What Can I Take with Cialis to Make It Work Better? A Pharmacological Guide

October 10, 2025 •

4 min read

Tadalafil (Cialis) is effective for over 80% of men with erectile dysfunction (ED) [1.2.3]. So, what can I take with Cialis to make it work better while ensuring safety? This guide explores options from lifestyle adjustments to potential supplements.

Quick Summary

Optimizing Cialis (tadalafil) involves more than medication timing. Lifestyle changes like diet and exercise can significantly boost its effects. Certain substances must be avoided, while some supplements show promise under medical supervision.

Key Points

Consult a Doctor First: Always speak with a healthcare provider before combining Cialis with any other medication or supplement.
Lifestyle is Key: The most effective way to improve Cialis's performance is through healthy lifestyle changes like diet, exercise, and weight management [1.2.4].
Avoid Nitrates: Never take Cialis with nitrates (for chest pain) due to the risk of a life-threatening drop in blood pressure [1.7.2].
Beware of Grapefruit: Grapefruit juice can increase Cialis levels in your blood, raising the risk of side effects, and should be avoided [1.9.1].
Limit Alcohol: Excessive alcohol consumption can increase side effects like dizziness and may counteract the effectiveness of Cialis [1.8.3].
Be Cautious with Supplements: While some supplements like L-arginine show promise, their use should be supervised by a doctor [1.5.1].
Proper Dosing and Timing: Take Cialis exactly as prescribed. For 'as-needed' use, take it at least 30 minutes before sexual activity [1.2.1].

Important Medical Disclaimer

Always consult with a qualified healthcare provider before taking any new medications, supplements, or making changes to your existing treatment plan. The information in this article is for informational purposes only and does not constitute medical advice. Self-treating can be dangerous.

Understanding Cialis (Tadalafil) and Its Mechanism

Cialis, with the active ingredient tadalafil, belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors [1.8.2]. It works by increasing blood flow to the penis during sexual stimulation [1.8.2]. By inhibiting the PDE5 enzyme, tadalafil allows the smooth muscles in the penile blood vessels to relax for a longer period, facilitating and maintaining an erection [1.6.1]. Unlike some other ED medications, the absorption of tadalafil is not significantly affected by food, and its effects can last up to 36 hours [1.2.2, 1.6.3]. This provides flexibility, but also requires careful consideration of what other substances are in your system during this long window.

Lifestyle Changes: The Foundation for Better Efficacy

Before looking for other substances to take, the most effective and safest way to improve how Cialis works is by adopting a healthier lifestyle. Erectile dysfunction is often linked to cardiovascular health, diabetes, and other conditions that can be improved with lifestyle modifications [1.2.2].

Key Lifestyle Adjustments:

Regular Exercise: Engaging in cardiovascular exercise, like brisk walking for at least 30 minutes a day, can decrease the risk of ED by 41% according to one Harvard study [1.4.3]. Exercise improves blood flow throughout the body, which is essential for Cialis to work effectively [1.4.3].
Healthy Diet: A diet rich in fruits, vegetables, whole grains, and fish, while low in red meat and refined grains, can decrease the likelihood of ED [1.4.3]. This type of diet supports cardiovascular health, which is crucial for erectile function [1.4.5].
Weight Management: Obesity is a significant risk factor for ED. Losing even a small percentage of body weight can dramatically improve erectile function and the effectiveness of Cialis [1.2.3].
Limit Alcohol Consumption: While moderate alcohol intake (one to two drinks) is generally considered safe, excessive drinking (five or more drinks) can lower blood pressure and increase side effects like dizziness when combined with Cialis [1.8.3]. Heavy alcohol use can also directly impair your ability to get an erection, counteracting the medication's benefits [1.8.3].
Quit Smoking: Smoking damages blood vessels, which can worsen ED [1.4.3]. Quitting can lead to improvements in both overall cardiovascular health and erectile function [1.4.2].
Manage Stress and Sleep: High stress levels and poor sleep quality can negatively impact sexual performance [1.4.3]. Practices like meditation, yoga, and ensuring adequate sleep can support erectile function [1.2.4].

Crucial Interactions: What NOT to Take with Cialis

Combining Cialis with certain medications and substances can be extremely dangerous. The most critical interactions involve drugs that also affect blood pressure.

Absolutely Avoid:

Nitrates: This is a non-negotiable contraindication. Taking Cialis with any form of nitrates, often prescribed for chest pain (angina) like nitroglycerin, can cause a sudden and life-threatening drop in blood pressure [1.7.2, 1.7.3]. This also includes recreational drugs known as "poppers" (amyl nitrite or butyl nitrate) [1.7.4].
Guanylate Cyclase (GC) Stimulators: Medications like riociguat (Adempas), used for pulmonary hypertension, should not be taken with Cialis as the combination can lead to severe low blood pressure [1.7.3, 1.7.5].

Use with Caution and Medical Guidance:

Alpha-Blockers: Used for high blood pressure or an enlarged prostate (e.g., tamsulosin, doxazosin), these can also lower blood pressure. A doctor must carefully manage the combination to avoid dizziness and fainting [1.7.3].
Blood Pressure Medications: Cialis can add to the blood-pressure-lowering effects of antihypertensives [1.7.4].
CYP3A4 Inhibitors: Certain antifungal drugs (like ketoconazole), antibiotics (like erythromycin), and HIV protease inhibitors can increase the levels of Cialis in your blood, raising the risk of side effects [1.7.4]. Grapefruit and grapefruit juice are also CYP3A4 inhibitors and should be avoided, as they can increase Cialis concentration in the bloodstream for up to 72 hours [1.9.1, 1.9.2].
Other PDE5 Inhibitors: Do not combine Cialis with other ED drugs like sildenafil (Viagra) or vardenafil (Levitra) unless specifically instructed and supervised by a healthcare provider [1.7.4].

Supplements and Combination Therapies: What Does the Research Say?

Some studies suggest that certain supplements might help, but the evidence is often limited, and they should never be used without a doctor's approval.

L-arginine: This amino acid helps the body produce nitric oxide, which is key for erections. One 2020 study showed that L-arginine provided similar improvements in ED when used alone or when combined with tadalafil [1.5.1].
Panax Ginseng (Red Ginseng): Some analyses have shown that red ginseng can lead to significant improvements in erectile function and sexual satisfaction [1.5.1]. It may work by boosting nitric oxide production [1.5.5].
Testosterone Therapy: For men who have both ED and diagnosed low testosterone, Cialis may not work as well [1.2.3]. In these cases, a doctor may prescribe testosterone replacement therapy, which can improve the responsiveness of blood vessels and, in turn, the effectiveness of Cialis [1.2.3].


Approach	Evidence Level	Safety Concerns	Key Consideration
Lifestyle Changes	High	Low	Foundational for improving overall health and medication efficacy [1.4.1].
L-arginine	Moderate	Generally safe, but can interact with blood pressure medications.	A 2020 study suggests it can work with or without tadalafil [1.5.1].
Panax Ginseng	Moderate	Can cause insomnia; potential drug interactions.	May improve sexual satisfaction [1.5.1].
Avoiding Nitrates	High (Contraindicated)	Severe, life-threatening drop in blood pressure [1.7.3].	Absolute rule: Never combine Cialis and nitrates [1.7.2].
Avoiding Grapefruit	High	Increases drug concentration and risk of side effects [1.9.1].	Effect can last up to 72 hours; avoid completely if on daily Cialis [1.9.2].

Conclusion

To make Cialis work better, the most reliable and safest approach is to focus on comprehensive health improvements through diet, exercise, and weight management [1.2.4]. It is critically important to avoid dangerous drug interactions, especially with nitrates and grapefruit juice [1.7.2, 1.9.1]. While some supplements like L-arginine and Panax ginseng show promise, they lack extensive research and must be discussed with a healthcare professional before use. Never attempt to enhance Cialis's effects by taking more than the prescribed dose or by combining it with other ED medications without explicit medical guidance [1.2.1]. Your doctor can provide the best advice tailored to your specific health profile.

Authoritative Link: Tadalafil - StatPearls - NCBI Bookshelf [1.6.1]

Frequently Asked Questions

Moderate alcohol consumption (1-2 drinks) is generally considered safe. However, excessive drinking (5 or more drinks) can increase the risk of side effects like dizziness and low blood pressure, and can also worsen erectile dysfunction [1.8.3].

Grapefruit juice inhibits an enzyme that metabolizes Cialis, leading to higher levels of the drug in your bloodstream. This increases the risk of side effects like headaches and muscle pain. The effect can last for up to 3 days, so it's best to avoid it entirely [1.9.1, 1.9.2].

You should not take Cialis with other PDE5 inhibitors like Viagra unless specifically directed and monitored by a healthcare provider. Combining them significantly increases the risk of side effects such as dangerously low blood pressure [1.7.4].

Some research suggests that L-arginine may improve erectile function, and one study found it worked similarly whether used alone or with tadalafil [1.5.1]. However, you must consult your doctor before taking it, as it can interact with other medications.

Yes. Obesity is a major risk factor for ED. Studies show that weight loss can significantly improve erectile function and may dramatically enhance the effectiveness of Cialis [1.2.3].

Nitrates, which are medications often prescribed for chest pain (angina), are the most dangerous drugs to combine with Cialis. The interaction can cause a severe and potentially fatal drop in blood pressure [1.7.2, 1.7.3].

Unlike some other ED medications, Cialis's absorption is not significantly affected by food, including high-fat meals [1.2.1, 1.6.3]. You can take it with or without food. The only major food interaction to avoid is grapefruit [1.9.1].