On this page Jump to a section
- Key facts
- Does Cialis raise blood pressure?
- Does Viagra raise or lower blood pressure?
- Blood pressure effect in the FDA labels
- Taking them with blood pressure medicine
- Can I take ED pills with high blood pressure?
- What each path includes
- Label hard stops
- Start an ED visit
- Mendoxa plans and prices
- FAQ
- How we wrote this
- Sources and references
Key facts at a glance
- Cialis, healthy men
- 1.6/0.8 mm Hg supine versus placebo with 20 mg; “no significant difference”Cialis (tadalafil) label · DailyMed
- Viagra, healthy men
- Mean maximum drop 8.3/5.3 mmHg sitting with 100 mg; back to placebo level by 8 hoursViagra (sildenafil) label · DailyMed
- Cialis with BP pills
- 3/2 (amlodipine) to 8/4 mm Hg (ARBs) more than placeboCialis (tadalafil) label · DailyMed
- Viagra with amlodipine
- Additional 8/7 mmHg supine drop in hypertensive patientsViagra (sildenafil) label · DailyMed
- Never combine with
- Nitrates or riociguat: contraindicated with both drugsCialis (tadalafil) label · DailyMed
- Compounded status
- The Mendoxa compounded tablet is not FDA-approvedFDA compounding Q&A
Does Cialis raise blood pressure?
Usually no: tadalafil is a mild vasodilator, so the expected direction is down, not up. The Cialis (tadalafil) label reports that tadalafil 20 mg in healthy men produced “no significant difference compared to placebo” in blood pressure: 1.6/0.8 mm Hg lying down and 0.2/4.6 mm Hg standing, with no significant effect on heart rate.
Can Cialis cause high blood pressure? The label records reports of it. In one 24-week once-daily study in the Cialis (tadalafil) label, hypertension was reported as an adverse reaction in 0% on placebo, 1% on tadalafil 2.5 mg and 3% on tadalafil 5 mg. That is a reported reaction rate from one study, not proof that Cialis caused each case.
For the broader treatment picture, see our tadalafil guide and Viagra and heart health guide. For cardiovascular precautions, see the Viagra (sildenafil) label.
Does Viagra raise or lower blood pressure?
Viagra lowers it a little, temporarily. The Viagra (sildenafil) label reports a mean maximum decrease of 8.3/5.3 mmHg sitting after sildenafil 100 mg in healthy volunteers, most notable about 1–2 hours after the dose and no different from placebo at 8 hours.
See the sildenafil guide for dosing context; the Viagra (sildenafil) label remains the reference for numbers.
Blood pressure effect in the FDA labels
Read these as separate study results, not a head-to-head comparison. The Viagra (sildenafil) label and Cialis (tadalafil) label use different doses, positions and comparisons. Supine means lying down; ambulatory means measured during daily activity. These averages do not predict your individual response.
| Situation studied | Viagra (sildenafil) label | Cialis (tadalafil) label |
|---|---|---|
| Healthy men, single dose | 100 mg: mean maximum decrease of 8.3/5.3 mmHg sitting (8.4/5.5 mmHg supine in section 5.1); most notable about 1–2 hours after dosing, not different from placebo at 8 hours; similar with 25, 50 and 100 mg (Sildenafil label) | 20 mg: difference from placebo in mean maximal decrease of 1.6/0.8 mm Hg supine and 0.2/4.6 mm Hg standing; “no significant difference compared to placebo” and no significant effect on heart rate (Tadalafil label) |
| Amlodipine | 100 mg with amlodipine 5 or 10 mg in hypertensive patients: mean additional supine drop of 8 mmHg systolic and 7 mmHg diastolic (Sildenafil label) | 10 mg with amlodipine 5 mg: 3/2 mm Hg supine versus placebo; with 20 mg, no clinically significant difference (Tadalafil label) |
| Angiotensin II receptor blockers (ARBs) | No separate figure in this label; it warns that Viagra “may further lower blood pressure in patients taking anti-hypertensive medications” (Sildenafil label) | 20 mg in men taking any marketed ARB (alone or with other antihypertensives): 8/4 mm Hg versus placebo on ambulatory monitoring (Tadalafil label) |
| Enalapril (ACE inhibitor) | No separate figure in this label (Sildenafil label) | 10 mg with enalapril 10–20 mg: 4/1 mm Hg supine versus placebo (Tadalafil label) |
| Metoprolol | No separate figure in this label (Sildenafil label) | 10 mg with sustained-release metoprolol 25–200 mg: 5/3 mm Hg supine versus placebo (Tadalafil label) |
| Bendrofluazide | No separate figure in this label (Sildenafil label) | 10 mg with bendrofluazide 2.5 mg: 6/4 mm Hg supine versus placebo (Tadalafil label) |
| Alpha-blocker: doxazosin | Placebo-subtracted mean maximum systolic drop, supine/standing: 7.4/6.0 mm Hg (25 mg), 9.08/11.62 mm Hg (50 mg), 7.9/4.3 mm Hg (100 mg); start at 25 mg with an alpha-blocker (Sildenafil label) | 20 mg with doxazosin 8 mg: placebo-subtracted mean maximal systolic drop of 3.6 mm Hg supine and 9.8 mm Hg standing (Tadalafil label) |
| Alpha-blockers: tamsulosin, alfuzosin | Covered by the general alpha-blocker caution; no separate figure (Sildenafil label) | Placebo-subtracted mean maximal systolic decrease: tadalafil 10 mg with tamsulosin 0.4 mg, 3.2 supine / 1.7 standing mm Hg; tadalafil 20 mg, 3.2 supine / 2.3 standing mm Hg. Tadalafil 20 mg with alfuzosin 10 mg: 2.2 supine / 4.4 standing mm Hg (Tadalafil label) |
| Alcohol | 50 mg with alcohol 0.5 g/kg: maximum observed systolic change −18.5 mmHg versus −17.4 mmHg with alcohol alone; diastolic −17.2 versus −11.1 mmHg; “did not potentiate the hypotensive effect of alcohol”; 100 mg not evaluated (Sildenafil label) | At 0.7 g/kg alcohol, more men had clinically significant drops than with alcohol alone and some orthostatic hypotension; 5 units or more can increase dizziness and standing blood-pressure drops (Tadalafil label) |
| Nitrates and riociguat | Contraindicated: Viagra potentiates the hypotensive effects of nitrates; do not use with riociguat (Sildenafil label) | Contraindicated; the 48-hour emergency nitrate provision requires close medical supervision and monitoring, not self-directed use (Tadalafil label) |
| Blood pressure limits in section 5.1 | No controlled data with resting hypotension (below 90/50 mmHg) or hypertension (above 170/110 mmHg); if prescribed, with caution (Sildenafil label) | Not recommended with hypotension (below 90/50 mm Hg) or uncontrolled hypertension (Tadalafil label) |
Sources: Viagra (sildenafil) label, sections 4, 5.1, 5.5, 7 and 12.2; Cialis (tadalafil) label, sections 4, 5.1, 5.6, 5.9, 7.1 and 12.2. Figures are placebo-subtracted only where stated. Paired figures describe systolic/diastolic pressure unless a row explicitly says supine/standing systolic pressure; mm Hg is the pressure unit. Accessed Oct 23, 2026.
Do not choose a drug by subtracting the table figures from your own reading. The Viagra (sildenafil) label reports a mean maximum sitting decrease; the Cialis (tadalafil) label reports differences from placebo in mean maximal decreases. Neither figure establishes which drug is safer for you.
Taking Viagra or Cialis with blood pressure medicine
Most blood pressure medicines are not a contraindication, but the effects add up. The Cialis (tadalafil) label says “small reductions in blood pressure occurred” when tadalafil was combined with amlodipine, ARBs, bendrofluazide, enalapril and metoprolol; the Viagra (sildenafil) label says sildenafil “may further lower blood pressure in patients taking anti-hypertensive medications.”
Alpha-blockers need extra care. Both the Viagra (sildenafil) label and Cialis (tadalafil) label say you should be stable on the alpha-blocker before starting a PDE5 inhibitor, which is then started at the lowest dose; the combination can cause symptomatic hypotension such as dizziness, lightheadedness or fainting.
If the question is whether your blood pressure pills are causing ED, that is a different issue: NIDDK lists high blood pressure and blood pressure medicines among causes of ED. Read ED and blood pressure and lisinopril and ED. For medicine-interaction precautions, see the Viagra (sildenafil) label and Cialis (tadalafil) label.
Can I take ED pills if I have high blood pressure?
Controlled high blood pressure is not listed as a contraindication in the Viagra (sildenafil) label or Cialis (tadalafil) label. Suitability still depends on cardiovascular status and interactions; use this checklist to prepare for a prescribing decision.
- Check for a contraindication. Do not combine either medicine with nitrates, organic nitrites such as poppers, or riociguat (Viagra (sildenafil) label; Cialis (tadalafil) label). Read ED medication and nitrates.
- Flag uncontrolled or low readings before treatment. Cialis is not recommended with uncontrolled hypertension or blood pressure below 90/50 mm Hg (Cialis (tadalafil) label); Viagra has no controlled safety or efficacy data with resting readings below 90/50 or above 170/110 mmHg and calls for caution if prescribed (Viagra (sildenafil) label). These are label precautions, not treatment targets.
- Share heart history. Viagra calls for caution after a heart attack, stroke or life-threatening arrhythmia within the last 6 months (Viagra (sildenafil) label); Cialis is not recommended after a heart attack within 90 days or stroke within 6 months, among other cardiovascular conditions (Cialis (tadalafil) label). See Viagra and your heart.
- List all medicines and alcohol use. Alpha-blockers require stability on therapy before starting the ED medicine at its lowest recommended dose; other antihypertensives can add to blood-pressure lowering (Viagra (sildenafil) label; Cialis (tadalafil) label). Substantial alcohol use also increases hypotension risk with tadalafil (Cialis (tadalafil) label).
- Prepare for the visit. Have recent readings, your medicine list and the questions you want answered ready. Independent licensed providers assess suitability. Prescription required.
Ready for an assessment? Start the online ED visit with that information at hand. For background before the visit, compare sildenafil vs tadalafil.
Could Mendoxa ED care fit you?
Online ED visit · Prescription required · Independent licensed providers · Not available in California
What each path includes
Use the visit to answer a specific question. This guide helps you prepare; a clinician makes the prescribing decision.
| Path | Question it addresses | What it includes | Boundary |
|---|---|---|---|
| Blood pressure review | Is my blood pressure controlled, and which medicines do I take? | Recent readings and a full medicine list, which the Viagra (sildenafil) label and Cialis (tadalafil) label ask prescribers to weigh | Changes to blood pressure medicine are made with the clinician who prescribes it |
| ED assessment | What is causing ED? | Medical, sexual and mental health history, an exam and tests (NIDDK); high blood pressure and some blood pressure medicines are listed causes (NIDDK) | A cause is not the same as a treatment plan |
| Standalone ED prescription | Is sildenafil or tadalafil suitable with my readings? | A cardiovascular and medicine review against the Viagra (sildenafil) label and Cialis (tadalafil) label | Nitrates and riociguat rule both out (Viagra (sildenafil) label; Cialis (tadalafil) label) |
| Mendoxa 3-in-1 visit | Does the compounded tablet fit? | Share blood pressure readings, heart history and medicines during the online intake; Independent licensed providers review it; Prescription required. It also contains apomorphine, reviewed against the APOKYN (apomorphine) label | Compounded drugs are not FDA-approved |
Sources: Viagra (sildenafil) label; Cialis (tadalafil) label; APOKYN (apomorphine) label; NIDDK diagnosis; NIDDK causes; FDA compounding Q&A; Mendoxa ED care information. Accessed Oct 23, 2026.
Read the broader erectile dysfunction guide or how online ED prescriptions work before the visit.
Label hard stops
- The APOKYN (apomorphine) label reports dose-related decreases in systolic and diastolic blood pressure, larger with alcohol or sublingual nitroglycerin, and says other vasodilators and antihypertensives may add to them.
Label hard stops (nitrates, riociguat, an erection over 4 hours, sudden vision or hearing loss) are listed once in our sildenafil guide, from the Viagra (sildenafil) label and Cialis (tadalafil) label.
If you have high blood pressure and want ED treatment
Start the online visit to find out whether Mendoxa ED care is appropriate for you. Share your recent blood pressure readings, heart history and every medicine you take; the Viagra (sildenafil) label and Cialis (tadalafil) label ask prescribers to weigh cardiovascular status. Independent licensed providers assess suitability. Prescription required.
The tablet combines sildenafil, tadalafil and apomorphine; it is not FDA-approved. Ingredient references are the Viagra (sildenafil) label, Cialis (tadalafil) label and APOKYN (apomorphine) label; APOKYN is an injectable Parkinson’s treatment, and its label is not approval of this ED combination.
Use the online visit to ask whether the compounded option meets your needs and what alternatives apply. See the combination ED tablet guide and how online ED prescriptions work. Costs appear in the table below.
Mendoxa ED plans and prices
The Mendoxa ED tablet is a compounded rapid-dissolve tablet with sildenafil (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis) and apomorphine (APOKYN label). It dissolves under the tongue. A licensed clinician decides if it fits you and selects the strength. Compounded medicines are not FDA-approved.
| Tablets per month | 1-month total | Per tablet (1 month) | 3-month total | Per tablet (3 months) |
|---|---|---|---|---|
| 6 tablets / month | $129 | $21.50 | $329 | $18.28 |
| 10 tablets / month | $149 | $14.90 | $379 | $12.63 |
| 20 tablets / month | $179 | $8.95 | $449 | $7.48 |
The 3-month total covers three months at the monthly tablet quantity shown.
If prescribed · Cancel anytime · Available in 49 states (not California). Prices from the Mendoxa intake at try.mendoxa.co/f/ed on Oct 23, 2026. The intake always shows the current price.
FAQ
How much does Cialis lower your blood pressure?
The Cialis (tadalafil) label reports differences from placebo in mean maximal decreases of 1.6/0.8 mm Hg lying down and 0.2/4.6 mm Hg standing after 20 mg in healthy men, with no significant difference compared with placebo. Your own response may differ.
Does Viagra lower blood pressure?
Yes, slightly and temporarily: the Viagra (sildenafil) label reports a mean maximum decrease of 8.3/5.3 mmHg sitting after sildenafil 100 mg in healthy volunteers, most notable 1–2 hours after the dose and no different from placebo at 8 hours.
Can Cialis cause high blood pressure?
The label records reports: in one 24-week once-daily study, hypertension was reported in 3% on tadalafil 5 mg, 1% on 2.5 mg and 0% on placebo (Cialis (tadalafil) label). The label does not establish that Cialis caused each case; tell your provider if your readings rise.
Can I take Viagra or Cialis with blood pressure medicine?
Often, with review: the Cialis (tadalafil) label found small additional drops with amlodipine, ARBs, enalapril, metoprolol and bendrofluazide, and the Viagra (sildenafil) label warns sildenafil may further lower blood pressure with antihypertensives. Alpha-blockers need a stable dose first and a low ED starting dose; nitrates and riociguat are contraindicated with both.
Is it safe to take Cialis with high blood pressure?
The Cialis (tadalafil) label does not recommend tadalafil with uncontrolled hypertension or hypotension below 90/50 mm Hg, and the Viagra (sildenafil) label has no controlled data above 170/110 mmHg. Controlled blood pressure is not on either contraindication list, but a provider should check your readings, heart history and medicines.
Does tadalafil raise blood pressure?
Tadalafil generally has a mild blood-pressure-lowering effect, according to the Cialis (tadalafil) label. Hypertension was nevertheless reported in a once-daily trial; that report does not establish the cause. Share any higher readings with your provider.
Ready to see if the Mendoxa ED tablet fits you?
From $129/month if prescribed · Cancel anytime · Available in 49 states (not California)
How we wrote this
Written by the Mendoxa editorial team · Sources: DailyMed/FDA. Medical facts on this page come from the FDA-approved labels on DailyMed and Drugs@FDA; each drug name links to its label. We checked the Viagra (sildenafil) label, Cialis (tadalafil) label and APOKYN (apomorphine) label on Oct 23, 2026, copying blood pressure figures exactly as each label states them and noting whether they are placebo-subtracted, supine, standing or ambulatory. Single-study figures are not predictions for any one person. Ingredient labels describe their approved products; they do not establish safety or effectiveness of Mendoxa’s compounded combination.
Updated Oct 23, 2026. This page is general information, not medical advice. A licensed clinician decides what fits you.
References
- DailyMed: VIAGRA (sildenafil citrate) tablet, film coated, label revised 12/2017. Accessed Oct 23, 2026.
- DailyMed: CIALIS (tadalafil) tablet, film coated, label revised 3/2026. Accessed Oct 23, 2026.
- DailyMed: APOKYN (apomorphine hydrochloride) injection, label revised 6/2022. Accessed Oct 23, 2026.
- FDA (Drugs@FDA): VIAGRA (sildenafil) prescribing information, NDA 020895. Accessed Oct 23, 2026.
- FDA (Drugs@FDA): CIALIS (tadalafil) prescribing information, NDA 021368. Accessed Oct 23, 2026.
- FDA: Compounding and the FDA, questions and answers. Accessed Oct 23, 2026.
- NIDDK: symptoms and causes of ED. Accessed Oct 23, 2026.
- NIDDK: diagnosis of ED. Accessed Oct 23, 2026.
- Mendoxa ED care (product, format, max 1 dose per 24 hours). Accessed Oct 23, 2026.
- Mendoxa ED intake: plan prices (term_options). Accessed Oct 23, 2026.
About Mendoxa
Mendoxa (mendoxa.co) is a US telehealth brand. Independent licensed providers (licensed clinicians in the LocumTele network) review each online visit, and prescriptions are filled by Rush Pharmacy, a licensed US pharmacy. Available in 49 states (not California).
- Prescription required. A licensed clinician reviews every visit and can say no. A prescription is not automatic.
- A compounded medicine is not an FDA-approved finished product (FDA compounding Q&A).
- Plans: 1 month or 3 months, from $129. If prescribed · Cancel anytime · Available in 49 states (not California).
Compounded medication prescribed only if a licensed U.S. clinician decides it is appropriate. Not FDA-approved as a finished product. Not available in California. This site is not for emergencies. Call 911 if you need urgent care.