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Drug Info

Can you take Cialis with lisinopril?

Lisinopril and Cialis can generally be taken together, but there are some risks you should monitor for
By | Dec. 12, 2024 Medically reviewed by Josephine Bawab, Pharm.D.
Three little blue pills with question marks: Can you take Cialis with lisinopril?

Key takeaways

  • Lisinopril is an ACE inhibitor used to treat high blood pressure. Cialis is a PDE5 inhibitor used to treat erectile dysfunction and symptoms of an enlarged prostate in men.

  • Cialis and lisinopril are typically safe to take together. The main contraindication to Cialis is nitrates, which can cause an unsafe drop in blood pressure.

  • While rare, there is a risk of blood pressure decreasing when taking Cialis and lisinopril, which may lead to dizziness, lightheadedness, and fainting.

  • The most common starting dose for lisinopril is between 2.5 and 10 mg daily. The typical starting dose for Cialis when treating erectile dysfunction is 10 mg as needed. A 5 mg dose is often used to treat benign prostatic hyperplasia (BPH).

In this article:

Cialis (tadalafil) is a phosphodiesterase 5 (PDE5) inhibitor used to treat erectile dysfunction (ED) and symptoms of enlarged prostate. Like Viagra (sildenafil), another common PDE5 inhibitor, Cialis works by relaxing the blood vessels and improving blood flow. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. It’s a prescription drug used to treat hypertension (high blood pressure) and works by causing the blood vessels to widen so that blood can move more freely. In general, Cialis and lisinopril can be taken together safely.

 Can you take Cialis with lisinopril? 

Cialis and lisinopril are generally safe to take together.

 “Lisinopril and Cialis may be taken together, but you should be aware of the potential risks and monitor for them,” explains Dr. Christina Bookwalter, Pharm.D., a clinical pharmacist with the Veterans Health Administration. “When these drugs are taken together, there is a risk of blood pressure decreasing, which may cause dizziness, lightheadedness, and fainting.”

 Other blood pressure medications, such as alpha blockers, may also interact with Cialis and cause blood pressure to drop suddenly.

 Lisinopril should not be taken with aliskiren, another type of antihypertensive in the direct renin inhibitor class. Taking lisinopril and aliskiren together may increase the risk of kidney problems, hypotension (low blood pressure), and high potassium levels in the blood.

 Diuretics, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), and lithium also carry risks when taken with lisinopril. Dr. Brookwalter cautions that a healthcare professional should monitor anyone taking one of these medications with lisinopril.

 Nitrates, which are taken for chest pain (angina), are the main medications to avoid when taking Cialis and other PDE5 inhibitors. Mixing Cialis with nitrates, such as nitroglycerin, nitrofurantoin, and isosorbide, carries the most risk because it can lead to such a severe drop in blood pressure that it can cause a fatal heart attack or stroke.

 It is also important to note that many conditions that lisinopril is used to treat – including heart disease, clogged blood vessels, high blood pressure, and diabetes – can also cause erectile dysfunction. 

What happens if you take lisinopril and Cialis together?

Common side effects of lisinopril include:

  • Headaches
  • Dizziness
  • Diarrhea
  • Cough
  • Blurred vision
  • Chest pain
  • Sweating
  • Metallic taste in mouth
  • Confusion
  • Cloudy urine
  • Excessive fatigue

 Serious side effects, although rare, may include:

  • High blood potassium (hyperkalemia)
  • Low white blood cell counts (leukopenia)
  • Swelling under the skin (angioedema)
  • Kidney problems
  • Liver problems

 Erectile dysfunction is a very rare side effect of lisinopril, occurring in less than 1% of patients.

 “It’s a well-tolerated medicine,” says Dr. Paul Pavlov, MD, a family doctor at North Bay Family Medical Clinic in Biloxi, Mississippi. “The most serious side effect is angioedema. That’s where you have a very severe allergic reaction where your throat and tongue swell and it becomes a medical emergency.”

 Dr. Pavlov estimates that 98% of his patients do just fine on lisinopril.

 “You worry about a few minor side effects with lisinopril, primarily metallic taste in the mouth, which is like 2-5% of patients, or the rarer side effect of angioedema, which is about one in 1,000.”

 Common side effects of Cialis include:

  • Upset stomach
  • Headaches
  • Heartburn
  • Facial flushing and hot flashes
  • Stuffy nose
  • Muscle aches
  • Back pain
  • Cough
  • Abdominal pain
  • Diarrhea

 Serious side effects, although very rare, may include:

  • Changes in hearing
  • Hearing loss
  • Dizziness
  • Vision loss
  • Allergic reaction
  • Erection lasting more than four hours

 If a patient is having chest pain or shortness of breath going up two flights of stairs, they may need to use caution before taking Cialis and being sexually active, according to Dr. Justin Dubin, MD, a urologist and men’s health specialist in South Florida and co-host of the Man Up Podcast.

 Dr. Dubin says that while Cialis and other erectile dysfunction meds, such as Levitra (vardenafil), do not cause heart attacks, men who have not had an active sex life in a while may take these drugs and suddenly, they’re motivated to have sex. “Their bodies are not used to straining themselves so much, so it’s the active sex that they haven’t done in a while that causes the heart attack,” he explains. Dr. Dubin recommends that patients who have heart issues or lack physical stamina seek medical advice from a cardiologist or primary healthcare provider before starting Cialis.

How long after taking lisinopril can I take Cialis?

 It is generally safe to take lisinopril and Cialis at the same time.

 The max dose for Cialis is 20 milligrams (mg) as needed. Most men take 5 or 10 mg daily.

 For benign prostatic hyperplasia (BPH), the typical Cialis dosage is 5 or 10 mg.

 An advantage of Cialis is it can last up to 36 hours. This is why Cialis is referred to as the “weekend pill.” A man can take one Cialis on a Friday evening, and he should be able to achieve a firm erection during sexual activity over the next few days. “You can set it and forget it,” Dr. Pavlov says.

 Lisinopril is typically given in dosages ranging from 5 to 40 mg, but the usual dose is 10 to 20 mg once daily. It is also used as a combination drug with hydrochlorothiazide, a diuretic.

 “That combination does better as far as lowering blood pressure, as opposed to one or the other,” Dr. Pavlov says.

 Both Cialis and lisinopril can be taken in the morning or at night, and neither need to be taken with food. 

Is it safe to take Cialis with lisinopril?

For most people, it is safe to mix lisinopril with Cialis. The drugs treat different conditions. Lisinopril is for high blood pressure, and Cialis is for erectile dysfunction or benign prostatic hyperplasia.

 Because both Cialis and lisinopril can lower blood pressure, these drugs might cause severe hypotension together. This is uncommon, but together, the drugs can lead to an increased risk of side effects, including dizziness, fainting, lightheadedness, blurry vision, and fatigue.

 Taking Cialis will not affect the effectiveness of lisinopril and vice versa.

 “There’s no benefit to taking them both together,” Dr. Pavlov says. “You take one for blood pressure, and you take the other for either erectile dysfunction or prostatic enlargement.”

 Dr. Dubin echoes Dr. Pavlov. “I don’t think there’s much of a synergistic component here,” Dr. Dubin explains. “I think you’re getting the benefit of getting good erections and getting blood pressure control.”

 However, Dr. Dubin says there is limited data showing that better blood pressure control may improve erections. “We do know that having good blood pressure control is very important for good erectile function,” he says.

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