Cialis and alcohol: is it safe to mix the two?

You might already have a beer in hand as you search online for an answer to the question, “Can you mix Cialis and alcohol?” The simple answer is yes. You can have a drink or two while taking Cialis (tadalafil). There are a few caveats, though.

Cialis works in part by widening the blood vessels in your penis. But it does the same thing elsewhere in your body. And just like on a highway, if you have a wider road, you’ve got less traffic. Less traffic in your blood vessels means lower blood pressure. 

Much like Cialis and other erectile dysfunction (ED) medications, alcohol also widens your blood vessels. That means that combining the two can make your blood pressure drop significantly, leading to dizziness. And if a dizzy spell isn’t enough to turn down that fifth drink, alcohol is known to make it harder to get hard. Yes, “whiskey dick” is a thing, and it can inhibit the effects of a drug like Cialis. 

Here’s what you need to know about mixing Cialis and alcohol. 

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It’s generally safe to mix Cialis and alcohol, as long as we’re talking about having a drink or two. Moderate alcohol consumption is unlikely to affect Cialis or cause any health risks, but drinking excessively while taking the ED drug is not advised, as it can be harmful to your health. 

More specifically, the prescribing information for Cialis (and that for tadalafil) cautions against drinking too much alcohol—“for example, 5 glasses of wine or 5 shots of whiskey”—when taking the medication. That’s because drinking heavily on the drug can lead to an increased heart rate or a drop in blood pressure, among other adverse side effects. 

So, what is moderate vs. excessive drinking, exactly? The Centers for Disease Control and Prevention (CDC) defines moderate drinking as one drink per day for women and up to two drinks per day for men. Excessive drinking, on the other hand, is four or more drinks per day for women and five or more drinks per day for men. Drinking this much in a day—considered binge drinking—is too much when you’re taking Cialis.

Wondering what counts as one drink? One serving of alcohol can translate to:

• 12 ounces of beer (assuming 5% alcohol by volume)

• 5 ounces of wine

• 8 ounces of malt liquor 

• 1.5 ounces of 80-proof liquor (e.g. brandy, gin, rum, tequila, vodka, whiskey)

Consuming too much alcohol (i.e. five or more drinks in a day) while taking Cialis can increase your chances of the following side effects:

• Headache

• Dizziness 

• Increased heart rate

• Lowered blood pressure 

Both alcohol and Cialis act as vasodilators; they relax and widen blood vessels, increasing and lowering blood pressure. So, combining the two substances can amplify the BP-lowering effect, potentially leading to orthostatic hypotension, a sudden drop in blood pressure that can involve dizziness, fainting, headache, and rapid heart rate. In extreme cases, it can make you lose consciousness.

Then, there’s the risk of the dreaded “whiskey dick.” You’ve probably heard, or experienced firsthand, that alcohol can make it harder to get an erection. If you struggle with ED, steering clear of alcoholic beverages altogether may be a good idea. And if you want to test the water (or whiskey), you can see how one drink affects your ability to get an erection while taking Cialis before trying more. That said, it’s always a good idea to consult your healthcare provider before taking matters into your own hands—always. 

Overall, it’s unlikely for moderate drinking on Cialis to cause serious side effects. Still, it’s always a good idea to discuss possible drug interactions between any medications (including Cialis) and alcohol with a healthcare provider before giving it a go.

Alcohol isn’t the only thing that can interact with Cialis. If you are taking any of the following medications, let your healthcare provider know before starting treatment with Cialis :

• Nitrates such as nitroglycerin (NitroStat)

• Guanylate cyclase (GC) stimulators, such as riociguat

• Alpha-blockers such as tamsulosin

• Blood pressure medications

• HIV medications

• Ketoconazole (Nizoral)

• Itraconazole (Sporanox)

• Erythromycin

• Other ED treatments like Viagra (sildenafil) 

You also might not be able to take Cialis if you have certain health conditions, including:

• A history of heart problems, such as a heart attack, stroke, or heart disease

• Liver problems

• Stomach ulcers

• Bleeding problems 

Medications and medical conditions aside, you could still experience side effects of Cialis without drinking alcohol or combining it with another drug. The most common possible side effects of Cialis include headache, indigestion, back pain, stuffy or runny nose, muscle aches, flushing, and dizziness. 

The drug may also cause priapism, which is when an erection lasts for four hours or longer. Other rare but serious side effects include sudden loss of vision or hearing. Seek immediate medical attention if you experience these symptoms.

There is no official “waiting period” after drinking alcohol before you should take Cialis. Some medications should be separated from alcohol, but Cialis generally isn’t one of them. If you only have one or two drinks in a day, you should still be able to take Cialis at your usual time. When it comes to mixing Cialis and alcohol, the main thing to be aware of is how much you drink. 

That’s because moderate alcohol use while taking Cialis is generally considered safe. Consuming heavy amounts of alcohol, however, can increase your risk of adverse side effects (e.g. dizziness, low blood pressure, fainting) and reduce sexual performance, undermining the drug’s purpose. 

It’s best not to take Cialis if you’ve been drinking a lot of alcohol. In studies, people who took Cialis within 10 minutes of having a large amount of alcohol (about six shots of vodka) were more likely to feel dizzy or have their blood pressure drop too low. When people drank a small amount (up to two shots), the effects weren’t any worse than with alcohol alone.

If you know you’re going to be drinking more than a few alcoholic beverages, you may want to hold off on taking Cialis and check with your healthcare provider about what’s safe for you. 

If your prescriber tells you to avoid alcohol with Cialis, it’s best to wait until the medication wears off. Cialis’ effects on erectile function can last 36 hours, but it may take up to four days for the drug to completely clear out of your system. That said, most people can safely take Cialis with a moderate

amount of alcohol. That’s one or two drinks a day for men. 

Other ED medications like Viagra are mostly eliminated from your system within 24 hours. So, if you’re looking for a shorter-acting ED treatment, talk to your healthcare provider about whether switching medications might be right for you. Keep in mind, though, that drinking more than a moderate amount of alcohol while taking Viagra may also lead to an increase in side effects  of alcohol.)

So, if you had a couple of drinks with dinner before you and your date head to the bedroom, you’re likely fine to take Cialis—as long as you didn’t go overboard. It’s best to skip your dose of alcohol if you’ve been drinking heavily,  since combining Cialis with a lot of alcohol (i.e. five drinks or more) can make you feel dizzy or cause your blood pressure to drop.

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Sometimes, you just want to have a beer with your friends, and you don’t want to have to worry about how that drink (or two) may affect your ED treatment. Before throwing back a couple of cold ones, though, there are a couple of basics about Cialis and alcohol you’re going to want to keep in mind. 

• Drinking alcohol in moderation (~1–2 alcoholic beverages in a day) is generally safe while taking Cialis. 

• Upping your alcoholic intake to five or more drinks at a time, however, can increase the risk of side effects such as low blood pressure, headache, dizziness, and rapid heart rate. 

• That’s because both Cialis and alcohol are vasodilators that can lower blood pressure. Mixing the two can amplify their BP-lowering effects. 

• In addition to increasing your chances of experiencing the aforementioned orthostatic symptoms, drinking lots of alcohol can make it harder for you to get and maintain an erection—a phenomenon you might better know as “whiskey dick.” This ultimately counteracts the point of taking the ED drug in the first place.  

• If you have any questions about potential interactions or are taking certain medications, always consult your healthcare provider before taking Cialis—or any other new drug, for that matter.