking pregabalin and wish to try a different ED medicine, do not take more than one PDE5 inhibitor in the same 24-hour period. For example, do not take sildenafil if you have already taken tadalafil that day. Always wait for the previous dose to clear your system, and follow your prescriber's instructions. If you are unsure, contact Cured Pharmacy or your GP for advice before making any changes.
In summary
- No major direct interaction between tadalafil and pregabalin is commonly reported in clinical practice.
- Both medicines can cause dizziness, so your prescriber reviews your full history before approval.
- Never take tadalafil with nitrates, nicorandil, riociguat, or poppers—this is dangerous.
- Declare all medicines during your online consultation to ensure tadalafil is safe for you.
- Seek urgent help for chest pain during sex, erection lasting over 4 hours, or sudden vision loss.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 24 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 24 October 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 24 October 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 24 October 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 24 October 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 24 October 2026]
- Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 24 October 2026]
- Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 24 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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Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)