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Cialis and Grapefruit: Is There an Interaction?

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD

Written by Our Editorial Team

Published 03/27/2021

Updated 03/12/2024

Cialis® is one of the most well-known medications for treating erectile dysfunction approved by the U.S. Food and Drug Administration (FDA), but if you want to take it safely, you’d better watch your consumption of one food: grapefruit.

Unlike orange juice, grapefruit juice can impact how Cialis is metabolized in your body, leading to increased levels of the medication in your system. That can be dangerous for a variety of reasons.

Does this mean you have to stop drinking grapefruit juice every morning? It’s a little complicated. Read on to learn why there’s caution, and what to do with your breakfast beverage for your safety.

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You should avoid mixing grapefruit and Cialis because grapefruit has the ability to increase the concentration levels of Cialis in your bloodstream, which may cause an increased risk of side effects.

Let’s back up for a second, though. 

Like Viagra® and Stendra®, Cialis (tadalafil) works to increase blood flow to the penis, which can treat erectile dysfunction and help to improve your sexual satisfaction — it’s also used in the treatment of benign prostatic hyperplasia, otherwise known as prostate enlargement.

In its role as a PDE5 inhibitor, tadalafil acts as a vasodilator to promote the flow of blood to the penis.

Grapefruit can increase the amount of Cialis in your bloodstream.

CYP3A4 (an enzyme in your intestine) is responsible for the metabolism of many drugs, including Cialis. Grapefruit can inhibit CYP3A4. Therefore, grapefruit can block the metabolism of Cialis, and more of the drug enters the body’s circulation.

Grapefruit has been known to cause similar effects when taken with some antihypertensives, as well as other PDE5 inhibitors like sildenafil (generic Viagra) and vardenafil. 

It has even been known to cause strokes when taken with certain migraine medications.

For the best results, avoid drinking or eating grapefruit around the time you intend to use Cialis.

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While grapefruit consumption may seem harmless, you may actually experience heightened side effects of Cialis. 

Tadalafil and grapefruit may not produce noticeable side effects in smaller amounts, but there’s no clear way to predict how many side effects you’ll experience from a tadalafil grapefruit combination — or how severe they’ll be.

Keep your eyes open for: 

  • Headaches

  • Indigestion

  • Back pain

  • Muscle pain

  • Nasal congestion

  • Flushing

If you feel signs of less common but serious side effects like changes in vision, changes in hearing, priapism (an erection lasting more than four hours) or chest pain — whether you’ve consumed grapefruit juice or not with Cialis — seek medical advice immediately.

Choose your chew

Here’s an important spoiler: grapefruit is not the secret answer to the question, “What can I take to enhance Cialis?” Trying to create some Cialis grapefruit mixture in the name of harder erections is unsafe, and rolling the dice on those side effects risks is how some men end up in the emergency room.

In the case of grapefruit and Cialis, this liquid or the fruit itself produces an unwanted effect — known as a “drug interaction.” 

Cialis also interacts with drugs like alpha blockers and nitrates.

There are plenty of ways to give Cialis the best conditions to do its job, and those might be better considered enhancements. Things on that list include timing your dose properly and talking to your healthcare provider about the most appropriate dose for you.

“How long does grapefruit stay in your system” is a different question. According to the journal, American Family Physician, an 8oz glass of grapefruit juice can stay in your digestive system for up to 72 hours.

That being the case, anyone taking Cialis should not eat grapefruit or drink grapefruit juice for three days before starting the medication.

If you are taking a daily dose of Cialis (a.k.a. tadalafil 2.5mg or 5mg taken every day), you may not be able to consume grapefruit at all. Be sure to talk to your healthcare provider about this possible tadalafil interaction.

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Cialis is high up on the recommendation list when it comes to managing erectile dysfunction.

However, care must be taken to avoid the effects of grapefruit juice when taking Cialis (namely, the increased risk of experiencing side effects).

Learn more about the effects Cialis can have on your body by speaking with a qualified healthcare provider.

6 Sources

  1. Bailey, D. D. G., & Dresser, G. K. (2012, August 17). Interactions between grapefruit juice and cardiovascular drugs. American Journal of Cardiovascular Drugs. Retrieved October 28, 2021, from https://link.springer.com/article/10.2165/00129784-200404050-00002.
  2. Blum, et al. (2006, August 15). Management of grapefruit-drug interactions. American Family Physician. Retrieved October 28, 2021, from https://www.aafp.org/afp/2006/0815/p605.html. Aliotta, et al. (2006, July 27). Tadalafil dosed once a day in men with erectile dysfunction: A randomized, double-blind, placebo-controlled study in the US. Nature News. Retrieved October 28, 2021, from https://www.nature.com/articles/3901496.
  3. Casabé, et al. (n.d.). Long-term safety and tolerability of Tadalafil in the treatment of erectile dysfunction. European urology. Retrieved October 28, 2021, from https://pubmed.ncbi.nlm.nih.gov/15036680/.
  4. Choi, et al Y. (2010). Efficacy and safety of tadalafil 5 mg administered once daily in Korean men with erectile dysfunction: A prospective, Multicenter Study. Korean Journal of Urology, 51(9), 647. https://doi.org/10.4111/kju.2010.51.9.647
  5. Coward, R. M., & Carson, C. C. (2008, December). Tadalafil in the treatment of erectile dysfunction. Therapeutics and clinical risk management. Retrieved October 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643112/.
  6. U.S. Department of Health and Human Services. (n.d.). Definition & Facts for erectile dysfunction. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved October 28, 2021, from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts.
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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