From the Guidelines
It is recommended to limit alcohol intake to 1-2 drinks per day while taking tadalafil, as excessive alcohol consumption can increase the risk of side effects. When considering the consumption of alcohol while taking tadalafil, it's essential to be aware of the potential interactions and risks. Moderate alcohol consumption, typically defined as 1-2 drinks per day, is generally considered safe but may not be suitable for everyone, particularly those with certain health conditions or taking other medications. The combination of alcohol and tadalafil can amplify the vasodilatory effects, potentially leading to orthostatic hypotension, which is a sudden drop in blood pressure when standing, and this can cause dizziness, headaches, and fainting 1. Key considerations for patients taking tadalafil include:
- Limiting alcohol intake to reduce the risk of adverse effects, as recommended by the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease 1.
- Being aware of how their body responds to the combination of alcohol and tadalafil, and seeking medical attention if they experience any concerning symptoms.
- Consulting their healthcare provider for specific recommendations, especially if they have liver problems, cardiovascular conditions, or are taking other medications.
- Following the general guidelines for alcohol consumption, such as those outlined in the 2024 ESC guidelines for the management of elevated blood pressure and hypertension, which recommend restricting alcohol consumption to less than 14 units/week for men and less than 8 units/week for women 1. Ultimately, the decision to consume alcohol while taking tadalafil should be made with caution and under the guidance of a healthcare provider, prioritizing the patient's safety and well-being.
From the FDA Drug Label
Do not drink too much alcohol when taking tadalafil tablets (for example, 5 glasses of wine or 5 shots of whiskey). Drinking too much alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate, or lowering your blood pressure Alcohol — Both alcohol and tadalafil, a PDE5 inhibitor, act as mild vasodilators. When mild vasodilators are taken in combination, blood-pressure-lowering effects of each individual compound may be increased. Substantial consumption of alcohol (e.g., 5 units or greater) in combination with tadalafil can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache.
It is not recommended to drink excessive alcohol while taking tadalafil, as it may increase the risk of orthostatic hypotension, dizziness, and headache. However, moderate alcohol consumption is not explicitly contraindicated. To be cautious, it is advised to limit alcohol intake to minimal levels and avoid consuming substantial amounts (5 units or more) when taking tadalafil 2, 2.
From the Research
Interaction between Tadalafil and Alcohol
- There is no direct evidence in the provided studies that addresses the interaction between tadalafil and alcohol consumption.
- However, it is known that both tadalafil and alcohol can have effects on blood pressure and cardiovascular health 3, 4.
- Tadalafil is a phosphodiesterase 5 inhibitor that can cause a slight reduction in arterial systemic blood pressure 4.
- Alcohol consumption can also lower blood pressure and may increase the risk of hypotension when combined with certain medications.
Cardiovascular Safety of Tadalafil
- Studies have shown that tadalafil is generally safe in patients with cardiovascular disease and those taking antihypertensive medications 3, 5, 6.
- The incidence of severe adverse cardiovascular events was rare in tadalafil users and similar in frequency to placebo 3.
- However, caution is advised when taking tadalafil with certain medications, such as nitric oxide donors, which can lead to significant arterial hypotension 3, 4.
Concomitant Use of Tadalafil with Other Medications
- Tadalafil can be safely used with many antihypertensive medications, but caution is needed when used with alpha-blocking agents 3, 7.
- The combination of tadalafil with doxazosin may increase the risk of hypotension, while the combination with tamsulosin appears to be safe 7.
- It is essential to consult with a healthcare professional before taking tadalafil, especially if you are taking other medications or have underlying health conditions 3, 5, 6.