Tadalafil and Rimegepant: 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 Rimegepant: Understanding the Interaction
Published: 25 October 2026
Many men who use tadalafil for erectile dysfunction also take rimegepant for migraine, and it's important to understand how tadalafil and rimegepant may interact. Rimegepant (brand name Vydura in the UK) is a CGRP receptor antagonist used to treat acute migraine attacks and prevent episodic migraine. Tadalafil is a PDE5 inhibitor that helps men achieve and maintain an erection when sexually stimulated. While no major direct interaction between these two medicines is commonly reported in clinical practice, your prescriber will carefully review both medications during your consultation to ensure the combination is appropriate for you.
Key takeaways
- Tadalafil and rimegepant can usually be taken together safely with prescriber approval
- Both are processed by the same liver enzyme but do not significantly affect each other
- Always declare all medicines during your consultation, including migraine treatments
- Do not take tadalafil with nitrates, nicorandil, riociguat, or poppers
- Contact your GP if you start a new medicine while taking tadalafil
What is tadalafil and how does it work?
Tadalafil is the generic name for Cialis, a prescription medicine used to treat erectile dysfunction in men. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. When you're sexually aroused, your body releases nitric oxide in the penis, which triggers a chain reaction that increases blood flow to the erectile tissue. Tadalafil works by blocking the PDE5 enzyme, which normally breaks down the chemical messenger (cGMP) responsible for relaxing the smooth muscle and allowing blood to flow into the penis [3][4].
Tadalafil is available in two main dosing schedules. The on-demand option (10mg or 20mg) is taken at least 30 minutes before sexual activity, and its effects can last up to 36 hours, earning it the nickname 'the weekend pill'. The daily option (2.5mg or 5mg) is taken once every day at the same time, allowing for spontaneity. Both require sexual stimulation to work—tadalafil does not cause an automatic erection [4]. At Cured Pharmacy, tadalafil is available only after an online consultation reviewed by a UK prescriber, who will check your medical history and current medications to ensure it's safe for you.
What is rimegepant and why is it prescribed?
Rimegepant is a relatively new migraine medicine licensed in the UK under the brand name Vydura. It belongs to a class of drugs called CGRP (calcitonin gene-related peptide) receptor antagonists. CGRP is a protein that plays a key role in migraine attacks by causing inflammation and dilating blood vessels around the brain. Rimegepant works by blocking the CGRP receptor, which helps to stop or prevent migraine headaches [12].
Rimegepant is used in two ways: as an acute treatment to relieve migraine symptoms when an attack starts (taken as a 75mg oral lyophilisate, a tablet that dissolves on the tongue), and as a preventive treatment to reduce the frequency of migraine attacks (taken every other day). It does not treat other types of headache and is only for migraine. Because rimegepant is processed in the body by liver enzymes, particularly CYP3A4, it can interact with other medicines that affect this enzyme system. Your prescriber will review all your medications, including any ED treatment, to check for potential interactions [12].
At a glance
How tadalafil and rimegepant may interact
Both tadalafil and rimegepant are metabolised (broken down) in the liver by the same enzyme system, CYP3A4. When two medicines share the same metabolic pathway, there is a theoretical possibility that one could affect the blood levels of the other. However, the interaction between tadalafil and rimegepant is not considered a major clinical concern in most cases. Rimegepant is a mild-to-moderate CYP3A4 substrate, and tadalafil is also processed by CYP3A4, but neither is a potent inhibitor or inducer of this enzyme at therapeutic doses [4][12].
In practice, this means that taking tadalafil and rimegepant together is not expected to cause a significant change in how either medicine works or a dangerous rise in side effects. There is no absolute contraindication to using them together, unlike the strict 'do not take together' warning that applies when tadalafil is combined with nitrates, nicorandil, riociguat, or poppers. That said, every person's medical history is unique, and your prescriber will assess your individual situation during the consultation. They will check for other medicines you're taking, any underlying health conditions, and whether the combination is appropriate for you. If you experience unusual symptoms after taking both medicines, contact your GP or pharmacist for advice.
What your prescriber checks
During your online consultation at Cured Pharmacy, the prescriber will ask about all your current medicines, including rimegepant and any other migraine treatments. They will review your full medication list to identify any medicines that could interact with tadalafil, such as nitrates, alpha-blockers, or potent CYP3A4 inhibitors. They will also check your cardiovascular health, blood pressure, and any history of heart disease, stroke, or liver problems. This comprehensive review ensures that tadalafil is safe and suitable for you, even if you're taking rimegepant or other medications. Always declare every medicine you take, including over-the-counter products, herbal remedies, and supplements, as these can sometimes interact with prescription treatments.
Practical advice for taking tadalafil and rimegepant safely
If your prescriber approves the combination, you can take tadalafil and rimegepant on the same day without needing to space them out by a specific number of hours. However, it's sensible to follow the dosing instructions for each medicine separately. For example, if you're using on-demand tadalafil (10mg or 20mg), take it at least 30 minutes before planned sexual activity. If you're taking daily tadalafil (2.5mg or 5mg), take it at the same time each day. For rimegepant, follow your prescriber's instructions—either as needed for an acute migraine attack or every other day for prevention [4][12].
Be aware of the side effects of each medicine. Common side effects of tadalafil include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion [4]. Rimegepant can cause nausea and, less commonly, allergic reactions [12]. If you notice an increase in side effects when taking both medicines together, or if you develop new symptoms such as dizziness, chest pain, or severe headache, stop taking the medicines and seek medical advice promptly. Do not drink excessive alcohol when using tadalafil, as this can worsen erectile dysfunction and increase the risk of low blood pressure and dizziness. Grapefruit juice should also be avoided, as it can raise the levels of both tadalafil and rimegepant in your blood.
When to seek further advice
If you start a new medicine for migraine or any other condition while you're taking tadalafil, inform your GP or pharmacist so they can check for interactions. Similarly, if your migraine treatment changes—for example, if you're prescribed a different CGRP antagonist or a potent CYP3A4 inhibitor such as ketoconazole or clarithromycin—your tadalafil dose may need to be adjusted. Never stop or change a prescribed medicine without professional advice. If you're unsure whether a new medicine is safe to take with tadalafil, contact Cured Pharmacy or your GP before starting it.
Declare all your medicines
During your online consultation, list every medicine you take—including rimegepant, over-the-counter painkillers, and herbal supplements. This ensures your prescriber can check for interactions and prescribe tadalafil safely.
Other medicines that interact with tadalafil
While tadalafil and rimegepant can usually be taken together, there are several other medicines that do interact significantly with tadalafil. Do not take tadalafil if you are using nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites). Combining tadalafil with any of these can cause a dangerous drop in blood pressure that may be life-threatening [3][4].
Alpha-blockers (such as doxazosin, tamsulosin, alfuzosin, or terazosin) are used to treat high blood pressure or prostate problems. If you take an alpha-blocker, you can still use tadalafil, but you must be stable on the alpha-blocker first, and your prescriber will start you on the lowest dose of tadalafil to minimise the risk of dizziness or fainting [4]. Potent CYP3A4 inhibitors—including ritonavir, cobicistat (found in some HIV medicines), Paxlovid (used for COVID-19), ketoconazole, itraconazole, and clarithromycin—can significantly raise tadalafil levels. If you're taking any of these, your prescriber will reduce your tadalafil dose or may advise against using it [4]. CYP3A4 inducers, such as rifampicin, carbamazepine, phenytoin, and St John's wort, can make tadalafil less effective. Always declare every medicine during your consultation.
Getting tadalafil safely from Cured Pharmacy
Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering a range of erectile dysfunction treatments, including tadalafil. All prescription medicines are supplied only after an online consultation reviewed by a UK-registered prescriber. The consultation asks about your medical history, current medications (including rimegepant), cardiovascular health, and any other conditions that might affect the safety of tadalafil. This ensures that the treatment is appropriate and safe for you [1][2].
Tadalafil is available in several forms at Cured Pharmacy, including generic tadalafil (£7.95, or £6.36 with first-order code Ednew), Tadalafil 20mg (Teva) (£9.99, or £7.99 with code Ednew), Avarante (tadalafil) 10mg (£11.49, or £9.19 with code Ednew), and branded Cialis (£12.00, or £9.60 with code Ednew). If tadalafil is not suitable for you, the prescriber may recommend an alternative PDE5 inhibitor such as sildenafil, vardenafil, or avanafil. If you have new or worsening erectile dysfunction, it's important to see your GP, as ED can be an early warning sign of heart disease or diabetes [1][2]. Cured Pharmacy's service complements, but does not replace, the care provided by your GP.
Why choose Cured Pharmacy?
Cured Pharmacy combines clinical expertise with convenience and discretion. Your consultation is reviewed by a UK prescriber, and your medication is dispensed by GPhC-registered pharmacists. Medicines are delivered in plain, unmarked packaging to protect your privacy. If you have questions about tadalafil, rimegepant, or any other aspect of your treatment, the pharmacy team is available to help. The online consultation is straightforward, and you'll receive a clear answer about whether tadalafil is suitable for you, taking into account all your current medicines and health conditions.
When to get urgent help
- Erection lasting more than 4 hours (priapism)—go to A&E immediately
- Sudden loss of vision or hearing—stop tadalafil and seek urgent medical help
- Chest pain during or after sex—call 999; do not take nitrates if you've used tadalafil in the last 48 hours
- Severe allergic reaction (swelling of face, lips, tongue, or difficulty breathing)—call 999
- Severe dizziness or fainting—stop both medicines and contact your GP or call 111
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 25 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 25 October 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 25 October 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 25 October 2026]
- Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 25 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.
Your Questions Answered
Can't find your answer? Our UK pharmacists review every consultation and can help.
Can I take tadalafil and rimegepant on the same day?
Yes, if your prescriber has approved both medicines for you. There is no need to space them out by a specific number of hours, but follow the dosing instructions for each medicine separately.
Will rimegepant make tadalafil less effective?
No, rimegepant is not expected to reduce the effectiveness of tadalafil. Both are processed by the same liver enzyme, but neither significantly affects the other's activity at normal doses.
Do I need to tell my prescriber I'm taking rimegepant?
Yes, always declare every medicine you take, including rimegepant, during your online consultation. This allows the prescriber to check for interactions and ensure tadalafil is safe for you.
Can I take tadalafil if I use other migraine medicines?
In most cases, yes. Tadalafil does not interact with common migraine treatments such as triptans or CGRP antibodies, but your prescriber will review your full medication list to confirm.
What should I do if I get a headache after taking tadalafil?
Headache is a common side effect of tadalafil. You can take your usual over-the-counter painkiller (such as paracetamol or ibuprofen) or, if prescribed, your migraine medicine like rimegepant. If the headache is severe or unusual, seek medical advice.
Are there any medicines I must not take with tadalafil?
Yes. Do not take tadalafil with nitrates, nicorandil, riociguat, poppers, or another PDE5 inhibitor. These combinations can cause a dangerous drop in blood pressure.
Can I drink alcohol while taking tadalafil and rimegepant?
Limit alcohol intake. Heavy drinking can worsen erectile dysfunction and increase the risk of low blood pressure and dizziness when taking tadalafil. Moderate alcohol is usually fine, but avoid excess.
What if I start a new medicine while taking tadalafil?
Inform your GP or pharmacist whenever you start a new medicine, so they can check for interactions with tadalafil. Do not stop or change your prescribed medicines without professional advice.
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Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)