No, you should not take Viagra (sildenafil) and Cialis (tadalafil) together. These medications are both PDE5 inhibitors, and taking them together can cause a dangerous drop in blood pressure, leading to serious health complications, such as dizziness, fainting, or heart problems.
The Reason Behind Why You Shouldn’t Use It Together
Viagra (sildenafil) and Cialis (tadalafil) work by increasing blood flow to the penis by blocking the enzyme phosphodiesterase type 5 (PDE5).
When taken together, they can amplify their effects, leading to a significant drop in blood pressure (hypotension), which can be risky, especially for those with heart problems or who take medications like nitrates.
This combination also increases the likelihood of experiencing side effects like headaches, dizziness, and prolonged erections (priapism), which could require emergency medical attention.
What Happens if I Take Viagra and Cialis Together?
Taking Viagra (sildenafil) and Cialis (tadalafil) together is strongly not recommended. Doing so can lead to several serious health risks. Here’s what could happen:
Dangerously Low Blood Pressure (Hypotension)
Both Viagra and Cialis work by relaxing the blood vessels to increase blood flow to the penis, which can lower your blood pressure. When taken together, they can cause an extreme drop in blood pressure, leading to symptoms like:
Dizziness
Fainting
Blurred vision
Heart palpitations
This can be life-threatening, particularly for individuals with existing heart or blood pressure issues.
Increased Risk of Side Effects
Taking both medications at the same time amplifies their individual side effects. You could experience:
Severe headaches
Nausea
Flushing
Dizziness
Prolonged erection (priapism), which can be painful and may require emergency medical attention if it lasts for more than 4 hours.
Strain on Your Heart
Both drugs can affect your cardiovascular system by lowering blood pressure. If you have a history of heart disease or are taking medications for heart problems, combining these drugs could strain your heart, potentially causing serious complications like a heart attack or stroke.
Increased Risk of Priapism
Priapism is a prolonged and painful erection lasting more than 4 hours. Taking Viagra and Cialis together increases the likelihood of this rare but serious side effect. If left untreated, it can lead to permanent damage to the penis.
Can You Take Viagra in the Morning and Cialis at night?
No, it is not recommended to take Viagra (sildenafil) in the morning and Cialis (tadalafil) at night, as both are PDE5 inhibitors and work similarly to increase blood flow to the penis.
Tips for Safely Combining Viagra and Cialis
Talk to a doctor before combining these tablets. Watch closely for unusual symptoms or side effects.
Safe Alternatives and What to Do Instead:
Consult Your Doctor
Always speak to your healthcare provider if you’re considering changes in your medication. Your doctor may adjust the dosage or recommend trying a different medication or treatment plan that’s safer and more effective.
Stick to One Medication
Typically, you should use either Viagra or Cialis, depending on your preference for short-term (Viagra) or long-term (Cialis) effectiveness. Your doctor will help you decide based on your health and lifestyle.
Adjust Dosage
If one medication is not effective, your doctor may recommend adjusting the dose of either Viagra or Cialis, but never take both at once.
Timing Considerations
Cialis is longer-lasting (up to 36 hours), while Viagra typically lasts 4-6 hours. This makes Cialis a good option for spontaneous use, while Viagra is better for planned activities.
Alternative ED Treatments if the Combination Doesn’t Work
If combining Viagra (sildenafil) and Cialis (tadalafil) doesn’t work, there are several alternative treatments for erectile dysfunction (ED) that your doctor might recommend. These options can be tailored to your needs and are designed to help with ED if PDE5 inhibitors are ineffective or cause side effects.
Other Oral Medications
If Viagra and Cialis don’t provide the desired effect, other PDE5 inhibitors or different medications might help:
Levitra (Vardenafil): Similar to Viagra, it helps increase blood flow to the penis. It’s often used for those who don’t respond well to Viagra.
Stendra (Avanafil): A newer PDE5 inhibitor with a quicker onset of action (around 15 minutes) and fewer side effects for some people.
Testosterone Therapy
If ED is caused by low testosterone levels (hypogonadism), testosterone replacement therapy (TRT) might be a solution. TRT can be administered through injections, skin patches, or gels to improve libido and sexual performance.
Penile Injections (Intracavernosal Injections)
Alprostadil (Caverject, Edex): Caverject injection is injected directly into the penis to help relax blood vessels and increase blood flow. It’s effective for many men who don’t respond to oral medications.
Bimix or Trimix: These are combinations of medications (alprostadil, papaverine, and phentolamine) injected into the penis for more intense effects.
Penile Suppositories (Intraurethral Therapy)
Alprostadil Urethral Suppository (Muse): A small pellet of alprostadil is inserted into the urethra using a special applicator. It works by increasing blood flow to the penis and can be a good alternative for those who prefer not to use injections.
Vacuum Erection Devices (VEDs)
Penis Pumps: A vacuum erection device involves placing a plastic cylinder over the penis, which creates a vacuum that draws blood into the penis to cause an erection. A constriction band is then placed around the base of the penis to maintain the erection. It is a non-invasive option, especially for those who cannot take medication.
Penile Implants
Surgical Implants: If other treatments fail, a penile implant may be considered. This involves surgically placing a device into the penis that can be inflated or manipulated to produce an erection. This is generally a last resort for severe cases of ED.
Psychological Counseling or Therapy
Sex Therapy or Counseling: Sometimes ED has psychological causes such as stress, anxiety, or relationship issues. Working with a therapist can help address emotional or mental barriers to sexual performance.
Cognitive Behavioral Therapy (CBT): This is effective for overcoming performance anxiety, depression, and other psychological factors that contribute to ED.
Lifestyle Changes
Exercise and Diet: Regular physical activity and a healthy diet can improve blood flow and overall health, often helping with ED. Weight loss and quitting smoking also contribute to improved sexual health.
Reduce Alcohol and Stress: Limiting alcohol consumption and managing stress can improve erectile function.
Herbal or Natural Supplements
Some people try herbal supplements like ginseng, L-arginine, or yohimbine, but these should only be taken under the guidance of a healthcare provider. Some supplements can interact with other medications or cause side effects.