A lot of men suffering from ED (here and below – erectile dysfunction) are successfully using specific drugs like Viagra, Cialis, or Levitra to improve their health status.

Cialis is characterized by its mild impact on the body and prolonged effect lasting up to 36 hours. However, it can cause some side effects in combination with other drugs. You can easily avoid troubles by eliminating those substances during the treatment.

What Is Cialis?

Cialis is the popular medication for ED with the active ingredient tadalafil belonging to the class of PDE5 (phosphodiesterase type 5) inhibitors. The drug stimulates the release of nitric oxide, relaxing smooth muscles in the penile chambers and supplying the vessels with blood. Sexual arousal or stimulation result in the increased blood flow to the penis. Eventually, the man gets an erection which declines after the climax.

Medications such as Cialis and Kamagra help men to maintain an erection no matter what. Unlike most of them, Cialis kicks in much quicker – within 15-45 minutes – and lasts longer. Because of its ability to remain active during 36 hours after use, the remedy was called the “weekend drug” among patients.

The drug has contraindications as well as many others. Consult your doctor before starting a treatment if you have the below-mentioned conditions:

• blood cell disorders;
• liver or kidney failure;
• recent heart attack, surgery or hypertensive crisis;
• injury or defect of the penis;
• cardiac diseases;
• pressure fluctuations or arrhythmias.

Also, Cialis is not intended for people with a specific sensitivity to tadalafil, patients younger than 18 years old, and women.

An average dosage of tadalafil is 5-20 mg per intake. It is suitable for daily usage, but its prolonged effects allow men to take one tablet every second day.

Cialis Interactions

Cialis interacts with numerous substances including:

• drugs based on nitrates (nitroglycerin, isosorbide dinitrate, isosorbide mononitrate);
• CYP3A4 (here – Cytochrome P450 3A4) and PDE5 inhibitors (sildenafil, avanafil, vardenafil and some herbal supplements with similar action);
• grapefruit juice;
• liver and kidneys medications;
• alcohol;
• azole antifungals;
• macrolide antibiotics;
• bronchodilators;
• alpha-blockers;
• HIV protease and hepatitis C virus protease inhibitors.

Even though this list is not full, those interactions proved to be the most critical for the human’s body. So, let’s take a closer look at Cialis’ consumption together with most widespread drugs and substances which you may take right now.

Cialis and Alcohol Consumption

Many people are asking the question “Does alcohol affect Сialis?” There is nothing surprising about this because alcoholic beverages are often associated with a good time. Some men prefer to get a drink before sex due to its libido enhancement. However, exceeding the right dose may cause an adverse effect and lead to erectile dysfunction even in healthy people.

Can you drink alcohol with tadalafil? It depends on the alcohol’s dosage. Small or moderate amounts of it don’t interfere with the medication’s action. At the same time, you may experience undesirable effects such as vertigo, dizziness, low blood pressure, and headache while taking Сialis and alcohol together in large doses. Consume wisely and don’t get drunk during the treatment.

Cialis with Food

Unlike Viagra, Cialis is compatible with food, except for a few products. Its action will be not suspended if you eat before taking the medication. That is why you can feel free about combining your meal and the pill containing tadalafil.

However, some people still have doubts about how to take Cialis: with or without food. Several patients get better erections on an empty stomach, and there is a simple explanation. Physical activity (sex also belongs to this category of activities) becomes quite challenging after indulging in fatty food or overeating. Some experts recommend refraining from physical activities for 2-3 hours after the last meal, so you can make a conclusion from that.

Other scientists are skeptical about Cialis’ kicking in after a meal. They suggest that the stomach needs time to digest food, and that’s why it can’t absorb tadalafil immediately. Anyway, you can have a meal but choose lighter dishes and take the medicine in advance.

Grapefruit and Grapefruit Juice

The only noticeable product incompatible with Cialis is grapefruit. This seemingly innocuous fruit contains specific enzymes that prevent the drug’s excretion from the body. Such an interaction increases a risk of overdose and the emergence of side effects such as:

• headache;
• low blood pressure;
• flushing;
• lightheadedness or even fainting.

Don’t worry: it doesn’t mean that you should avoid eating grapefruits and drinking grapefruit juice during the entire period of treatment. Discuss a reasonable amount of it with your doctor and consume it from time to time if you are not going to use the drug on a daily basis. The enzymes in grapefruit need about 72 hours to leave the body, so don’t eat this product shortly before the intake of Cialis.

Cialis Drug Interactions

Here we are going to talk about Cialis interactions with the other medications. Mixing this ED remedy with some of those drugs before or after intercourse may be dangerous for your health. Let’s sort out which medicines are prohibited during treatment and how they react with tadalafil.

Flomax

Flomax belongs to alpha-blockers and is used to relieve the condition of those who suffer from benign prostatic hyperplasia (also known as an enlarged prostate or BPH). The drug relaxes the smooth muscles of the bladder and prostate, making the urination less difficult for patients.

In some cases, Cialis is also prescribed to treat BPH. If you have this condition, it is better to choose the one which is more suitable particularly for you. Still, Flomax can’t help with ED, so patients with both ED and BPH should consider Cialis as the only medication for both disorders.

Why is it undesirable to take Flomax and Cialis together? They may cause similar side effects that increase while using both drugs.

You may experience:

• headache;
• chest pain;
• dizziness or lightheadedness;
• fainting;
• cardiovascular malfunctions (arrhythmia, faster heartbeat);
• low blood pressure.

This mix is not considered to be dangerous for the overall health condition, but patients with low blood pressure, liver and kidney diseases, and prostate cancer should consult their doctor before starting the treatment.

Tamsulosin

In fact, tamsulosin is an active ingredient in Flomax and is also its generic drug’s name. They both are used for the same purpose: the treatment of BPH mentioned above. Taking it with Cialis causes the effects which were listed in the previous paragraph.

Even though these two drugs together don’t lead to dire consequences, alcohol, Cialis, and tamsulosin interaction is far from safe. Tadalafil and tamsulosin reinforce each other’s effects the same as alcohol does. The triple combination may enhance dizziness and lightheadedness, as well as cause indigestion, blurred vision, and diarrhea. Avoid alcohol during your BPH treatment.

Lisinopril

Lisinopril belongs to ACE (here and below angiotensin-converting enzyme) inhibitors. Those substances are used for hypertension, heart attack, and congestive heart failure treatment. They reduce the element called angiotensin II in blood content, dilate blood vessels, increase the production of the urine, and decrease the levels of noradrenaline and aldosterone. As the result, all these processes lower blood pressure.

What this means is that Cialis and lisinopril being taken together may lower blood pressure to a critical level. It leads to the increase of such side effects as dizziness, faintness, or lightheadedness, which are inherent to both drugs.

Otherwise, the interaction of Cialis and lisinopril is designated to be mild and don’t cause any other unwanted effects. You can combine them carefully unless you have hypotension or cardiovascular problems. In this case, you should contact your doctor prior to mixing them.

Hydrocodone Drugs

Hydrocodone is an opioid pain reliever. This medicine may be used alone or with other components in compound drugs (for instance, Vicodin). People take it mostly for severe pain treatment because the substance is very potent and can cause addiction. Mild and moderate pains are usually treated by more sparing medications.

Its interaction with Cialis hasn’t been studied well, although it is not recommended taking these drugs together. Hydrocodone is able to cause noticeable side effects including:

• breathing problems;
• pain during urination;
• severe drowsiness, dizziness and light-headed feeling;
• impotence and loss of libido;
• nausea and vomiting.

Hydrocodone decreases libido and may lead to erectile dysfunction. That is why it’s a bad idea to take the drug if you want to eliminate your men’s health problems. On the other hand, hydrocodone enhances side effects of Cialis which they have in common.

Nitroglycerin Medication

Nitroglycerin is a nitrate drug (nitrovasodilator) used for heart conditions and angina pectoris. This medication is contraindicated for people who use Cialis due to the risk of a fatal decrease in blood pressure or heart failure.

If it is necessary for you to use nitroglycerin from time to time, you can take it 48 hours after the last intake of tadalafil. The substance’s remains will be completely removed from the body during this period.

Propranolol

Propranolol is a prescription non-selective beta-receptor blocking agent. The group of medicines called beta-blockers is widely used for heart disease treatment. Some studies proved their efficiency for reducing chest pain, migraines, and tremors.

Also, this drug has an influence on blood pressure and can cause hypotension with all the attendant consequences. In turn, low blood pressure is one of the possible side effects of Cialis. Even though the combination is relatively safe, there is always a small risk of drowsiness and weakness while mixing these medicines.

Another issue which you can encounter when combining the drugs is a change in sex drive or performance. This effect interferes with ED treatment, so it’s better to avoid propranolol on the days you take Cialis.

Ramipril

Ramipril is a popular remedy for hypertension which is also sold as Altace. Besides, it reduces the probability of heart attack, stroke, or sudden death due to heart failure. Sometimes it can be prescribed for people after heart surgery or those who survived a recent heart attack.

This drug belongs to the class of ACE inhibitors. The mechanism of those substances’ action has been described in the paragraph dedicated to lisinopril. Therefore, it causes the same reactions as the majority medications for hypertension. The patients may experience a reduction in blood pressure, headache, and weakness while taking ramipril and Cialis together.

Losartan

Losartan is another medication for high blood pressure similar to ramipril, Flomax, and tamsulosin. However, it referred to another group of substances called angiotensin receptor blockers (further mentioned as ARBs). Once incorporated into the body, they act similarly to ACE inhibitors by blocking the angiotensin production, dilating vessels, and increasing the blood flow through them. It leads to lowering the blood pressure.

The medication also used for other purposes, such as:

• reducing the risk of strokes in patients with enlarged heart;
• protecting kidneys in patients with diabetes.

If you are not suffering from hypotension nor taking the specific drugs which also lower it, you can use losartan in combination with Cialis. Patients with pressure issues should be careful because the lowering of blood pressure results in dizziness, weakness, headache, and other undesirable side effects.

Xanax

Xanax is a medicine intended for the treatment of anxiety and panic disorders. Also, it may be efficient for people with depression. The active ingredient of the remedy, alprazolam, is a benzodiazepine. This class of agents affects the central nervous system through selective activation of the specific receptors in the brain. Those receptors reduce the activity of neurons and soothe the nervous system.

There are some reports from people using both Xanax and Cialis that benzodiazepines interfere with normal sexual lives. They say the drug decreases the libido and sometimes it is hard to reach climax. By the way, there are no studies which show the relation between weak erections and the combination of Xanax and Cialis.

If you have anxiety and should take Xanax on a daily basis, try to lower the dose before taking Cialis. In case, you use Xanax occasionally, simply avoid taking this medicine 48 hours in advance of intercourse.

Can I Take Cialis with Nitrates?

As it was previously mentioned, nitroglycerin and similar medications which belong to the nitrates group are prohibited to use together at the same time with Cialis. One research proved that the sudden deaths of several patients who used both drugs were not a coincidence. In 1998, 16 out of 130 people who died after using Viagra (also a PDE5 inhibitor, a similar drug to Cialis) were taking also nitrates. The other deaths happened for other reasons.

Nitrates plus Cialis may cause severe weakness, fainting, and abnormally low blood pressure. People with angina pectoris, the disease which is often being treated by nitroglycerin, are at significant risk of heart attack in the case of critical decrease in blood pressure.

There are four of the most widespread forms of nitrates you should avoid within 48 hours before and after using Cialis:

1. Nitroglycerin (Deponit, Nitrodisc, Nitro-DUR, Nitrogard, Nitroglyn, Minitran, Nitrek, Nitrolingual, Nitro-Time, Transderm-Nitro, Nitrol, Nitrong, Nitro-Par Nitrostat).
2. Isosorbide mononitrate (Imdur, Ismo, Monoket).
3. Isosorbide dinitrate (Sorbitrate, Erythrityl tetranitrate, Dilatrate-SR, pentaerythritol tetranitrate, Isordil, sodium nitroprusside).
4. Street drugs called “poppers” or alkyl nitrites (isoamyl nitrite, isopentyl nitrite, isobutyl nitrite, isopropyl nitrite, pentyl nitrite, butyl nitrite).

This list may not be full, so if you suspect that your medicine is a nitrate or nitrite, call your healthcare provider and clarify this information.

Does Cialis Interact As Well As Viagra?

People often compare Viagra vs Сialis: there are lots of ongoing debates on forums dedicated to ED or other medical conditions. Actually, nobody wins this battle. Both sildenafil (Viagra) and tadalafil (Cialis) are PDE5 inhibitors used to treat erectile dysfunction. Belonging to the same class of drugs, they demonstrate similar effects on a male body.

The differences are the following:

1. Duration of the effect: Cialis lasts up to 36 hours, Viagra – only 5-6 hours max.
2. Time needed for kicking in: Cialis works after 15-45 minutes while Viagra needs 30-60 minutes.
3. Success rate: various sources provide different information on the effectiveness of those drugs. However, it is still not obvious which one works better.

The registered interactions of Viagra and Cialis are quite similar. Both drugs are contraindicated with nitrates and work with alcohol, antibiotics, alpha-blockers, blood pressure medications, and liver or kidney remedies in the same way.

It is not recommended to mix both Viagra and Cialis shortly after a meal, especially if it contains fatty food. You should also avoid drinking or eating grapefruit and grapefruit juice while using Viagra.

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