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9 Tadalafil (Cialis) Interactions You Should Know About ED When CIALIS is coadministered with an alpha-blocker in patients being treated for ED, patients should be stable on alpha-blocker therapy prior to initiating treatment, and CIALIS should be initiated at the lowest recommended dose [see Warnings and Precautions, Drug Interactions, and Clinical Pharmacology ]. Other drugs may interact with tadalafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this cialis interactions with other drugs Tadalafil exerts a therapeutic effect in ED by increasing sexual stimulation-dependant smooth muscle relaxation in the penis, allowing the corpus cavernosum to fill with blood Niacin Interactions. There are 104 drugs known to interact with niacin, along with 5 disease interactions, and 2 alcohol/food interactions.Of the total drug interactions, 14 are major, 78 are moderate, and 12 are minor. Physicians should be aware that CIALIS for once daily use provides continuous plasma tadalafil levels and should consider this when evaluating the potential for interactions with medications (e.g, nitrates, alpha-blockers, anti-hypertensives and potent inhibitors of CYP3A4) and with substantial consumption of alcohol [see Drug Interactions (7.