Tadalafil (Cialis) and Ketamine Therapy | Tovani Health
Cialis (Tadalafil) (also: Adcirca) — PDE5 inhibitor
Verdict at Tovani Health
Compatible; same BP-stacking considerations as sildenafil, with much longer duration.
Tadalafil and ketamine are compatible. The clinical considerations are the same as sildenafil: vasodilation plus ketamine's transient pressor response means BP fluctuations during the session window. Tadalafil's distinguishing feature is its much longer half-life (17.5 hours vs sildenafil's 4 hours), so the timing window for interaction is longer. As with sildenafil, absolute contraindication with nitrates applies regardless of KAP.
If you take Cialis regularly and are considering at-home ketamine therapy, the combination is safe with monitoring or dose adjustment. This page covers the brief pharmacologic context and what we do at intake.
How Cialis interacts with ketamine
Tadalafil inhibits phosphodiesterase-5 with a much longer duration of action than sildenafil. Used for ED and benign prostatic hyperplasia (low daily dose) or pulmonary hypertension (Adcirca).
What we do at intake
Disclose use, dose, and frequency. Tell us about any nitrate medications. For daily-dose tadalafil (BPH), the steady-state interaction matters more than timing.
Bottom line
Tadalafil and ketamine are compatible. The clinical considerations are the same as sildenafil: vasodilation plus ketamine's transient pressor response means BP fluctuations during the session window. Tadalafil's distinguishing feature is its much longer half-life (17.5 hours vs sildenafil's 4 hours), so the timing window for interaction is longer. As with sildenafil, absolute contraindication with nitrates applies regardless of KAP.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Cialis (Tadalafil) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 17, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.