Yes. Alcohol can be consumed with tadalafil. PDE5 inhibitors, including tadalafil, and alcohol are both mild systemic vasodilators. When mild vasodilators are taken in combination, blood pressure-lowering effects of each individual compound may be increased. The substantial consumption of alcohol (e.g., 5 units or greater) in combination with tadalafil can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache.
A unit of alcohol is roughly Supplement Vol. 2, No. 1, pp. 141–157, March 2005 149 equivalent to a half pint of beer, 25 mL measure of ‘‘hard alcohol’’ (eg., vodka, whisky, or gin), or 125 mLof wine. In a clinical studywhen0.7 g/kg alcohol (equivalent to 6 ounces of 80-proof vodka in an 80 kg male) was imbibed within 10 minutes concomitantly with tadalafil, more subjects had clinically significant decreases in blood pressure than in subjects receiving alcohol alone. When tadalafil 20 mg was administered concurrently with alcohol at a lower dose of 0.6 g/kg (equivalent to approximately 4 ounces of 80-proof vodka imbibed within 10 minutes), hypotension was not observed and dizziness occurred with a similar frequency to alcohol alone, and the hypotensive effects of alcohol were not potentiated. Clinicians should discuss with their patients the following precautions before prescribing tadalafil for the treatment of erectile dysfunction: There is the potential for PDE5 inhibitors to augment the blood pressure lowering effect of excessive alcohol consumption. Additionally, excessive alcohol consumption may impair sexual performance and the ability to achieve an erection. 
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