Does Cialis (Tadalafil) Lower Blood Pressure?

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Cialis is a popular treatment for ED. The two reasons for this are:
  • The 10mg and 20mg ‘when required doses’ have a 36-hour window of action
  • The 2.5mg and 5mg doses can be taken daily, providing a sustained low dose in the body. This prevents scheduling doses allowing men to get an erection spontaneously.

What effect does Cialis have on blood pressure?

Approximately one in two men suffer from erectile dysfunction (ED) at some point in their life. ED is a common condition, so there’s no need to feel as though you’re alone or unusual for experiencing these common symptoms. It may also come as a relief to learn that there are several ED tablets available, that can treat – and potentially reverse the effects of ED. Cialis, the branded version of the drug, tadalafil, is a very popular and proven treatment for men to achieve and maintain an erection hard enough for sexual intercourse. However, Cialis can slightly lower blood pressure. In order to increase blood flow to the penis, tadalafil, the active ingredient in Cialis, widens blood vessels. This is to make it easier for blood to enter the penis and cause an erection. In turn, this can temporarily cause a drop in blood pressure. Most men will not notice any effects, as the drop in blood pressure is usually too low to have a meaningful impact. This article explores the link between Cialis and blood pressure in more detail.

What is Cialis (tadalafil)?

Tadalafil is a drug that belongs to a class of medication known as PDE-5 inhibitors. It is often referred to as ‘generic Cialis.’ A relatively newer impotence treatment, tadalafil doesn’t increase sex drive, and will only work in situations where sexual stimulation occurs. Tadalafil tablets can also be used to treat an enlarged prostate, and high blood pressure in the lungs. 

Cialis is a tablet that is taken by mouth, and the onset is typically within half an hour of ingestion. The effects of Cialis may last for up to 36 hours, hence the nickname ‘the weekend pill.’ There are two ways you can take Cialis – it is available in a daily dosage, or the aforementioned ‘use when ready’ form. 

Below, details the different doses of tadalafil:

Cialis Daily (2.5mg & 5mg)

Cialis Daily is available in 2.5mg and 5mg tablets. Cialis Daily is taken every day as opposed to taking it before sexual activity. The benefit of taking these lower dosages means that there is always a steady stream of the mediation in your system, and that you’re prepared for sexual activity whenever the need arises.

Cialis daily takes effect from around 3-5 days, and the medication has a continuous effect until you stop taking it.

If you’re interested in taking tadalafil daily, you should begin by taking Cialis or the generic version in the 2.5mg dosage. Should you feel that the effects of this dosage are unsatisfactory, speak to your doctor or pharmacist about increasing the dosage to 5mg. 

The continuous effect provided by taking tadalafil can help you maintain spontaneity in your sex life and remove the need to schedule sexual activity aligned with medication dosages from some other common ED treatments. Whether taken daily, or as needed, Cialis may remain in your system for up to 1.5 days after your last dosage. 

Cialis 36 hour (10mg & 20mg)

Cialis 36 hour is taken 30-60 minutes before sexual activity and has a duration of action for up to 36 hours, which is why these higher dosages are so aptly named as ‘the weekend pill.’ Although you may not take these pills every day, you’ll still be able to enjoy a long window of action from an appropriately timed single dose.

Cialis 10mg & 20mg take approximately 30-60 minutes to kick in, and the effects can last for up to 36 hours.

If you’re looking to begin a treatment protocol, the most commonly prescribed starting dose is 10mg, as this dosage leaves you less susceptible to any side effects. If you’re a man with a history of low blood pressure, you will want to consult your doctor or healthcare provider to ensure this medication is right for you. 

You should only take one tablet at a time, approximately half an hour before you plan to engage in sexual activity. Avoid alcohol consumption prior to taking tadalafil, as this can have a negative effect on your ability to achieve and maintain an erection. Do not take more than one tablet in a 24-hour period

How does Cialis work?

Cialis – or tadalafil – similar to other erectile function medications like Viagra, works by facilitating blood flow to the penis. When you’re sexually stimulated, your nervous system releases nitrous oxide, which acts as a vasodilator, relaxing blood vessels and allowing oxygen and other nutrients to pass through the body. 

For men suffering from ED, the PDE-5 enzyme blocks this action. Cialis works to lower PDE-5 levels. This allows blood vessels to widen, increasing blood flow around the body, including the penis. This action has an effect on blood pressure, lowering it.

How does Cialis affect people with low blood pressure?

Cialis lowers blood pressure by causing blood vessels to widen, with the aim of increasing blood flow to the penis. This is usually safe for most men.

Where this becomes a problem, is if you have uncontrolled blood pressure, or a history of excessive fluctuation. Temporarily lowering your blood pressure before it increases again can put you at risk of a cardiovascular event, or potentially even a heart attack. 

Another area of concern is if you’re taking any alpha-blockers or nitrates (such as glyceryl trinitrate or Isosorbide Mononitrate) which are used to treat angina, then you should avoid taking Cialis. A combination of tadalafil and nitrates can cause a sudden drop in blood pressure to a dangerously low level. If you are taking an alpha-blocker, you will need to be initiated on Cialis at the lowest dose, as a combination of the two can cause a significant drop in blood pressure.

If you are taking medication to treat high blood pressure, Cialis is usually safe to take, provided that your blood pressure is under control. Beta blockers, ACE-inhibitors or diuretic medications shouldn’t pose a danger to your health if combined with Cialis. There is a small risk of experiencing a drop in blood pressure, but this risk is usually managed by starting with a low dose and working your way up if necessary. This should only be done under the supervision of your doctor. You may be asked to monitor your blood pressure after taking a tablet and record the readings.

A clinical study looking at the effect of Cialis 20mg on blood pressure, found that on average, Cialis lowers systolic blood pressure (the top reading) by 4.8 mmHg, and diastolic blood pressure by 2.9 mmHg. This drop in blood pressure is too small to have a meaningful impact.

To put it into perspective, your blood pressure would need to drop 5 times more, to feel any side effects such as headache and dizziness.

What are the side effects of Cialis (Tadalafil) on blood pressure?

Aside from the risk of hypotension, or a significant lowering of blood pressure, the medication presents few other side effects directly related to blood pressure. Since tadalafil works as a vasodilator, the medication slightly lowers blood pressure, but it shouldn’t dramatically affect your levels unless you’re also taking a nitrate medication.

Common side effects of Cialis include:

  • A slightly lower than normal blood pressure level
  • Headaches
  • Blurred, or changes in colour of your vision
  • Abnormal ejaculation
  • Priapism – A prolonged erection that is painful or lasts longer than 4 hours 
  • Dyspepsia (a condition where proper digestion is impaired, resulting in upper abdominal discomfort)
  • Nasal congestion 
  • Indigestion
  • Flushing (sense of warmth in the face, ears, neck, and trunk)
  • Nosebleeds

Remember, tadalafil tablets will only work in the event that you’re sexually aroused: The treatment itself (or any other type of ED drugs) will not increase your libido.

The verdict

Whilst tadalafil has the ability to lower blood pressure, the effects are not usually a cause for concern in healthy individuals. It is important to discuss your medical history in full with your healthcare provider, including any medication being taken.

If you are taking medication that can interact with tadalafil, your healthcare provider may wish to start you on a lower dose, to minimise any chances of experiencing side effects.


Is Cialis good for your heart?

Cialis is generally safe for men with healthy hearts – in fact, the medication was created as a result of exploring heart condition treatments. Even if you are taking medication to treat high blood pressure, there is a good chance that it is safe for you to take Cialis. Whilst there is evidence to suggest that Cialis is good for the heart, overall, the data is not robust enough to be confident of this.

Does Cialis raise or lower blood pressure?

Cialis does not raise blood pressure, in fact, it lowers blood pressure. Additionally, Cialis can cause your blood pressure to drop to an unsafe level very rapidly if it is combined with any nitrate medication. This could result in symptoms ranging from feeling dizzy, to having a heart attack or stroke. As with any new medication, it is wise to consult your doctor if you’re thinking of taking Cialis.

Is Cialis good for high blood pressure?

Cialis can lower blood pressure, which in principle, can be good for those with uncontrolled high blood pressure. However, it does not lower blood pressure to the extent that antihypertensives do, so it is unlikely to have a meaningful impact on lower blood pressure. If you have uncontrolled high blood pressure, you should not use Cialis. Lowering blood pressure and allowing it to increase above the normal range can put you at risk of having a heart attack.

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.