Medications · FAQ
Why must tadalafil never be combined with nitrates or poppers?
Short answer
Tadalafil must not be combined with nitrates or recreational nitrites, often called poppers, because the combination can cause a dangerous drop in blood pressure. If you have chest pain after taking tadalafil, call 911. Do not take nitroglycerin yourself, and tell emergency staff when you last took tadalafil.
Nitrates include nitroglycerin and isosorbide medicines used for chest pain and some heart conditions. Recreational nitrites, such as amyl nitrite or butyl nitrite, are often called poppers. Combining any of these with tadalafil can sharply lower blood pressure and cause fainting or a life-threatening emergency.
Do not stop a prescribed nitrate so you can take tadalafil. Tell your prescriber about all nitrate use, including medicine you carry for occasional chest pain. A licensed physician in your state must review this before deciding whether ED treatment is appropriate.
If chest pain happens during sex, stop the activity and call 911. Do not take nitroglycerin yourself after tadalafil. Tell emergency staff your tadalafil dose and the exact time you last took it, if known.
In a life-threatening situation, clinicians generally wait at least 48 hours after the last tadalafil dose before considering a nitrate, and only with close monitoring. This is not a safe self-use rule. Never decide on your own when to restart nitrates.
Sources
Written by the Verra clinical team · Medical review pending
General information, not medical advice. If you're in crisis, call or text 988.
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