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Last updated June 23, 2020. 5 minute read

Can you drink alcohol with Cialis? Is it safe?

Eli Lilly, the makers of Cialis, warn that combining the ED drug with too much alcohol may cause dizziness or headache, increase your heart rate, or lower your blood pressure. They warn against “too much alcohol” and define that as five glasses of wine or five shots of whiskey. That leaves you with a window for a drink with dinner.

Linnea Zielinski Written by Linnea Zielinski
Reviewed by Dr. Mike Bohl, MD, MPH

Alcohol and erections have an odd relationship. Bars, where the booze flows freely, are perhaps the go-to pick-up spot and likely rank among the top Tinder meet-up locations. A bit of a buzz may even boost your confidence, helping you approach someone. But stay at the bar long enough to pull a Chumbawamba—you had a whiskey drink, you had a vodka drink, you had a lager drink, and you had a cider drink—and you just might find that your pecker packed it in for the night. Yes, we’re talking about “whiskey dick.” 

But what, if any, of that changes if you’re taking Cialis to treat erectile dysfunction? Can you drink alcohol with Cialis, or will the same results follow? Here’s what you need to know about the common medication and how it’s affected by cocktails.

Vitals

  • Cialis is an ED medication that can be taken daily or in anticipation of sexual activity.
  • It works by increasing blood flow to—and decreasing blood flow away from—the penis.
  • Alcohol is also a vasodilator, which means it may lower blood pressure.
  • This could move blood away from the penis, interfering with Cialis’ effect.
  • Alcohol in moderation (two drinks per day for men) shouldn’t cause serious side effects.

What is Cialis, and how does it work?

Cialis is, as you likely already know, a medication designed to treat erectile dysfunction, more commonly known as ED. Although the brand name is Cialis, the active ingredient is actually tadalafil. Cialis comes in four different doses (2.5 mg, 5 mg, 10 mg, and 20 mg) and is taken in advance of expected sexual activity. But there’s also daily Cialis, which comes in either 2.5 mg or 5 mg doses. This version of the medication is taken each day, which may be helpful for people who want more spontaneity and flexibility in their sex lives.

Like other medications to boost sexual function you’ve heard of—such as Viagra, sildenafil, and Levitra—Cialis falls into a class of drugs called phosphodiesterase 5 inhibitors (PDE5 inhibitors). Although erections are surprisingly complicated, these drugs do something simple to help: They all relax muscles in the penis and improve blood flow in order to treat ED.

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What are PDE5 inhibitors?

Erections aren’t just complicated when it comes to alcohol, though. They’re plenty complicated all on their own. Many systems have to work together properly to make one happen. Even if you ignore the emotional and psychological aspects of arousal, the biology of an erection is complex. ED drugs like Cialis work by targeting one specific step in the process where things tend to go wrong.

Blood flow plays a big role in getting and keeping an erection. Before an erection can happen, a messenger called cGMP tells erectile tissue to relax, which allows blood to flow in. But this blood needs to be kept localized to the penis. To make that happen, blood vessels that take the blood back to your heart get compressed so that more blood is trapped in the penis. If all that goes right, you get an erection. The penis is able to relax thanks to an enzyme called phosphodiesterase 5 (PDE5) that breaks down cGMP, ending the signal to the erectile tissue. This is where things tend to go wrong

This enzyme essentially does a balancing act. If you have too much phosphodiesterase or it takes over too soon, cGMP can’t do its job. PDE5 inhibitors like Cialis block this enzyme from breaking down this important messenger that kick starts the blood flow needed to get and maintain an erection. Though getting an erection is complicated, higher levels of cGMP make this process easier.

Is it safe to take Cialis with alcohol?

This requires a bit of nuance and your best judgment. Drinking too much alcohol with Cialis can cause low blood pressure. Both alcohol and Cialis are vasodilators, which means they both lower blood pressure by widening blood vessels. Together, this effect may be dangerous (and unhelpful for erectile function). 

Extending the time between taking your Cialis and tossing back a couple may not help, either. Compared to other ED drugs, Cialis can stay in your system much longer. Viagra lasts somewhere between four and five hours. Levitra can last up to eight hours. Cialis, on the other hand, can stay in your system for up to 36 hours. Unlike Viagra, however, Cialis doesn’t need to be taken on an empty stomach.

Moderation is key here

Eli Lilly, the makers of Cialis, also warn that combining the ED drug with too much alcohol may cause dizziness or headache, increase your heart rate, or lower your blood pressure (Eli Lilly and Company, 2013). But they also underscore moderation on drinking, not total abstinence. In fact, you may find where they draw the line relatively liberal. They warn against “too much alcohol” and define that as five glasses of wine or five shots of whiskey. That leaves you with a window for a drink with dinner.

The Centers for Disease Control and Prevention (CDC) defines moderate drinking as one drink per day for women and two drinks per day for men (Facts about moderate drinking, 2019). And, as you all likely learned in high school health class, one drink isn’t about the container it comes in. A 5-ounce glass of wine, a 12-ounce glass of beer, or a 1.5-ounce shot is one serving of alcohol. Overall, it’s unlikely for moderate drinking to cause serious side effects, but it’s always a good idea to discuss possible drug interactions between your medicine and alcohol with a healthcare provider before giving it a go. And if you are drinking and taking Cialis, always stop drinking if you start to feel dizzy.

Alcohol may interfere with the medication

Contrary to what you may assume, more than one vasodilator also doesn’t help with your erection. Though ED medications like Cialis improve blood flow to your penis in order to enable an erection, they also trap the blood locally. Alcohol widens blood vessels, lowering blood pressure, but doesn’t help contain the blood where it’s needed more. Alcohol can also cause dehydration, which interferes with your penis getting the blood and oxygen flow it needs to perform. And, yes, a simple case of dehydration can cause erectile dysfunction.

Cialis does have its own side effects

These prescription drugs aren’t without their own side effects, however. The most common possible side effects of Cialis and daily Cialis include headache, indigestion, back pain, stuffy or runny nose, blurred vision, muscle aches, rash, and dizziness. If you know that the medication makes you dizzy, seek medical advice about combining the ED drug with alcohol, which could make this problem worse.

Like other ED medications, Cialis may also cause priapism, a serious medical condition characterized by an erection lasting four hours or longer, or sudden loss of vision or hearing. There are some people for whom Cialis may not be advised, such as those with a history of heart problems like heart attack and heart disease or those taking certain medications such as nitroglycerin.