Tadalafil and Vedolizumab: Can They Be Taken Together?

Takes less than 2 minutes to complete 100% online

What is tadalafil and how does it work?

Tadalafil is a prescription medicine used to treat erectile dysfunction (ED) in men. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors, which also includes sildenafil (Viagra), vardenafil (Levitra), and avanafil (Spedra) [3][4].

Tadalafil works by relaxing the 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. It is important to understand that tadalafil does not work without sexual stimulation—it simply makes it easier for your body to respond naturally [4].

Tadalafil is available in two forms: on-demand tablets (usually 10 mg or 20 mg taken at least 30 minutes before sex, with effects lasting up to 36 hours) and daily low-dose tablets (2.5 mg or 5 mg taken once a day). The choice depends on how often you have sex and your personal preference. Both forms require a prescription following a clinical assessment by a UK-registered prescriber [2][4].

What is vedolizumab and why is it prescribed?

Vedolizumab is a biological medicine (a monoclonal antibody) used to treat moderate to severe ulcerative colitis and Crohn's disease, which are types of inflammatory bowel disease (IBD). It is given by intravenous infusion, usually in a hospital or specialist clinic, and works by targeting specific proteins that cause inflammation in the gut.

Unlike older immunosuppressant medicines, vedolizumab is gut-selective, meaning it mainly affects the digestive system rather than the whole immune system. This can reduce some of the risks associated with broader immunosuppression. Vedolizumab is typically prescribed when other treatments have not worked well enough or have caused unacceptable side effects.

Because vedolizumab is a specialist medicine, it is always prescribed and monitored by a gastroenterologist or IBD specialist. If you are taking vedolizumab and considering treatment for erectile dysfunction, it is important that your ED prescriber knows about all your current medicines, including biologics like vedolizumab, so they can check for any potential interactions or contraindications.

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 help
• Chest pain during or after sex – stop activity and call 999
• Severe dizziness or fainting after taking tadalafil – seek same-day medical advice

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.

Is there an interaction between tadalafil and vedolizumab?

There is no well-documented direct pharmacological interaction between tadalafil and vedolizumab. These medicines work through completely different mechanisms in different parts of the body: tadalafil affects blood flow in the penis by inhibiting the PDE5 enzyme, while vedolizumab targets gut inflammation by blocking specific immune cell migration.

Vedolizumab is not known to affect the liver enzymes (such as CYP3A4) that break down tadalafil, so it should not significantly alter tadalafil levels in your blood. Similarly, tadalafil does not interfere with the immune-modulating effects of vedolizumab. This means the two medicines can generally be used together without one affecting how the other works [4][12].

However, it is essential to remember that every person's situation is different. Your prescriber will review your full medical history, including your IBD, any other health conditions (such as heart disease or high blood pressure), and all your current medicines. This comprehensive check ensures that tadalafil is safe and suitable for you specifically, even though no major interaction with vedolizumab is expected.

Why a full medication review still matters

Even when two medicines do not interact directly, your prescriber needs to know about all your treatments. Some people with inflammatory bowel disease may also take other medicines—such as corticosteroids, other immunosuppressants, or treatments for related conditions—that could have their own interactions with tadalafil. Additionally, chronic illness can sometimes affect cardiovascular health, which is an important consideration when prescribing any PDE5 inhibitor [2][4].

What does your prescriber check before approving tadalafil?

When you request tadalafil through an online consultation at Cured Pharmacy, a UK-registered prescriber will review your answers to ensure the medicine is safe for you. They will check your current medicines, including vedolizumab and any other treatments for IBD or other conditions, to identify any potential interactions or contraindications [2][4].

Your prescriber will also ask about your cardiovascular health. Tadalafil can lower blood pressure slightly, so it is not suitable if you have very low blood pressure, unstable angina, or have had a recent heart attack or stroke. Sexual activity itself puts some strain on the heart, so your prescriber needs to confirm that it is safe for you to be sexually active [4].

You will be asked about any medicines that are absolutely contraindicated with tadalafil, such as nitrates (GTN spray, isosorbide mononitrate), nicorandil, riociguat, or recreational drugs called 'poppers'. You must never take tadalafil with these medicines, as the combination can cause a dangerous drop in blood pressure. If you are on alpha-blockers (such as tamsulosin or doxazosin), your prescriber will ensure you are stable on that treatment and may start you on a lower dose of tadalafil [3][4].

Declaring all your medicines is essential

Always list every medicine you take—prescription, over-the-counter, herbal, and supplements—in your consultation. This includes vedolizumab infusions, any IBD medicines, blood pressure tablets, and anything else. Honest, complete information helps your prescriber make the safest decision for you [2].

At a glance

Practical advice for taking tadalafil with vedolizumab

If your prescriber approves tadalafil, you can take it as directed without needing to time it around your vedolizumab infusions. There is no need to avoid tadalafil on the day of your infusion or in the days before or after. The two medicines work independently and do not interfere with each other's absorption or effectiveness.

Follow the dosing instructions for tadalafil carefully. If you are using on-demand tadalafil (10 mg or 20 mg), take it at least 30 minutes before you plan to have sex, and do not take more than one dose in 24 hours. If you are on daily tadalafil (2.5 mg or 5 mg), take one tablet at the same time each day, whether or not you plan to have sex. Sexual stimulation is still needed for the medicine to work [4].

Be aware of common side effects of tadalafil, such as headache, indigestion, back pain, muscle aches, flushing, or a stuffy nose. These are usually mild and temporary. If you experience chest pain during sex, stop immediately and seek urgent medical help. If you have an erection lasting more than four hours, or sudden loss of vision or hearing, go to A&E straight away [4].

When to seek further advice about tadalafil and vedolizumab

If you start any new medicine while taking tadalafil, including a change to your IBD treatment, tell both your gastroenterologist and the prescriber who manages your ED treatment. Some medicines can interact with tadalafil, and your dose may need adjusting or you may need additional monitoring [4][12].

If your inflammatory bowel disease becomes more active or you develop new symptoms, see your IBD specialist. While vedolizumab and tadalafil do not interact, feeling unwell or fatigued from a flare-up can affect your interest in sex and your ability to get an erection. Treating the underlying condition often helps improve ED as well [1][2].

Remember that erectile dysfunction can sometimes be an early warning sign of cardiovascular disease or diabetes, especially if it is a new problem. If you have not already done so, see your GP for a general health check, including blood pressure, cholesterol, and blood sugar tests. Managing these conditions can improve both your overall health and your erectile function [1][2].

Support beyond medication

Living with a chronic condition like IBD can be stressful, and stress, anxiety, and low mood can all contribute to erectile dysfunction. If you think psychological factors are playing a role, talk to your GP about counselling or psychosexual therapy. Lifestyle changes—such as regular exercise, a healthy diet, reducing alcohol, stopping smoking, and maintaining a healthy weight—can also make a real difference to ED [1][2].

In summary

• No major direct interaction is reported between tadalafil and vedolizumab
• Your prescriber will review all your medicines before approving tadalafil
• You do not need to avoid tadalafil on the day of your vedolizumab infusion
• Always declare all IBD treatments and other medicines in your consultation
• Erectile dysfunction can be linked to chronic illness and stress

Choose your treatment

Select from our recommended UK-licensed medications.

Answer quick questions

Select safe UK treatments. Quick answers.

Get it delivered fast

We will deliver direct to you as quickly as tomorrow.

Ready to Speak to a Pharmacist?

Start your journey to better health today.

• Reviewed by UK-based prescribers
• Takes under 3 minutes
• Discreet Packaging

Frequently Asked Questions