Tadalafil and Ticagrelor: Can You Take Them Together?

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Tadalafil and Ticagrelor: Understanding the Interaction

Published: 26 October 2026

Many men prescribed ticagrelor for heart conditions wonder whether tadalafil and ticagrelor can be taken together safely. The good news is that there is no major direct interaction between these two medicines, and tadalafil can often be prescribed for men taking ticagrelor. However, because both medicines affect your cardiovascular system, your prescriber will carefully assess your heart health and overall medical history before approving treatment.

What is tadalafil and ticagrelor used for?

Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor licensed to treat erectile dysfunction (ED). It works by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused [3][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 tablet (2.5mg or 5mg). It is the active ingredient in branded Cialis and is also available as a generic medicine.

Ticagrelor is an antiplatelet medicine that prevents blood clots by stopping platelets from sticking together. It is commonly prescribed after a heart attack, stroke, or for people with acute coronary syndrome or certain heart conditions. Ticagrelor is usually taken twice daily and is often given alongside low-dose aspirin. Because it reduces clotting, it lowers the risk of further cardiovascular events but also slightly increases bleeding risk.

Both medicines play important roles in cardiovascular health, so understanding how they work together is essential for safe treatment.

Is there an interaction between tadalafil and ticagrelor?

There is no major direct drug interaction between tadalafil and ticagrelor reported in standard reference sources [3][4]. This means that tadalafil does not significantly affect how ticagrelor works, and ticagrelor does not substantially change tadalafil levels in your body. Many men taking ticagrelor can be prescribed tadalafil for erectile dysfunction after a careful medical assessment.

However, the reason you are taking ticagrelor—usually a recent heart attack, stroke, or unstable angina—is highly relevant. PDE5 inhibitors like tadalafil are not suitable when sexual activity itself is inadvisable, such as in the weeks following a heart attack or stroke, or if you have unstable angina or severe heart failure [1][2]. Your prescriber will review your cardiovascular history, current symptoms, and how stable your condition is before deciding whether tadalafil is safe for you.

Additionally, tadalafil can cause a small drop in blood pressure, which is usually well tolerated but must be considered if you are taking other blood-pressure-lowering medicines or have low blood pressure. Your prescriber will check all your current medicines and your recent cardiac history during the consultation to ensure tadalafil is appropriate.

How tadalafil affects blood pressure

Tadalafil works by relaxing blood vessels, which can cause a modest reduction in blood pressure. For most men, this effect is mild and causes no problems. However, if you are taking other medicines that lower blood pressure, or if you have a history of low blood pressure or dizziness, the combined effect needs careful consideration. Your prescriber will assess your blood pressure, current medicines, and overall cardiovascular stability before approving tadalafil.

What your prescriber checks before approving tadalafil and ticagrelor together

When you request tadalafil and you are taking ticagrelor, your prescriber will conduct a thorough cardiovascular assessment. They will ask about the reason you are taking ticagrelor, when your heart event occurred, and whether you have any ongoing chest pain, breathlessness, or other cardiac symptoms. Sexual activity places demands on your heart, so your prescriber must confirm that you are stable enough for this level of exertion [2].

Your prescriber will also review all your current medicines to check for any contraindications. Tadalafil must never be taken with nitrates (such as GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, or amyl/alkyl nitrites (poppers), as the combination can cause a dangerous drop in blood pressure [3][4]. If you are taking alpha-blockers (such as doxazosin or tamsulosin), your prescriber will ensure you are stable on that medicine and may start you on the lowest dose of tadalafil.

Your prescriber will also consider any other blood-pressure medicines you take, your blood pressure readings, and any history of heart failure, stroke, or other cardiovascular conditions. If you have had a recent heart attack or stroke (typically within the last few weeks to months, depending on severity and recovery), tadalafil may not be suitable until your condition is fully stable. Your prescriber will use clinical guidelines to make this decision [2].

Practical advice for taking tadalafil and ticagrelor safely

If your prescriber approves tadalafil, take it exactly as directed. For on-demand tadalafil (10mg or 20mg), take one tablet at least 30 minutes before sexual activity; the effect can last up to 36 hours, so do not take more than one dose in 24 hours. For daily tadalafil (2.5mg or 5mg), take one tablet at the same time each day, whether or not you plan to have sex. Tadalafil requires sexual stimulation to work; it will not cause an erection on its own [4].

Continue taking ticagrelor exactly as prescribed by your cardiologist or GP. Do not stop or change your ticagrelor dose without medical advice, as this could increase your risk of a blood clot or further heart event. If you experience any new chest pain, breathlessness, dizziness, or other concerning symptoms after starting tadalafil, stop taking it and contact your GP or call 111 for advice.

Avoid heavy alcohol when taking tadalafil, as it can worsen erectile dysfunction and add to the blood-pressure-lowering effect, increasing the risk of dizziness. Grapefruit juice can raise tadalafil levels in your blood, so it is best to avoid it. If you are prescribed any new medicines, always tell the prescriber or pharmacist that you are taking both tadalafil and ticagrelor so they can check for interactions.

When to seek urgent help

Seek immediate medical help (call 999 or go to A&E) if you experience chest pain or discomfort during or after sexual activity, as this may indicate a heart problem. Also seek urgent help if you have an erection lasting more than four hours (priapism), sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing. These are rare but serious side effects that require prompt treatment [3][4].

Other medicines and conditions to consider with tadalafil and ticagrelor

If you are taking ticagrelor, you are likely also taking other cardiovascular medicines. Low-dose aspirin is commonly prescribed alongside ticagrelor; there is no direct interaction between aspirin and tadalafil, but your prescriber will review your full medicine list. If you are on a statin (such as atorvastatin or simvastatin) or an ACE inhibitor (such as ramipril), these do not have major interactions with tadalafil, but the combined blood-pressure-lowering effect will be considered [3][4].

Alpha-blockers (doxazosin, tamsulosin, alfuzosin) are sometimes prescribed for prostate symptoms or high blood pressure. If you take an alpha-blocker, you must be stable on it before starting tadalafil, and your prescriber will usually start you on the lowest dose of tadalafil to minimise the risk of dizziness or fainting. Potent CYP3A4 inhibitors (such as ritonavir, ketoconazole, itraconazole, or clarithromycin) can raise tadalafil levels; your prescriber will adjust the dose or advise against tadalafil if you are taking these medicines [4].

If you have a history of stroke, heart failure, very low blood pressure, or previous sudden vision loss (non-arteritic anterior ischaemic optic neuropathy, or NAION), tadalafil may not be suitable. Your prescriber will assess these conditions during your consultation. Always declare all your current medicines, supplements, and medical history to ensure safe prescribing.

How to access tadalafil and ticagrelor treatment through Cured Pharmacy

Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering a convenient, confidential service for erectile dysfunction treatment. All prescription medicines, including tadalafil, are only supplied after an online consultation reviewed by a UK-registered prescriber. During the consultation, you will be asked about your medical history, current medicines (including ticagrelor), cardiovascular health, and any recent heart events or symptoms.

If tadalafil is deemed safe and appropriate for you, your prescription will be dispensed by our pharmacy team and delivered discreetly to your door. We offer a range of ED treatments, including generic tadalafil from £7.95 (£6.36 with first-order code Ednew), branded Cialis from £12.00 (£9.60 with code Ednew), and other options such as sildenafil, vardenafil, and avanafil. Your prescriber will recommend the most suitable treatment based on your individual needs and medical history.

If you have any questions about taking tadalafil and ticagrelor together, our pharmacist-led team is here to help. You can contact us through the website or speak to a pharmacist for advice. Remember, if you have new or worsening erectile dysfunction, it is important to see your GP, as ED can be an early sign of heart disease or diabetes [1][2].

Why choose Cured Pharmacy?

Cured Pharmacy combines clinical expertise with convenience. Every prescription is reviewed by a UK-registered prescriber, and our team of experienced pharmacists is available to answer your questions. We offer discreet packaging, fast delivery, and a straightforward online consultation process. All our services are fully regulated by the General Pharmaceutical Council, ensuring the highest standards of safety and care.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 26 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 26 October 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 26 October 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [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.

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