STOP — Contraindicated
FDA contraindication. Tadalafil longer half-life (17.5h) means the 48-hour contraindication window is longer than sildenafil (24h).
Evidence level: STRONG
Cialis (tadalafil) with nitroglycerin can cause a fatal blood pressure drop, just like Viagra. Because Cialis lasts much longer in your body (up to 36 hours), you must wait at least 48 hours after taking Cialis before using any nitrate.
Same mechanism as sildenafil-nitrate interaction. Tadalafil has longer half-life (17.5h) so the contraindication window is 48 hours. FDA tadalafil label contraindicates nitrates.
Do not take nitroglycerin within 48 hours of Cialis. Tell emergency responders if you have taken Cialis in the past 2 days — they need to know before giving nitrates for chest pain.
Take Tadalafil and Nitroglycerin as prescribed by your healthcare provider. If both are taken daily, maintain consistent timing for each. Ask your pharmacist about optimal spacing — they have access to comprehensive interaction databases and can provide personalized timing guidance.
Higher risk for: elderly, those with liver or kidney impairment, polypharmacy (5+ medications), recent medication changes, or those with multiple chronic conditions. Consult your pharmacist for specific risk factors.
Severe drop in blood pressure, dizziness, fainting, loss of consciousness, rapid heartbeat, chest pain
Note the longer contraindication window (48h vs 24h for sildenafil). Carry medical ID. Discuss alternative chest pain management if ED medication was recently taken.
Discuss safer alternatives with your healthcare provider. They can recommend substitutions based on your specific health goals while minimizing interaction risks. Always bring a complete list of everything you take to your appointments.
Cialis (tadalafil) with nitroglycerin can cause a fatal blood pressure drop, just like Viagra. Because Cialis lasts much longer in your body (up to 36 hours), you must wait at least 48 hours after taking Cialis before using any nitrate.
Take Tadalafil and Nitroglycerin as prescribed by your healthcare provider. If both are taken daily, maintain consistent timing for each. Ask your pharmacist about optimal spacing — they have access to comprehensive interaction databases and can provide personalized timing guidance.
Severe drop in blood pressure, dizziness, fainting, loss of consciousness, rapid heartbeat, chest pain
Discuss safer alternatives with your healthcare provider. They can recommend substitutions based on your specific health goals while minimizing interaction risks. Always bring a complete list of everything you take to your appointments.
Note the longer contraindication window (48h vs 24h for sildenafil). Carry medical ID. Discuss alternative chest pain management if ED medication was recently taken.
Or browse the full interaction database (121,000+ pairs).