Does Cialis Lower Blood Pressure?

There are many common side effects associated with Cialis® use — as well as generic Cialis (known as tadalafil).

While this erectile dysfunction (ED) medication is known for its benefits as an ED treatment, the fact is that the active ingredient tadalafil can cause some problems of its own. This includes vision impairment, dizziness, back pain, indigestion and flu-like symptoms, among others.

Before this medication was an ED treatment, it was a treatment for an enlarged prostate (also known as benign prostatic hyperplasia or BPH). And before that, uses of tadalafil included cardiovascular treatment to manage high blood pressure (hypertension).

In other words, the very reason we have Cialis is that some scientists once thought it could be harnessed to lower blood pressure.

Does Cialis actually lower someone’s blood pressure when they take it?

Below, we’ll explain how this medication works, what it does to your blood pressure and why that’s vital information for safe use of this ED drug. We’ll also give you some reminders about how to protect yourself from a bad day taking tadalafil.

Tadalafil is an FDA-approved phosphodiesterase type 5 inhibitor (or PDE5 inhibitor for short).

PDE is an enzyme that prevents smooth muscles — like the ones that let your penis become erect — from relaxing. When you use a PDE-5 inhibitor, your blood vessels can dilate to accommodate blood flow, making erections easier to achieve and maintain.

ED can be caused by a number of issues relating to physical or mental health. But at the center of many sexual function problems is a blood flow issue.

Tadalafil is just one of several PDE5 inhibitors, including Viagra® (sold as generic sildenafil) and Levitra® (or generic vardenafil). But unlike those taken as needed, you can also take tadalafil daily at a low dose — in part because it can stay in your system and be effective for up to 36 hours.

Since tadalafil has vasodilating effects, it can lower blood pressure. And depending on how healthy your blood pressure is, this can either be a benefit or one of the side effects of Cialis.

Most research says these drops are generally safe at the dosages used for ED.

A clinical study found that healthy men taking 20 mg (milligrams) of Cialis® versus a placebo experienced an average decrease of up to 1.6 mm Hg (millimeters of mercury) in systolic blood pressure and 0.8 mm Hg in diastolic blood pressure when lying down. They had a decrease of 0.2 Hg in systolic blood pressure and 4.6 mm Hg in diastolic blood pressure when standing.

For context, people may begin to feel negative effects after a sudden blood pressure drop of 20 mm Hg.

Tadalafil can have a greater effect on lowering pulmonary blood pressure (the one that tells you how well blood is moving through your lungs). That’s why this medication is sometimes used to treat pulmonary hypertension under the brand name Adcirca®.

On its own, tadalafil isn’t likely to cause a dangerous drop in blood pressure in healthy men. But certain medical conditions and drugs can potentially heighten its hypotensive effects.

For instance, tadalafil is currently not recommended for people who have had:

• Recent heart failure

• Recent heart attack

• Recent stroke

• Severe, uncontrolled arrhythmia (irregular heartbeat)

• Angina (chest pain)

• Uncontrolled hypertension

• Hypotension (low blood pressure)

Tadalafil may likewise not be perfectly safe for:

• People with left ventricle obstructions, such as idiopathic hypertrophic subaortic stenosis or aortic stenosis

• Those in too poor of health for sexual activity

• People with bleeding problems or disorders, like multiple myeloma or leukemia, sickle cell anemia or severely impaired autonomic control of blood pressure

• Individuals with liver problems or kidney problems (including those on dialysis)

• Folks with vision loss, non-arteritic anterior ischemic optic neuropathy (NAION) or retinitis pigmentosa

• People with stomach ulcers

Additionally, Cialis may not be safe for men suffering from penile deformations or Peyronie’s disease. It could also be a risk for those predisposed to or with a history of priapism (prolonged erection lasting more than four hours).

Certain disorders can make Cialis dangerous for some users. On top of that, you also need to worry about potential tadalafil interactions.

Some medications can increase the drug’s hypotensive effects to a dangerous level, including:

• Guanylate cyclase stimulators

• Alpha-blockers

• Prescription and over-the-counter nitrates, including poppers, nitric oxide and nitroglycerin

• Substantial amounts of alcohol

• Antihypertensives

• Other medicines that treat erectile dysfunction

Be sure to let your provider know if you take any of these medications.

Things are about to get a little technical here. But chances are, if you’re worried about your blood pressure, you’ve already got some background on the numbers.

Healthcare professionals generally define low blood pressure as any reading below 90/60 mm Hg. If blood pressure goes too low, it can lead to heart attacks, strokes or shock.

If you experience symptoms like chest pain, nausea, vomiting or anything unusual during sex, seek medical attention right away.

Other signs of low blood pressure in the danger zone include:

• Poor concentration

• Fainting

• Difficulty breathing

• Fatigue

• Dehydration or unusual thirst

• Blurry vision

• Cold, clammy or pale skin

• Rapid heart rate

Check in with your healthcare provider if you experience any of these after taking tadalafil.

The effects of tadalafil on your penis are well known. Like other FDA-approved treatment options for ED, it can be safe and effective when used properly.

But here’s the disclaimer: Some people aren’t in a position to use it safely — ever.

If you’re unsure whether you’re one of them, seek medical advice before using tadalafil.

In the meantime, here’s the big picture on tadalafil and your blood pressure:

• While tadalafil does have the potential to lower blood pressure, this effect is typically not cause for concern in healthy men.

• In some cases, however, certain medical conditions or prescription drugs can increase tadalafil’s hypotensive effects — sometimes to a dangerous level.

• That’s why it’s crucial to discuss your medical history and current medications with your healthcare provider before starting this drug.

With a robust understanding of your health, your healthcare provider can work with you to find the best erectile dysfunction solution.

Want to learn more?

We also offer various other erectile dysfunction treatments  — sildenafil (generic for Viagra), Stendra (avanafil) and our chewable ED hard mints — along with therapy and mental health support.