Are there any contraindications with taking Tadalafil (Cialis) and Diltiazem (Cardizem)?

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Last updated: April 5, 2025View editorial policy

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From the Guidelines

Taking tadalafil and diltiazem together requires caution due to potential drug interactions, and it is recommended to avoid their concurrent use, especially in patients with certain cardiovascular conditions, as stated in the guidelines 1. When considering the use of tadalafil and diltiazem together, it is essential to weigh the potential benefits against the risks of adverse interactions. Tadalafil, a phosphodiesterase type 5 inhibitor, is used for erectile dysfunction, while diltiazem, a calcium channel blocker, is used for hypertension, angina, and certain heart rhythm disorders. The primary concern with concurrent use is the potential for excessive vasodilation, leading to hypotension, which can cause dizziness, lightheadedness, or fainting.

  • The guidelines for managing patients with ST-elevation myocardial infarction suggest caution with the use of nitrates in patients who have taken phosphodiesterase inhibitors like tadalafil within the past 24 to 48 hours 1.
  • Diltiazem, being a calcium channel blocker, can also contribute to hypotension, especially when combined with other vasodilators like tadalafil.
  • The management of hypertension and heart conditions often involves careful consideration of drug interactions to minimize risks and maximize therapeutic benefits, as outlined in the American College of Cardiology/American Heart Association guidelines 1.
  • It is crucial for patients to inform their healthcare providers about all medications they are taking, including those for erectile dysfunction, to ensure safe and effective management of their conditions.
  • In clinical practice, the decision to use tadalafil and diltiazem together should be made on a case-by-case basis, considering the individual patient's health status, the severity of their conditions, and the potential risks and benefits of concurrent therapy, with close monitoring of blood pressure and adjustment of dosages as necessary.

From the Research

Tadalafil and Diltiazem Contraindications

  • There are no direct studies on the interaction between Tadalafil and Diltiazem in the provided evidence.
  • However, it is known that Tadalafil is a phosphodiesterase-5 (PDE5) inhibitor, and its interaction with other medications can be significant 2, 3.
  • Diltiazem is a calcium channel blocker, which can also affect blood pressure and interact with other medications.
  • PDE5 inhibitors, such as Tadalafil, can cause a decrease in blood pressure, and their use with other medications that affect blood pressure, such as calcium channel blockers, may require caution 2, 4.
  • The use of PDE5 inhibitors with certain medications, such as nitrates or alpha-blockers, is contraindicated due to the risk of severe hypotension and syncope 2, 5, 3.
  • It is recommended to exercise caution when using Tadalafil with other medications that affect blood pressure, and to consult with a healthcare professional before taking any new medications 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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