Tadalafil and Sertraline: Can You Take Them Together?
Learn about the interaction, safety checks, and what your UK prescriber needs to know.
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Tadalafil and Sertraline: Understanding the Interaction
Published: 25 October 2026
Many men wonder whether tadalafil and sertraline can be taken together safely. The good news is that tadalafil (Cialis), a treatment for erectile dysfunction, does not have a major direct interaction with sertraline, an antidepressant commonly prescribed for depression, anxiety, and premature ejaculation. However, your prescriber will still need to review your full medical history and current medicines during a consultation to ensure the combination is appropriate for you.
At a glance
What is tadalafil and sertraline used for?
Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor licensed to treat erectile dysfunction (ED) in men [4]. It works by relaxing the blood vessels in the penis, allowing increased blood flow when you are sexually aroused. Tadalafil is available as an on-demand treatment (10 mg or 20 mg taken at least 30 minutes before sex, with effects lasting up to 36 hours) or as a daily low-dose tablet (2.5 mg or 5 mg) [4]. It requires sexual stimulation to work and does not increase sexual desire on its own.
Sertraline belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It is prescribed for depression, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and sometimes for premature ejaculation. Sertraline works by increasing levels of serotonin, a chemical messenger in the brain that helps regulate mood. It is usually taken once daily and may take several weeks to show its full benefit.
Both medicines are prescription-only in the UK and should only be taken under the guidance of a qualified healthcare professional. If you are taking sertraline and experiencing erectile difficulties, it is important to discuss this with your GP or prescriber, as ED can sometimes be a side effect of antidepressant treatment or related to the underlying condition being treated [1].
How do tadalafil and sertraline interact?
There is no major direct pharmacological interaction between tadalafil and sertraline [3][4]. This means that the two medicines do not significantly affect each other's metabolism or increase the risk of serious adverse effects when taken together. Tadalafil is primarily metabolised by the liver enzyme CYP3A4, while sertraline is metabolised by multiple pathways and does not strongly inhibit or induce CYP3A4 at usual doses.
However, both medicines can individually cause a small reduction in blood pressure. Tadalafil relaxes blood vessels as part of its mechanism of action, and sertraline may occasionally cause dizziness or lightheadedness, particularly when you first start taking it or after a dose increase. When taken together, there is a theoretical possibility of an additive effect on blood pressure, which could lead to dizziness or feeling faint, especially when standing up quickly.
Your prescriber will assess your overall cardiovascular health, current blood pressure, and any other medicines you are taking during the consultation. If you are stable on sertraline and have no other risk factors, tadalafil is usually considered safe to prescribe. It is important to declare all your current medicines, including over-the-counter products and supplements, so that your prescriber can make a fully informed decision about your treatment.
Why sertraline is sometimes prescribed alongside ED treatment
Interestingly, some men are prescribed both sertraline and tadalafil intentionally. Sertraline and other SSRIs can delay ejaculation, which is helpful for men with premature ejaculation. Tadalafil, on the other hand, helps achieve and maintain an erection. In cases where a man experiences both premature ejaculation and erectile dysfunction, a prescriber may recommend both treatments together, having carefully weighed the benefits and risks. This combination is used in clinical practice and is generally well tolerated when appropriately monitored.
What your prescriber checks before prescribing tadalafil with sertraline
Before prescribing tadalafil to someone taking sertraline, a UK prescriber will conduct a thorough clinical assessment. This includes reviewing your medical history, current medicines, blood pressure, and cardiovascular health. Tadalafil is not suitable for everyone, particularly men with severe heart conditions, very low blood pressure, recent heart attack or stroke, or those taking certain other medicines such as nitrates, nicorandil, or riociguat [4].
Your prescriber will ask about any symptoms of low blood pressure, such as dizziness, fainting, or feeling lightheaded when standing. They will also check whether you are taking any other medicines that could interact with tadalafil, including alpha-blockers (used for prostate problems or high blood pressure), potent CYP3A4 inhibitors (such as certain antifungals or HIV medicines), or other blood-pressure-lowering drugs. Even though sertraline itself does not have a major interaction, the overall picture of your health and medication list is important.
If you experience erectile difficulties while taking sertraline, it is worth discussing this with your prescriber. ED can sometimes be a side effect of SSRIs, but it can also be related to depression, anxiety, or other underlying health conditions such as diabetes or cardiovascular disease [1][2]. Your prescriber may adjust your antidepressant, add an ED treatment, or refer you for further investigation if needed. Never stop or change your prescribed medicine without professional advice.
What you need to know
- Tadalafil and sertraline can usually be taken together safely with no major direct interaction
- Your prescriber will check your blood pressure, heart health, and all current medicines
- Never take tadalafil with nitrates, nicorandil, riociguat, or poppers
- Sertraline can sometimes cause sexual side effects; discuss any concerns with your GP
- Limit alcohol and avoid grapefruit juice while taking tadalafil
Practical advice for taking tadalafil and sertraline together
If you have been prescribed both tadalafil and sertraline, take each medicine exactly as directed by your prescriber. Sertraline is usually taken once daily, at the same time each day, with or without food. Tadalafil on-demand tablets (10 mg or 20 mg) should be taken at least 30 minutes before sexual activity, and you should not take more than one dose in 24 hours [4]. Daily tadalafil (2.5 mg or 5 mg) is taken once a day at the same time, regardless of when you plan to have sex.
Be aware of the potential for dizziness or lightheadedness, especially when you first start tadalafil or if your sertraline dose has recently changed. Avoid standing up too quickly from sitting or lying down, and take care when driving or operating machinery until you know how the combination affects you. Limit alcohol intake, as heavy drinking can worsen erectile dysfunction and add to the blood-pressure-lowering effects of both medicines.
Do not take tadalafil if you are also using nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites). The combination can cause a dangerous drop in blood pressure [4]. If you develop chest pain during sex, do not use nitrates; seek urgent medical help and tell the healthcare professional that you have taken tadalafil. If you experience an erection lasting more than four hours, sudden loss of vision or hearing, or severe dizziness, seek immediate medical attention.
Monitoring and follow-up
Once you start taking tadalafil alongside sertraline, monitor how you feel and report any new or worsening symptoms to your prescriber. If you experience persistent side effects, such as headache, indigestion, back pain, or muscle aches (common with tadalafil), or increased anxiety, sleep disturbance, or sexual side effects (which can occur with sertraline), discuss these with your healthcare professional. Your prescriber may adjust the dose or suggest an alternative treatment. Regular follow-up ensures that both your mental health and sexual health are managed effectively and safely.
Can tadalafil and sertraline be taken together safely?
Yes, tadalafil and sertraline can usually be taken together safely, provided you have been assessed by a qualified prescriber and have no contraindications [3][4]. The combination does not have a major direct drug interaction, and many men use both medicines without problems. The key is to ensure that your prescriber has a complete picture of your health, including your blood pressure, heart health, and all other medicines you are taking.
It is important to remember that erectile dysfunction can have many causes, including psychological factors, underlying health conditions, and side effects of medicines [1][2]. If you are experiencing ED while taking sertraline, do not assume it is solely due to the antidepressant. A thorough assessment by your GP or a specialist can help identify the cause and guide appropriate treatment. In some cases, adjusting the dose or type of antidepressant, adding an ED treatment, or addressing lifestyle factors such as exercise, diet, and stress can all make a difference.
At Cured Pharmacy, our UK-registered prescribers review every consultation individually, taking into account your current medicines, medical history, and treatment goals. If tadalafil is suitable for you, it will be dispensed by our GPhC-registered pharmacy and delivered discreetly to your door. Prescription treatments for erectile dysfunction are only supplied after an online consultation reviewed by a UK prescriber, ensuring your safety and the appropriateness of the treatment.
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 sex – stop activity, do not use nitrates, call 999
- Severe dizziness, fainting, or very low blood pressure – seek same-day medical 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.
Other medicines and lifestyle factors to consider with tadalafil and sertraline
In addition to sertraline, you should tell your prescriber about any other medicines you are taking, including over-the-counter products, herbal remedies, and supplements. St John's wort, a herbal remedy sometimes used for low mood, can reduce the effectiveness of tadalafil and should be avoided [4]. Grapefruit juice can increase tadalafil levels in the blood and should be consumed in moderation or avoided.
If you are taking medicines for high blood pressure, heart disease, or prostate problems (such as alpha-blockers like tamsulosin or doxazosin), your prescriber will need to check that tadalafil is safe for you. Alpha-blockers can interact with PDE5 inhibitors, increasing the risk of low blood pressure and dizziness [4]. If the combination is appropriate, you will usually be started on the lowest dose of tadalafil, and you should be stable on the alpha-blocker before starting ED treatment.
Lifestyle factors also play an important role in both erectile function and mental health. Regular physical activity, a balanced diet, maintaining a healthy weight, not smoking, and limiting alcohol can all improve erectile function and overall wellbeing [1][2]. If you are experiencing side effects from sertraline, such as reduced libido or difficulty reaching orgasm, discuss these with your prescriber. Sometimes a dose adjustment, switching to a different antidepressant, or adding an ED treatment can help. Never stop taking your antidepressant suddenly without medical advice, as this can cause withdrawal symptoms.
When to see your GP
If you are experiencing erectile dysfunction for the first time, it is important to see your GP for a full assessment [1]. ED can be an early warning sign of cardiovascular disease, diabetes, or other health conditions that need investigation and treatment. Your GP can arrange blood tests, check your blood pressure and cholesterol, and discuss any psychological or relationship factors that may be contributing. If you are already taking sertraline and develop new erectile difficulties, mention this to your GP, as it may be related to your medication or the condition being treated. Early assessment and treatment can improve outcomes and quality of life.
Declare all your medicines
Always tell your prescriber about every medicine you take, including sertraline, over-the-counter products, 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 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]
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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Start My Assessment Log in to Your AccountYour Questions Answered
Can I take tadalafil if I'm on sertraline?
Yes, tadalafil and sertraline can usually be taken together safely. There is no major direct interaction, but your prescriber will check your blood pressure, heart health, and other medicines during the consultation to ensure the combination is appropriate for you.
Does sertraline cause erectile dysfunction?
Sertraline and other SSRIs can sometimes cause sexual side effects, including reduced libido, delayed ejaculation, or difficulty achieving orgasm. If you experience ED while taking sertraline, discuss this with your GP, as it may be related to the medication, the underlying condition, or other factors.
Will tadalafil interfere with my antidepressant?
Tadalafil does not interfere with the effectiveness of sertraline or other SSRIs. The two medicines work through different mechanisms and do not significantly affect each other's metabolism or action.
What should I tell my prescriber before taking tadalafil with sertraline?
Declare all your current medicines, including over-the-counter products and supplements, your medical history (especially heart conditions, blood pressure, stroke, or eye problems), and any symptoms such as dizziness or chest pain. This helps your prescriber assess whether tadalafil is safe for you.
Can I drink alcohol while taking tadalafil and sertraline?
Limit alcohol intake, as heavy drinking can worsen erectile dysfunction and add to the blood-pressure-lowering effects of both medicines. Moderate alcohol (1–2 units) is usually acceptable, but excessive drinking should be avoided.
Are there any medicines I must not take with tadalafil?
Do not take tadalafil with nitrates (GTN spray, isosorbide mononitrate/dinitrate), nicorandil, riociguat, or poppers (amyl/alkyl nitrites). The combination can cause a dangerous drop in blood pressure. Always check with your prescriber before starting any new medicine.
How long does tadalafil last compared to other ED treatments?
Tadalafil on-demand (10 mg or 20 mg) can last up to 36 hours, which is longer than sildenafil (about 4–6 hours) or vardenafil (about 4–5 hours). Daily tadalafil (2.5 mg or 5 mg) provides continuous support and can be taken regardless of when you plan to have sex.
What should I do if I experience side effects from tadalafil or sertraline?
Common side effects of tadalafil include headache, indigestion, back pain, and muscle aches. If side effects are persistent or bothersome, contact your prescriber. If you experience an erection lasting more than four hours, sudden vision or hearing loss, or chest pain during sex, seek urgent medical help.
Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)