Accutane and Alcohol: Is It Safe To Take Them Together?

Cialis is the brand name for the generic drug tadalafil. Like many other prescription drugs, Cialis is not always compatible with alcohol.[1] There are some examples of prescription medications that cannot be used with alcohol, such as certain sedatives and antidepressants. The FDA-approved prescribing information for Cialis advises against heavy drinking. There’s a reason for that.

Both Cialis and Alcohol Reduce Blood Pressure

Cialis (tadalafil) is part of a family of medications called phosphodiesterase type 5 inhibitors (PDE5). PDE5s increase blood flow to the penis via relaxation of the smooth muscles in the blood vessel walls.[2] Vasodilation is another term for relaxing the blood vessel walls to allow for better blood flow.

Alcohol is also a vasodilator, so when someone drinks alcohol while taking Tadalafil, both are working on their blood vessels in a similar fashion. When that occurs, the blood pressure-reducing effects of both drugs combine to produce a larger decrease in blood pressure than either drug would produce individually.

What Does Vasodilation Mean in Terms of the Interaction?

As mentioned earlier, vasodilation is essentially how PDE5s function to improve blood flow to the penis. The concern lies in the cumulative effects on blood vessels from consuming alcohol along with a PDE5 inhibitor.

Although vasodilation itself is not the issue, it is the primary way Cialis achieves its intended purpose. Problems arise when two vasodilating agents enter a person’s bloodstream simultaneously, producing a synergistic effect on blood vessels that exceeds what either agent would cause on its own.

Not everybody who combines Cialis with alcohol will experience adverse reactions. Some people will consume moderate amounts of alcohol and take Cialis without experiencing significant side effects. Other people, particularly those with pre-existing cardiovascular conditions (e.g., heart disease) or hypertension or low blood pressure, are more likely to experience sudden reductions in blood pressure or other adverse reactions associated with Cialis.

What Does Vasodilation Mean in Terms of the Interaction?

As mentioned earlier, vasodilation is essentially how PDE5s function to improve blood flow to the penis. The concern lies in the cumulative effects on blood vessels from consuming alcohol along with a PDE5 inhibitor.

Although vasodilation itself is not the issue, it is the primary way Cialis achieves its intended purpose. Problems arise when two vasodilating agents enter a person’s bloodstream simultaneously, producing a synergistic effect on blood vessels that exceeds what either agent would cause on its own.

Not everybody who combines Cialis with alcohol will experience adverse reactions. Some people will consume moderate amounts of alcohol and take Cialis without experiencing significant side effects. Other people, particularly those with pre-existing cardiovascular conditions (e.g., heart disease) or hypertension or low blood pressure, are more likely to experience sudden reductions in blood pressure or other adverse reactions associated with Cialis.

Will Drinking Stop Cialis From Working?

This question arises frequently and has two aspects to the response. First, pharmacologically speaking, no. The prescribing information approved by the U.S. Food and Drug Administration states that neither Tadalafil nor alcohol affected the other’s concentration levels in the bloodstream.[3]

Hence, in this limited sense, alcohol does not interfere with Cialis’ functioning at the biochemical level. Second, although alcohol does not chemically interact with Cialis and does not inhibit its functioning, alcohol can still impede a person’s ability to obtain or sustain an erection regardless of whether Cialis is functioning properly at the biochemical level. Heavy drinking can prevent many people from achieving an erection even when they are receiving effective treatment for erectile dysfunction (ED) with a PDE5 inhibitor like Tadalafil.

The National Institute of Diabetes and Digestive and Kidney Diseases identifies excessive drinking as a lifestyle variable that contributes to erectile dysfunction as a distinct entity from any potential contribution due to medication.[4]

Alcohol does not counteract Tadalafil chemically. It merely impedes the desired outcome, which can appear virtually identical to chemical counteraction.

What Happens if I Mix Cialis and Alcohol?

Potential side effects that may occur when combining Cialis and alcohol include:[5]

• Feeling dizzy or lightheaded
• A headache
• Flushing
• Rapid heartbeat
• Low blood pressure
• Faintness or passing out

All of these possible side effects are consistent with what is found in the prescribing information for Cialis, as well as in patient drug information materials provided by the manufacturers of Cialis. Mild forms of these side effects are extremely prevalent, whereas severe side effects are relatively rare. As noted previously, the risk of side effects increases proportionally to the amount of alcohol consumed and not based on whether one consumes any alcohol whatsoever.

Why Excessive Drinking May Cause Worsening Erectile Dysfunction

In addition to inhibiting a person’s ability to attain an erection when taken concomitantly with Cialis, excessive drinking impairs sexual function per se and apart from any influence exerted by any ED medication.[6] The impact of alcohol on a person’s nervous system, blood circulation, and hormonal balance can render attaining erections significantly more difficult regardless of whether they receive treatment for erectile dysfunction with a PDE5 inhibitor.

The National Institute of Diabetes and Digestive and Kidney Diseases indicates that excessive drinking is a risk factor for sexual dysfunction in general, including erectile dysfunction specifically. Individuals suffering from heart-related problems or other medical issues pose a heightened risk of complications stemming from combining excessive drinking with ED medication.

Who Should Exercise Caution Regarding Mixing Cialis and Alcohol?

Individuals belonging to certain categories require additional consideration relative to combining Cialis and alcohol, specifically:[8]

• Low blood pressure or histories of fainting
• Heart-related problems (e.g., myocardial infarction)
• Prescribed alpha blockers for BPH
• Consuming any other prescription medication or dietary supplement affecting blood pressure
• Dizziness or lightheadedness following ingestion of Cialis (with or without alcohol)
• Regularly engaging in excessive drinking

As stated earlier, Cialis contains several potential drug-drug interactions in addition to its interactions with alcohol. Nitrates represent the most serious example of these interactions; taking nitrates with any PDE5 inhibitor (i.e., Cialis, Viagra [sildenafil], Levitra [vardenafil]) creates an unacceptable risk of precipitous declines in blood pressure.[9]

This article addresses interactions involving only alcohol; nonetheless, patients taking multiple medications should consult their physician or pharmacist concerning the complete scope of their medication regimen.

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Frequently Asked Questions About Mixing Cialis and Alcohol