Sildalis (Sildenafil Citrate 100 mg + Tadalafil 20 mg) – Patient Information (UK)

Sildalis contains a combination of two well-known medicines used for erectile and sexual function support: sildenafil citrate 100 mg and tadalafil 20 mg. This combination is designed to provide flexible support for erectile function, drawing on the differing onset and duration of action of each ingredient.

This page explains how Sildalis works, how it is typically used, what to expect, and key safety information. It is written for people in the United Kingdom and covers practical tips, interactions (including food, alcohol, and other medicines), and frequently asked questions.

Quick product overview

What Sildalis is used for (indications)

Sildalis is used to help treat erectile dysfunction (ED)—the difficulty in achieving or maintaining an erection firm enough for satisfactory sexual activity.

Important: Sildalis does not increase sexual desire. It works by helping blood flow to the penis in response to sexual stimulation.

How it works (mechanism of action)

Sildalis combines two medicines that both belong to the phosphodiesterase type 5 (PDE5) inhibitor group:

• Sildenafil helps relax blood vessels by supporting nitric oxide (NO) signalling and improving blood flow.
• Tadalafil also inhibits PDE5, further supporting the NO–cGMP pathway for blood vessel relaxation.

When a man is sexually stimulated, nitric oxide is released, which increases cGMP. PDE5 normally breaks down cGMP. By blocking PDE5, both sildenafil and tadalafil help maintain cGMP levels, leading to improved blood flow and a better chance of erection.

Note: PDE5 inhibitors work only when sexual stimulation is present. They are not an “instant” mechanical device, and psychological factors and overall health can still affect outcomes.

Pharmacokinetics (how the body handles it)

“Pharmacokinetics” describes absorption, distribution, metabolism, and elimination of medicines. Because Sildalis combines two active PDE5 inhibitors, both contribute to the overall clinical effect.

Sildenafil component (general overview)

• Absorption: Absorbs after oral administration; onset may be affected by food, especially high-fat meals.
• Peak effect: Typically occurs a few hours after taking.
• Metabolism: Primarily by the liver (notably the CYP enzyme system, including CYP3A4).
• Excretion: Metabolites are eliminated mainly via faeces and urine.

Tadalafil component (general overview)

• Absorption: Absorbs after oral administration; food effects are usually less pronounced than with sildenafil, but may still influence timing.
• Peak effect: Often occurs within a few hours after taking.
• Metabolism: Mainly via the liver (notably CYP3A4).
• Excretion: Primarily via faeces, with smaller amounts in urine.

Why this matters: Both ingredients are metabolised through similar liver pathways. Medicines that inhibit or strongly induce these pathways can change blood levels and side-effect risk.

Typical use and when to take it (timing)

Sildalis is taken by mouth shortly before sexual activity. The exact timing varies by person, dose response, and whether you have eaten recently.

General timing guidance:

• For faster onset: Some men prefer taking it about 30–60 minutes before sex.
• If meals are involved: If you eat a large or high-fat meal, onset may be delayed—consider taking it closer to the time you plan to be intimate.
• For longer support: The tadalafil component may help with a broader window of effect, but individual response varies.

Sexual stimulation is still required for the medicine to help you achieve an erection.

Dosing (how much to take)

Sildalis is formulated as a fixed-dose combination tablet containing:

• Sildenafil citrate 100 mg
• Tadalafil 20 mg

Because this is a combination product at relatively high single-dose strengths, it is especially important to follow safe-use advice and consider your medical history (heart conditions, blood pressure, and interacting medicines) before using.

Typical regimen:

• Many people use a single tablet as needed prior to sexual activity.
• Do not exceed the frequency recommended on the product instructions provided with your supply.

If you are unsure about dosing frequency, medical history, or interactions, seek personalised advice from a qualified healthcare professional.

Food interactions

Food can affect how quickly some PDE5 inhibitors work.

• High-fat meals: May delay onset (most noticeably for sildenafil). If you had a heavy meal, you may need to allow extra time before sex.
• Light meals: Usually less likely to cause significant delay.
• Hydration: Staying well-hydrated can support comfort and performance, but avoid excessive fluid intake right before sex if it makes you uncomfortable.

Practical tip: If you have tried PDE5 inhibitors before and noticed they “work slower” after dinner, consider timing your tablet accordingly or choosing a lighter meal on the day.

Alcohol interactions (and how alcohol affects erections)

Alcohol can influence erection quality in two ways: it may cause blood vessel relaxation and lowered blood pressure, and it can impair sexual performance through effects on arousal and coordination.

• Small to moderate alcohol: Some men may tolerate this without major issues, but alcohol can still reduce erection firmness.
• Heavy drinking: More likely to cause poor response, dizziness, and increased risk of side effects like headache or flushing.
• Safety caution: Using PDE5 inhibitors and alcohol together can increase the chance of low blood pressure symptoms (e.g., light-headedness).

Practical suggestion: Keep alcohol intake moderate and avoid binge drinking. Stop alcohol if you feel dizzy or unwell.

Medicine interactions (important)

Interactions can increase side effects or reduce effectiveness. Always review your current medicines before using Sildalis.

Absolute/major caution: nitrates and “nitric oxide donors”

Do not use Sildalis if you take medicines that contain nitrates (used for angina/chest pain), such as:

• Glyceryl trinitrate (GTN)
• Isosorbide dinitrate/mononitrate
• Any nitrate-based patch, spray, or tablet

Combining nitrates with PDE5 inhibitors can cause a dangerous drop in blood pressure.

Major caution: riociguat

Do not use Sildalis with riociguat (used for certain lung/blood pressure conditions), because the blood pressure-lowering effects can be harmful.

Alpha-blockers (prostate/BPH and blood pressure)

Medicines such as tamsulosin or some blood pressure medicines may cause low blood pressure. Combining them with PDE5 inhibitors can increase dizziness or fainting risk. Extra caution and careful timing may be needed.

Blood pressure medicines

• PDE5 inhibitors can lower blood pressure modestly. If you take antihypertensives, your clinician may advise careful use.
• Be cautious if you have a history of low blood pressure or fainting.

Other PDE5 inhibitors

Do not combine Sildalis with other PDE5 inhibitors (e.g., sildenafil, tadalafil, vardenafil, or similar), as this increases the chance of side effects without adding benefit.

CYP3A4 interactions (liver metabolism)

Sildenafil and tadalafil are metabolised primarily by CYP3A4. Medicines that affect CYP3A4 can change levels.

• Stronger CYP3A4 inhibitors may increase blood levels and side effects (examples include some antifungals and some HIV medicines).
• Strong CYP3A4 inducers may reduce effectiveness (examples include some seizure/epilepsy medicines and rifampicin).

Common medicines that may matter

Check with a clinician or pharmacist if you take any of the following categories:

• Medications for angina, heart rhythm, or blood pressure
• Anticoagulants (blood thinners) — usually not a direct contraindication, but overall safety considerations apply
• Prostate/BPH medicines (especially alpha-blockers)
• Some antidepressants/antipsychotics that can affect blood pressure or sexual function indirectly

Safety profile and potential side effects

Like all medicines, Sildalis can cause side effects. Many side effects are mild and temporary, but some require urgent medical attention.

Common side effects

• Headache
• Flushing (warmth/redness in the face)
• Indigestion or stomach discomfort
• Stuffy or runny nose
• Dizziness
• Back pain or muscle aches (more typical of tadalafil)
• Nausea

Less common but serious risks

• Sudden vision changes (including loss of vision)
• Sudden hearing changes
• Chest pain, severe dizziness, or fainting
• Prolonged erection (priapism) lasting more than 4 hours
• Severe allergic reaction (swelling of face/lips, difficulty breathing)

Seek urgent medical help if you experience chest pain, fainting, sudden vision or hearing loss, an erection lasting longer than 4 hours, or signs of severe allergy.

Who should take extra caution?

Special care is needed if you have:

• Known heart disease or you are advised to avoid sexual activity
• History of stroke or significant cardiovascular events
• Very low blood pressure or uncontrolled high blood pressure
• Severe liver or kidney impairment (effects and dosing may need adjustment)
• Conditions that increase priapism risk (e.g., sickle cell anaemia, leukaemia, or certain blood disorders)

Practical use tips for better results

• Give it time: If your first attempt doesn’t feel effective, consider timing adjustments (especially if you eat a heavy meal).
• Start with realistic expectations: PDE5 inhibitors help blood flow, but anxiety, fatigue, and alcohol can reduce performance.
• Use sexually stimulating activity: The medicine supports erection; it doesn’t replace arousal.
• Avoid mixing with risky substances: Be cautious with alcohol and avoid recreational drugs that affect blood pressure or heart rhythm.
• Monitor side effects: If you get frequent headaches, flushing, or dizziness, it may indicate intolerance or an interaction.
• Hydrate and rest: Being well-rested can improve overall sexual function.

If Sildalis doesn’t work for you: Causes of ED include vascular disease, diabetes, hormonal factors, medication side effects (such as some antidepressants), smoking, and psychological factors. It may be worth discussing options with a healthcare professional rather than repeatedly escalating use.

Alternative options

If Sildalis is not suitable, alternatives may include other PDE5 inhibitors available in the UK market:

• Sildenafil alone (faster onset for many people)
• Tadalafil alone (often longer duration of effect)
• Other PDE5 inhibitors such as vardenafil (depending on availability and local supply)

Depending on the underlying cause of ED, non-medicine approaches may also help:

• Lifestyle changes: reducing smoking, moderating alcohol, improving sleep, exercise, and weight management
• Addressing conditions: diabetes control, cardiovascular risk management, and reviewing medicines that may worsen ED
• Psychosexual support if anxiety or performance fears are involved
• Other medical options (your clinician may discuss vacuum erection devices, injections, or other therapies)

Important: Not all alternatives are suitable for everyone, especially if you take nitrates or have certain cardiovascular conditions.

Market and legal context for the United Kingdom (UK)

Medicines containing PDE5 inhibitors are widely used in the UK for erectile dysfunction. In the UK, medicines are regulated and supplied under legal frameworks that ensure quality, safety, and proper labelling.

When buying medicines online, it is important to ensure you are receiving a legitimate product from a supplier that complies with UK regulations for pharmaceutical supply. Look for clear product information, proper packaging, batch/expiry details where applicable, and transparent delivery terms.

If you are unsure about whether a product is appropriate for you—especially due to heart conditions or other medications—seek advice from a qualified healthcare professional.

Recent guidance and general safety updates (UK-oriented)

UK healthcare guidance and safety communications over time have consistently emphasised:

• Do not combine PDE5 inhibitors with nitrates or riociguat
• Careful screening for cardiovascular risk before use
• Awareness of side effects that require urgent attention (priapism, sudden vision/hearing loss)
• Checking interactions with alpha-blockers and other blood pressure medicines
• Considering that ED can be a marker of cardiovascular disease

Because product formulations and individual suitability vary, it’s wise to follow the specific instructions supplied with your medicine and to ensure your current medications are reviewed.

Delivery and availability (UK)

Availability can vary by supplier and stock levels. When ordering online in the UK, typical considerations include:

• Dispatch times: Some orders are dispatched quickly, while others may require processing.
• Delivery options: Courier or tracked postal services are commonly used.
• Packaging: Discreet packaging may be offered by some pharmacies.
• Tracking: Many suppliers provide tracking details once dispatched.

Before placing an order: check delivery coverage for your postcode area, estimated delivery timeframes, and the returns/refunds policy (if available).

Storage

• Store tablets in their original packaging to protect from moisture.
• Keep out of sight and reach of children.
• Store at a suitable room temperature (follow the packaging instructions).

FAQ (frequently asked questions)

How fast will Sildalis work?

Many people feel effects within about 30–60 minutes, but timing can vary. A large or high-fat meal may delay onset (especially for the sildenafil component). Tadalafil may contribute to a broader time window.

How long does it last?

Effects can last for several hours, but the exact duration differs by person. Factors such as dose, individual metabolism, and food/alcohol intake can influence how long you feel the medicine working.

Can I take Sildalis every day?

Use should follow the frequency instructions provided with your product. Many PDE5 inhibitors are taken as needed rather than daily. Taking more frequently than advised increases the risk of side effects.

Can I combine it with other ED medicines?

No. You should not combine Sildalis with other PDE5 inhibitors. This increases the likelihood of adverse effects.

What if it doesn’t work the first time?

ED can have multiple causes. It may be worth adjusting timing (especially around food), managing alcohol intake, and addressing anxiety or performance pressure. Persistent non-response may indicate an underlying health issue—consider speaking with a clinician.

Is it safe if I have high blood pressure?

Some men with controlled blood pressure may use PDE5 inhibitors with appropriate caution. However, you should be careful—especially if you take multiple blood pressure medicines or if you have symptoms like dizziness or fainting. If you have cardiovascular disease, seek personalised advice.

Can I use Sildalis with GTN (glyceryl trinitrate) or other nitrates?

No. Sildalis and nitrates must not be used together due to the risk of dangerous blood pressure drops.

Will alcohol stop it working?

Alcohol may reduce erection quality and increase side effects such as dizziness and headache. Moderate drinking may be tolerated by some, but heavy alcohol makes it less likely to work properly and increases risk.

Are there any warning signs that mean I should seek urgent help?

Yes. Seek urgent medical attention if you experience:

• An erection lasting more than 4 hours (priapism)
• Sudden vision loss or major vision changes
• Sudden hearing loss or severe dizziness
• Chest pain, fainting, or severe shortness of breath

What should I do if I forget a dose?

Sildalis is generally taken as needed before sexual activity. If you have already missed the planned time, wait until the next appropriate occasion rather than taking an extra dose.

Final safety reminder

Sildalis (sildenafil citrate + tadalafil) can help erectile function when used appropriately. Because PDE5 inhibitors interact with heart medications and can affect blood pressure, it is crucial to consider your medical history and other medicines before use—particularly nitrates, riociguat, and alpha-blockers.

If you are unsure whether Sildalis is suitable for you, or if you have questions about interactions, speak with a qualified healthcare professional. Your safety comes first.