Tadalafil and Sucralfate: Can They Be Taken Together?
UK pharmacist explains the interaction, what your prescriber checks, and practical advice for safe use.
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Tadalafil and Sucralfate: Understanding the Interaction
Published: 26 October 2026
Many men taking tadalafil and sucralfate together wonder whether the combination is safe. The good news is that no major interaction is commonly reported between tadalafil (Cialis) and sucralfate, a medicine used to treat stomach ulcers. However, sucralfate can reduce the absorption of some medicines, so timing and individual health factors matter—your prescriber will check your full medication list during your consultation to ensure tadalafil is suitable for you.
At a glance
What is tadalafil and how does it work?
Tadalafil is a prescription medicine used to treat erectile dysfunction (ED) in men [4]. 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. This helps you get and keep an erection suitable for sexual activity [1].
Tadalafil is available as the branded medicine Cialis and as generic versions. It comes in two forms: on-demand tablets (10mg or 20mg) taken at least 30 minutes before sex, 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 means you don't need to time it as precisely before sex.
Tadalafil only works when you are sexually stimulated—it will not cause an erection on its own. Common side effects include headache, indigestion, back pain, muscle aches, flushing, and a blocked or runny nose [4]. These are usually mild and short-lived. At Cured Pharmacy, tadalafil is available after an online consultation reviewed by a UK prescriber.
What is sucralfate and why is it prescribed?
Sucralfate is a prescription medicine used to treat and prevent stomach and duodenal ulcers. It works by forming a protective coating over ulcers and damaged areas of the stomach lining, shielding them from stomach acid and allowing them to heal. Sucralfate is usually taken two to four times a day, either one hour before meals and at bedtime, or as directed by your doctor.
Because sucralfate works by coating the stomach lining, it can interfere with the absorption of some other medicines if taken at the same time. For this reason, it is often recommended to take sucralfate separately from other tablets—usually at least two hours apart. This helps ensure that both medicines work as intended.
Sucralfate is generally well tolerated, with constipation being the most common side effect. It is important to tell your prescriber about all medicines you take, including over-the-counter products and supplements, so they can advise on the best timing and check for any interactions.
How sucralfate can affect other medicines
Sucralfate can reduce the absorption of certain medicines by binding to them in the stomach or by altering stomach acidity. This means that if you take sucralfate at the same time as another medicine, the other medicine may not work as well. Examples include some antibiotics, thyroid hormones, and certain heart medicines. Your pharmacist or prescriber will advise you on the correct timing to avoid this problem.
Tadalafil and sucralfate: is there an interaction?
No major interaction between tadalafil and sucralfate is commonly reported in clinical practice or standard drug interaction databases. This means that the two medicines are not known to cause serious problems when taken together. However, because sucralfate can reduce the absorption of some medicines, there is a theoretical possibility that it could slightly reduce how much tadalafil your body absorbs if both are taken at exactly the same time.
To minimise any potential effect on absorption, it is sensible to separate the doses. Taking tadalafil at least two hours before or after sucralfate is a practical approach that allows both medicines to work effectively. For example, if you take sucralfate before meals, you might take tadalafil in the evening or at a different time of day when your stomach is relatively empty.
Your prescriber will review your full medication list during your consultation to check for any interactions and to ensure tadalafil is safe for you. If you are already taking sucralfate and are prescribed tadalafil, mention it during your consultation so the prescriber can give you personalised advice on timing and dosing. Never stop or change a prescribed medicine without speaking to your doctor or pharmacist first.
What you need to know
- No major interaction is reported between tadalafil and sucralfate
- Take tadalafil at least 2 hours before or after sucralfate to ensure full absorption
- Always declare all medicines during your consultation so your prescriber can check for interactions
- Tadalafil must never be taken with nitrates, nicorandil, riociguat, or poppers
- See your GP if you have new or worsening ED, as it can signal underlying health problems
What your prescriber checks before prescribing tadalafil
Before prescribing tadalafil, your prescriber will ask about your medical history, current medicines, and overall health to make sure it is safe for you [2]. They will check for conditions that make tadalafil unsuitable, such as recent heart attack or stroke, unstable angina, severe heart failure, very low blood pressure, or a history of sudden vision loss (non-arteritic anterior ischaemic optic neuropathy, or NAION) [4].
Your prescriber will also check for medicines that must never be taken with tadalafil. These include nitrates (such as GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, and recreational drugs called 'poppers' (amyl or alkyl nitrites). Taking tadalafil with any of these can cause a dangerous drop in blood pressure [4]. Do not take tadalafil with another PDE5 inhibitor (such as sildenafil or vardenafil) at the same time.
If you take an alpha-blocker for prostate symptoms or high blood pressure (such as doxazosin or tamsulosin), your prescriber will ensure you are stable on that medicine and will usually start you on the lowest dose of tadalafil to reduce the risk of dizziness or low blood pressure [4]. Medicines that affect liver enzymes—such as ritonavir, ketoconazole, or clarithromycin—can raise tadalafil levels, so your dose may need to be adjusted. Always declare every medicine, supplement, and herbal product you take during your consultation.
Why timing matters with sucralfate
Because sucralfate can interfere with the absorption of other medicines, your prescriber may advise you to take tadalafil at a different time of day from your sucralfate doses. This simple step helps ensure that tadalafil is absorbed properly and works as intended. If you have any questions about timing, ask your prescriber or pharmacist—they can give you a clear schedule that fits your routine.
Practical advice for taking tadalafil and sucralfate safely
If you are prescribed both tadalafil and sucralfate, the key is to separate the doses. A gap of at least two hours between taking sucralfate and tadalafil is a sensible precaution. For example, if you take sucralfate one hour before breakfast and lunch, you could take tadalafil in the evening or at bedtime (if using the daily dose) or a few hours before planned sexual activity (if using the on-demand dose).
Tadalafil can be taken with or without food, although a very heavy or high-fat meal may delay how quickly it works [4]. Avoid drinking large amounts of alcohol when taking tadalafil, as alcohol can make it harder to get an erection and can add to the blood-pressure-lowering effect of the medicine, increasing the risk of dizziness or fainting [4]. Grapefruit juice can raise tadalafil levels in your blood, so it is best to avoid it.
If you experience side effects such as severe headache, chest pain during sex, dizziness, or an erection lasting more than four hours, seek medical help immediately. If you develop sudden loss of vision or hearing, stop taking tadalafil and contact a doctor straight away [4]. Keep both medicines in their original packaging, out of reach of children, and follow the storage instructions on the label.
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 advice
- Chest pain during sex – stop activity, call 999, and do not take more tadalafil
- Severe dizziness or fainting – sit or lie down and seek medical help if it does not improve
- Allergic reaction (swelling of face, lips, tongue, or difficulty breathing) – call 999
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
When to see your GP about erectile dysfunction
Erectile dysfunction is common—it affects around half of men aged 40 to 70 to some degree [10]—and it is often treatable. However, ED can be an early warning sign of underlying health problems such as heart disease, high blood pressure, or diabetes [1]. If you are experiencing ED for the first time, or if it is getting worse, it is important to see your GP for a check-up.
Your GP can assess your overall health, check for conditions that may be causing or contributing to ED, and discuss treatment options. They may arrange blood tests to check your cholesterol, blood sugar, and hormone levels, and they will review your current medicines to see if any could be affecting your erections [2]. Lifestyle changes—such as losing weight, exercising more, stopping smoking, and cutting down on alcohol—can also make a significant difference [1].
If your GP recommends a PDE5 inhibitor such as tadalafil, you can obtain it on prescription from your GP or through a registered online pharmacy such as Cured Pharmacy. Our service includes an online consultation reviewed by a UK prescriber, who will check your suitability and issue a prescription if appropriate. Treatment is then dispensed by our GPhC-registered pharmacy and delivered discreetly to your door. Never buy ED medicines from unregulated websites, as they may be counterfeit, unsafe, or ineffective.
Other treatment options for erectile dysfunction
If tadalafil is not suitable for you, or if you prefer a different option, other PDE5 inhibitors are available, including sildenafil (Viagra), vardenafil (Levitra), and avanafil (Spedra) [3][5][6]. Each has a slightly different duration of action and timing. For men who cannot take tablets, alternatives include alprostadil cream (Vitaros) or injection (Caverject), vacuum erection devices, and in some cases, surgery [7]. Your prescriber can discuss the best option for your individual circumstances.
Timing tip for best results
Take tadalafil at least two hours before or after sucralfate to ensure both medicines are absorbed properly and work as intended. If you're unsure, ask your pharmacist for a simple dosing schedule that fits your routine.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 26 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 26 October 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 26 October 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 26 October 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 26 October 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 26 October 2026]
- Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 26 October 2026]
- Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54–61. https://pubmed.ncbi.nlm.nih.gov/8254833/ [accessed 26 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.
Common Questions
Can I take tadalafil and sucralfate on the same day?
Yes, you can take both on the same day. To ensure tadalafil is absorbed properly, take it at least two hours before or after your sucralfate dose.
Will sucralfate stop tadalafil from working?
No major interaction is reported, but sucralfate may reduce absorption if taken at exactly the same time. Separating the doses by at least two hours minimises any risk.
Do I need to tell my prescriber I'm taking sucralfate?
Yes, always declare every medicine you take during your consultation, including sucralfate. Your prescriber will check for interactions and advise on the best timing.
Can I take tadalafil with other stomach medicines?
Most stomach medicines, such as proton pump inhibitors (omeprazole, lansoprazole) and H2 blockers (famotidine), do not interact significantly with tadalafil. Antacids should be taken at a different time.
How long does tadalafil last?
On-demand tadalafil (10mg or 20mg) can last up to 36 hours, while daily tadalafil (2.5mg or 5mg) maintains a steady level in your body for continuous effect.
What should I do if I get side effects from tadalafil?
Common side effects such as headache or indigestion are usually mild. If you experience chest pain, an erection lasting more than 4 hours, or sudden vision or hearing loss, seek urgent medical help.
Can I drink alcohol while taking tadalafil and sucralfate?
Heavy alcohol can worsen ED and increase the risk of dizziness or low blood pressure with tadalafil. Moderate alcohol is usually fine, but it's best to limit your intake.
Where can I get tadalafil in the UK?
Tadalafil is a prescription-only medicine available from your GP or a registered online pharmacy such as Cured Pharmacy after a consultation reviewed by a UK prescriber.
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Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)