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*Substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache

-------------------------------DRUG INTERACTIONS------------------------------

• CIALIS can potentiate the hypotensive effects of nitrates, alpha blockers, antihypertensives or alcohol (7.1).

Alcohol — Both alcohol and tadalafil, a PDE5 inhibitor, act as mild vasodilators. When mild vasodilators are taken in combination, blood-pressure-lowering effects of each individual compound may be increased. Substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Tadalafil did not affect alcohol plasma concentrations and alcohol did not affect tadalafil plasma concentrations. [see Warnings and Precautions (5.9) and Clinical Pharmacology (12.2)].

12.2 Pharmacodynamics

Effects on Blood Pressure

Tadalafil 20 mg administered to healthy male subjects produced no significant difference compared to placebo in supine systolic and diastolic blood pressure (difference in the mean maximal decrease of 1.6/0.8 mm Hg, respectively) and in standing systolic and diastolic blood pressure (difference in the mean maximal decrease of 0.2/4.6 mm Hg, respectively). In addition, there was no significant effect on heart rate.

Effects on Blood Pressure When Administered with Alcohol

Alcohol and PDE5 inhibitors, including tadalafil, are mild systemic vasodilators. The interaction of tadalafil with alcohol was evaluated in 3 clinical pharmacology studies. In 2 of these, alcohol was administered at a dose of 0.7 g/kg, which is equivalent to approximately 6 ounces of 80-proof vodka in an 80-kg male, and tadalafil was administered at a dose of 10 mg in one study and 20 mg in another. In both these studies, all patients imbibed the entire alcohol dose within 10 minutes of starting. In one of these two studies, blood alcohol levels of 0.08% were confirmed. In these two studies ,more patients had clinically significant decreases in blood pressure on the combination of tadalafil and alcohol as compared to alcohol alone. Some subjects reported postural dizziness, and orthostatic hypotension was observed in some subjects. When tadalafil 20 mg was administered with a lower dose of alcohol (0.6 g/kg, which is equivalent to approximately 4 ounces of 80-proof vodka, administered in less than 10 minutes), orthostatic hypotension was not observed, dizziness occurred with similar frequency to alcohol alone, and the hypotensive effects of alcohol were not potentiated.

<blockquote data-quote="madman" data-source="post: 287196" data-attributes="member: 13851">*Substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache-------------------------------DRUG INTERACTIONS------------------------------• CIALIS can potentiate the hypotensive effects of nitrates, alpha blockers, antihypertensives or alcohol (7.1).Alcohol — Both alcohol and tadalafil, a PDE5 inhibitor, act as mild vasodilators. When mild vasodilators are taken in combination, blood-pressure-lowering effects of each individual compound may be increased. Substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Tadalafil did not affect alcohol plasma concentrations and alcohol did not affect tadalafil plasma concentrations. [see Warnings and Precautions (5.9) and Clinical Pharmacology (12.2)].12.2 PharmacodynamicsEffects on Blood PressureTadalafil 20 mg administered to healthy male subjects produced no significant difference compared to placebo in supine systolic and diastolic blood pressure (difference in the mean maximal decrease of 1.6/0.8 mm Hg, respectively) and in standing systolic and diastolic blood pressure (difference in the mean maximal decrease of 0.2/4.6 mm Hg, respectively). In addition, there was no significant effect on heart rate.Effects on Blood Pressure When Administered with AlcoholAlcohol and PDE5 inhibitors, including tadalafil, are mild systemic vasodilators. The interaction of tadalafil with alcohol was evaluated in 3 clinical pharmacology studies. In 2 of these, alcohol was administered at a dose of 0.7 g/kg, which is equivalent to approximately 6 ounces of 80-proof vodka in an 80-kg male, and tadalafil was administered at a dose of 10 mg in one study and 20 mg in another. In both these studies, all patients imbibed the entire alcohol dose within 10 minutes of starting. In one of these two studies, blood alcohol levels of 0.08% were confirmed. In these two studies ,more patients had clinically significant decreases in blood pressure on the combination of tadalafil and alcohol as compared to alcohol alone. Some subjects reported postural dizziness, and orthostatic hypotension was observed in some subjects. When tadalafil 20 mg was administered with a lower dose of alcohol (0.6 g/kg, which is equivalent to approximately 4 ounces of 80-proof vodka, administered in less than 10 minutes), orthostatic hypotension was not observed, dizziness occurred with similar frequency to alcohol alone, and the hypotensive effects of alcohol were not potentiated.</blockquote>

[QUOTE="madman, post: 287196, member: 13851"] [B][I]*Substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS [U]can increase the potential for orthostatic signs and symptoms[/U], including increase in heart rate, decrease in standing blood pressure, dizziness, and headache[/I] -------------------------------DRUG INTERACTIONS------------------------------[/B] • [B]CIALIS can potentiate the hypotensive effects [/B]of nitrates, alpha blockers, antihypertensives or [B]alcohol (7.1). Alcohol — [I]Both alcohol and tadalafil, a PDE5 inhibitor, [U]act as mild vasodilators[/U]. [/I][/B][I][B][U]When mild vasodilators are taken in combination, blood-pressure-lowering effects of each individual compound may be increased[/U][/B][/I][B][I][B]. [/B][U]Substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache[/U]. [U]Tadalafil did not affect alcohol plasma concentrations and alcohol did not affect tadalafil plasma concentrations[/U]. [see Warnings and Precautions (5.9) and Clinical Pharmacology (12.2)].[/I] 12.2 Pharmacodynamics Effects on Blood Pressure [I]Tadalafil 20 mg administered to healthy male subjects produced [U]no significant difference[/U] compared to placebo in s[U]upine systolic and diastolic blood pressure[/U] (difference in the mean maximal decrease of 1.6/0.8 mm Hg, respectively) and in [U]standing systolic and diastolic blood pressure[/U] (difference in the mean maximal decrease of 0.2/4.6 mm Hg, respectively). In addition, there was [U]no significant effect on heart rate[/U].[/I] Effects on Blood Pressure When Administered with Alcohol[/B] [I][B]Alcohol and PDE5 inhibitors, including tadalafil, are [U]mild systemic vasodilators[/U]. The interaction of tadalafil with alcohol was evaluated in 3 clinical pharmacology studies. In 2 of these, alcohol was administered at a dose of 0.7 g/kg, which is equivalent to [U]approximately 6 ounces of 80-proof vodka in an 80-kg male, and tadalafil was administered at a dose of 10 mg in one study and 20 mg in another[/U]. In both these studies, [U]all patients imbibed the entire alcohol dose within 10 minutes of starting[/U]. In one of these two studies, [U]blood alcohol levels of 0.08% were confirmed[/U]. In these two studies ,[U]more patients had clinically significant decreases in blood pressure on the combination of tadalafil and alcohol as compared to alcohol alone[/U]. Some subjects reported [U]postural dizziness, and orthostatic hypotension was observed in some subjects[/U]. When tadalafil 20 mg was administered with a lower dose of alcohol (0.6 g/kg, which is equivalent to [U]approximately 4 ounces of 80-proof vodka, administered in less than 10 minutes), orthostatic hypotension was not observed, dizziness occurred with similar frequency to alcohol alone, and the hypotensive effects of alcohol were not potentiated[/U].[/B][/I] [/QUOTE]

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038