Cialis & Alcohol: What’s the Risk?

What Is Cialis (Tadalafil)?

Cialis is the brand name for the generic drug tadalafil. It is a prescription medication primarily used to treat erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) in men. Cialis belongs to a class of medications known as phosphodiesterase type 5 (PDE5) inhibitors. It increases blood flow to the penis when a man is sexually aroused, facilitating an erection. The appropriate Cialis dosage is determined by a healthcare provider based on individual needs and responses.

Cialis is a Food and Drug Administration (FDA) approved medication for the treatment of ED and BPH. When a product or medication is described as “FDA approved,” it signifies that the FDA has granted its approval, ensuring the safety and efficacy of this medication.¹

Can You Drink Alcohol While Taking Cialis?

When Cialis and alcohol are taken together, your blood pressure may decrease to dangerously low levels. Cialis and alcohol rely on the same group of liver enzymes for their metabolism. When you use both substances together, they might compete for these enzymes. This competition can result in a slower breakdown of one or both substances, leading to a higher risk of side effects. Therefore, physicians should inform patients that substantial consumption of alcohol in combination with Cialis can increase the potential for increased heart rate, decreased blood pressure, dizziness, and headache.¹

How Long After Taking Cialis Can You Drink Alcohol?

Generally, less than 5 units (50mL pure alcohol or about one 1 oz shot glass of pure alcohol) rarely cause elevated risk of side effects. If the patients want to drink more than 5 units of alcohol before taking Cialis, no specific guideline exists to prove the safe time interval between the two. Your doctor and your pharmacist may suggest waiting several hours to decrease the substance interaction between alcohol and Cialis.¹

Does Alcohol Make Cialis Less Effective?

There is no evidence to prove that drinking alcohol with Cialis will decrease the effects of Cialis. However, excessive alcohol consumption can impair sexual performance and desire, which may reduce the effectiveness of Cialis in achieving and maintaining an erection. So, drinking excessive alcohol before sex may negatively affect sexual functions and decrease the effects of Cialis.^{1, 2}

How Much Alcohol Can You Drink While Taking Cialis?

In general, according to the clinical trial and the FDA information, consuming 5 units (equivalent to 50 mL of pure alcohol, one 1 oz shot glass) seldom leads to a significant increase in the risk of side effects. Individual reactions can vary based on factors such as tolerance to alcohol, the dosage of Cialis, and overall health. If patients have particular concerns or medical conditions, it’s a good idea to talk to your doctor and pharmacists about drinking alcohol.¹

What Are the Side Effects of Mixing Alcohol & Cialis?

Combining alcohol and Cialis (tadalafil) can potentially lead to an increased risk of side effects. It may include intensifying feelings of dizziness and lightheadedness, stomach discomfort, and headache.¹

Common side effects of mixing alcohol and Cialis may include:*

• Nausea
• Dizziness
• Fatigue
• Headache
• Back Pain
• Flushing
• Dyspepsia

Mixing Cialis with alcohol has the potential to raise the likelihood of side effects, and these effects could be more noticeable or serious than when each substance is used on its own. The severe side effects caused by mixing alcohol and Cialis together include heart issues, visual disturbance, and hearing loss.¹

Severe side effects of mixing alcohol and Cialis may include:*

• Low blood pressure
• Fall
• Visual disturbances
• Hearing loss
• Heart failure
• Abnormal hepatic test
• Edema (swelling)

*All medications, including Cialis, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor or pharmacist about any questions you have and to understand the potential side effects and benefits of any medication.

Drug Interactions With Cialis

Besides alcohol, Cialis can potentially interact with various medications and substances, like nitrates (e.g. nitroglycerin, isosorbide), alpha-blocker medicines (e.g. doxazosin, tamsulosin), and other antihypertensives. It’s crucial to inform the healthcare provider about all the medicines, supplements, and substances to prevent potentially harmful interactions.¹

Cialis may have harmful interactions with these foods and drugs:

Nitrates

Nitrates are a group of medications commonly prescribed to treat chest pain (angina), as well as certain heart conditions. Simultaneous use of nitrates with Cialis can enhance the blood vessel relaxation effects, potentially leading to severely low blood pressure. Such combination therapy is strictly prohibited.^{1, 3}

Alpha-blocker

Caution is recommended when using Cialis alongside alpha-blockers. Cialis and alpha-adrenergic blockers like tamsulosin and doxazosin, which are medications for BPH and high blood pressure, both relax blood vessels and can lower blood pressure. When these medications are used together, there is the potential for an additive effect on lowering blood pressure.¹

Antihypertensives

Research studies show that when Cialis was used in combination with blood pressure medications like metoprolol and amlodipine, there were additional modest reductions in blood pressure in these patients.¹

Antacids

When Cialis and an antacid (e.g. Tums, Rolaids) are taken together, the antacid may slow down the rate at which Cialis is absorbed into the bloodstream. Most people can safely use antacids for digestive discomfort while taking Cialis. However, it’s advisable to consult your pharmacist for personalized guidance based on specific health and medication regimens.¹

ED Treatment Alternatives That Don’t Interact With Alcohol

If the patient is looking for alternative treatments for erectile dysfunction (ED) that do not have interactions with alcohol, there are various options to explore. It is crucial to have a discussion with your doctor or pharmacist to identify the most appropriate treatment based on individual health and lifestyle.¹

ED treatment alternatives that are safe to use with alcohol include:

• A vacuum ED device (VED): These devices create a vacuum around the penis, drawing blood into the area to produce an erection. VEDs do not interact with alcohol and can be used as needed.
• An implanted device: Surgical placement of a penile implant is a permanent solution for ED. It does not involve medication and is not affected by alcohol.
• Surgery to repair arteries: Surgery to repair arteries may be a treatment option for some individuals with vascular-related ED. This type of ED is often caused by poor blood flow to the penis due to narrowed or blocked arteries, and you would likely have other symptoms of vascular disease as well.

When to Seek Professional Help

Be aware of the symptoms of excessive drinking, including slurred speech, impaired coordination, confusion, mood swings, and loss of consciousness. Understand the potential risks of combining alcohol with specific medications like Cialis, including amplified side effects and interactions. If someone suspects the alcohol drinker is in danger due to excessive drinking or alcohol-medication interactions, do not wait for the situation to worsen. Call 911 or the local emergency number immediately. Be prepared to provide essential details about the person’s condition and the medications they are taking.¹

Questions to Ask Your Health Team About Cialis (Tadalafil Use With Alcohol

Engaging in open communication and asking questions with your healthcare providers is the most effective approach to educating oneself about potential risks, interactions, and safe protocols. Patients may ask how to drink alcohol when to drink alcohol, how much alcohol they could drink before taking Cialis, and the significant side effects it may cause. Your doctor and pharmacist can offer individualized advice and assist in making well-informed choices that prioritize personal health and overall well-being.¹

Questions to ask your doctor about alcohol and Cialis include:

• Is there a safe amount of alcohol that I can consume with Cialis?
• Is there a Cialis alternative that isn’t negatively affected by alcohol?
• What should I do if I decide to drink anyway and have an adverse reaction?
• How should I monitor my body’s response when using Cialis and alcohol together?
• What medical conditions or medications make combining Cialis and alcohol particularly risky for me?
• How long should I wait after taking Cialis before consuming alcohol?
• Will alcohol affect the effectiveness of Cialis?
• What are the potential long-term effects of using Cialis and alcohol together?
• Are there discounts or coupons available for Cialis to help me save money on my prescription?

In My Experience

In my experience, Cialis has proven its safety and effectiveness in patients. The interaction between alcohol and Cialis can be avoided easily when patients choose not to mix them together. If you would like to have alcoholic drinks with Cialis, keep a few of these things in mind. First, drink alcohol in moderation, if at all. Second, allow some time (several hours) to pass after taking Cialis before consuming alcohol. Third, be aware of how your body reacts to the combination, and if you experience severe or concerning side effects, seek immediate medical attention.

If you have specific concerns or medical conditions, consult your healthcare providers, including doctors and pharmacists, regarding alcohol consumption. These experts can provide personalized guidance, taking into account individual health and medications.¹