Does Kratom Interact With Tadalafil (Cialis)?
Yes. When taken together, there is a metabolic interaction between kratom and PDE5 inhibitors like tadalafil.
Most of the drugs and supplements we take are metabolized in the liver by the cytochrome P450 enzymes (CYP).
The CYP3A4 enzyme mainly metabolizes tadalafil [1]. The CYP3A4 enzyme, along with CYP2D6 and CYP2C9, metabolize kratom [2, 3]. This is why kratom can lessen the efficiency of tadalafil’s metabolization and cause increased levels of the drug, leading to adverse effects.
You need to talk to your doctor about whether or not this will cause serious complications.
Tadalafil Specs
| Drug Name | Tadalafil |
| Trade Names | Cialis, Cidala, Adcirca |
| Classification | PDE5 Inhibitor |
| CYP Metabolism | CYP3A4 |
| Interaction With Kratom | Metabolic inhibition |
| Risk of Interaction | Moderate |
Is it Safe to Take Kratom With Tadalafil?
Possibly, but not necessarily. How’s that for vague? Though, the metabolic interaction between these two compounds will always imply a certain level of risk.
Chances are, there won’t be significant complications from using them together, especially if they’re not used often. Still, only your doctor knows whether the risk is minimal or not.
The unique pharmacological properties of tadalafil — mainly its extended half-life — also mean that the risk is even more pronounced since the compound takes longer to be cleared from the body.
However, combining tadalafil and kratom does not necessarily mean a serious interaction, only that the risk of adverse effects is greater.
What is Tadalafil (Cialis)?
Tadalafil is a prescription medication classified as a phosphodiesterase type 5 inhibitor (PDE5 inhibitor).
PDE5 inhibitors work by blocking the PDE5 enzyme and preventing it from functioning. The effect of this inhibition is to relax blood vessels and increase blood flow to various tissues, including genitalia.
These properties are used to treat several different conditions, although PDE5 inhibitors are most commonly used for erectile dysfunction (ED).
What is Tadalafil Used for?
Tadalafil differs from other similar-use PDE5 inhibitors because of its extended half-life (17.5 hours). It’s even called “the weekend pill” due to this long duration. The half-life of vardenafil (Levitra) and sildenafil (Viagra) is around 5 hours.
Tadalafil is FDA-approved for the following treatments:
- Erectile dysfunction
- Symptoms of benign prostatic hyperplasia (BPH)
In general, the scientific literature demonstrates how tadalafil is just as safe and effective as other PDE5 inhibitors [4].
What’s the Dose of Tadalafil?
Tadalafil is available in 2.5, 5, 10, and 20 mg tablets.
The starting dose is 10 mg 1 hour before sexual activity. Depending on efficacy and tolerability, the dose may be increased to 20 g or decreased to 5 g [5].
While tadalafil is often taken on demand, it can also be used daily. For this, the dose should be between 2.5 and 5 mg.
Taladafil may be taken without food.
Always remember that tadalafil is a prescription medication. A licensed doctor must conduct a risk assessment to determine if tadalafil is right for you.
Generic & Brand Name Versions
Taladafil is available under the following brand names:
- Cialis
- Cidala
- Adcirca
What Are the Side Effects of Tadalafil?
Taladafil has a profile of adverse effects, much like other PDE5 inhibitors.
The most common side effects include [6]:
- Acid reflux
- Back pain
- Burping
- Flushing
- Headache
- Indigestion
- Muscle Aches
- Stomachal discomfort
More serious adverse effects include:
- Heart attack
- Hypotension
- Loss of hearing
- Loss of vision
- Priapism
Contraindications to taking tadalafil include:
- Administration with nitrates and nitric oxide donors
- Cardiovascular issues
- Concomitant use of alpha-blockers, antihypertensives, and acute amounts of alcohol
- Hepatic impairment
- Renal impairment
What is Kratom?
The kratom plant is indigenous to Southeast Asia, namely Vietnam, Thailand, and Indonesia. It’s also known by its scientific name: Mitragyna speciosa.
The leaves of the kratom plant are harvested by local farmers and ground down to make a powder — this is what we call kratom.
Kratom possesses potent psychoactive and pharmacological properties due to its powerful alkaloids. There are more than just two, but kratom’s effects come primarily from mitragynine and 7-hydroxymitragynine.
Although kratom is not an opioid, it behaves very much like one. This is one of the reasons it’s so popular —but also why some states ban it. As such, kratom can be addictive. However — and this is crucial — it’s not likely to cause an overdose and is not dangerous on its own.
Suggested Reading: The WHO’s Decision on the Kratom Ban
What is Kratom Used for?
Kratom is not an FDA-approved medication, but it has many beneficial properties.
The most common modern uses of kratom include:
- Anxiety disorders
- Arthritis pain
- Attention Deficit & Hyperactivity Disorder (ADHD)
- Benzodiazepine withdrawal symptoms
- Chronic back pain
- Mental and physical energy
- Euphoria
- Fibromyalgia
- Migraines
- Neuralgia (nerve pain)
- Reduce symptoms of opioid withdrawal
- Sleeping aid
- Weight-loss supplement
What’s the Dose of Kratom?
The effects of kratom are dose-dependent — the amount you take impacts the results you get.
Common dosing amounts are as follows:
- Low dose (1 – 5 g): Energizing; produces nootropic and stimulating effects such as increased focus, creativity, and euphoria.
- Medium dose (5 – 10 g): Relaxing and calming; provides pain relief and reduces anxiety.
- High dose (10 – 15 g): Sedating; these amounts are best for intense pain or withdrawal.
Still not sure? Here’s a dosing guide and calculator to help you dial it in.
If you’re starting with kratom, keep it under 5 g. Learn how your body reacts to kratom before you experiment with higher doses.
Also see: How to Take Kratom –Capsules, Powder & Extracts.
What Are the Side Effects of Kratom?
Kratom is safe, and most people don’t have any issues with it. But life isn’t perfect, and nothing is 100% safe. Kratom has side effects, but they’re usually not serious — especially when compared to many (most) prescription medications.
Here are kratom’s most common side effects:
- Anxiety
- Constipation
- Diarrhea
- Dizziness
- Headaches
- Heart palpitations
- Insomnia
- Nausea
- Itchiness
The following are less common but more serious:
- Liver damage (with long-term use)
- Loss of muscle coordination
- Low libido
- Nausea
- Poor appetite
- Seizures
- Tremors
Luckily, these side effects are usually relatively mild and are easily controlled by scaling back consumption.
What Are the Different Types of Kratom?
The first thing you might notice about kratom is its different strains. There are three main strains, with a fourth that likes to tag along.
Each strain can reduce pain, provide energy, or knock you out; however, each strain also contains different alkaloid levels, impacting how it’ll affect you physically.
White Vein Kratom
The white strains excel at producing energy, improved mood, and focus. Tired of relying on coffee? Try one of these strains.
Red Vein Kratom
Red strains are the “pharmacological strains” — great for pain, anxiety, and sleep. Whether you need help relaxing at the end of the day or dealing with chronic pain, these strains are the ones to reach for.
Green Vein Kratom
Green strains don’t offer focused benefits; instead, they offer the whole package. You can’t expect mind-blowing pain relief or energy, but you’ll get a little of everything. Of course, some are better one way or the other, so read descriptions before settling on one.
If you’re interested in experimenting with everything that kratom offers, try a green-veined strain.
Yellow Vein Kratom
Not much stands out with yellow strains, but they tend to be milder. They’re similar to green strains due to their overall balanced effects.
Many prefer it for these reasons, especially those with a proven sensitivity to kratom.
Key Takeaways: Is it Safe to Mix Kratom & Tadalafil (Cialis)?
Not quite. When taken together, kratom has an inhibitory effect on tadalafil’s metabolization. This increases the risk of adverse effects.
And yes, you might not experience severe side effects if you use them together from time to time. Still, tadalafil has an extra complicating factor that other PDE5 inhibitors do not have — its unusually long half-life. This particular feature of tadalafil makes it riskier to mix with kratom.
If you want to use them together, speak to your doctor first to ensure you won’t face adverse effects.
- Huang, S. A., & Lie, J. D. (2013). Phosphodiesterase-5 (PDE5) inhibitors in the management of erectile dysfunction. Pharmacy and Therapeutics, 38(7), 407.
- Kamble, S. H., Sharma, A., King, T. I., León, F., McCurdy, C. R., & Avery, B. A. (2019). Metabolite profiling and identification of enzymes responsible for the metabolism of mitragynine, the major alkaloid of Mitragyna speciosa (kratom). Xenobiotica, 49(11), 1279-1288.
- Hanapi, N. A., Ismail, S., & Mansor, S. M. (2013). Inhibitory effect of mitragynine on human cytochrome P450 enzyme activities. Pharmacognosy research, 5(4), 241.
- Carson, C. C., Rajfer, J., Eardley, I., Carrier, S., Denne, J. S., Walker, D. J., … & Cordell, W. H. (2004). The efficacy and safety of tadalafil: an update. BJU international, 93(9), 1276-1281.
- Coward, R. M., & Carson, C. C. (2008). Tadalafil in the treatment of erectile dysfunction. Therapeutics and Clinical Risk Management, 4(6), 1315-1330.
- Rajfer, J., Aliotta, P. J., Steidle, C. P., Fitch, W. 3., Zhao, Y., & Yu, A. (2007). Tadalafil dosed once a day in men with erectile dysfunction: a randomized, double-blind, placebo-controlled study in the US. International journal of impotence research, 19(1), 95-103.
