Vidalista 20 mg contains tadalafil, and it can interact with several medicines. The most important interactions are: Nitrates — do NOT combine. Examples include nitroglycerin, isosorbide mononitrate, and isosorbide dinitrate. The combination can cause a dangerous drop in blood pressure. D DailyMed +1 Riociguat and similar guanylate-cyclase stimulators — do NOT combine, because blood pressure can fall dangerously low. D DailyMed Alpha-blockers such as tamsulosin, alfuzosin, or doxazosin can cause additional blood-pressure Vidalista 20 mg and dizziness; medical supervision is recommended. D DailyMed Blood-pressure medicines can have an additive blood-pressure-lowering effect. D DailyMed Strong CYP3A4 inhibitors such as ketoconazole, itraconazole, and ritonavir can substantially increase tadalafil levels, potentially increasing side effects. D DailyMed +1 Some CYP3A4 inducers, such as rifampicin, carbamazepine, and phenytoin, can reduce tadalafil levels and make it less effective. D DailyMed Large amounts of alcohol can increase the blood-pressure-lowering effects of tadalafil and increase dizziness. D DailyMed One particularly important point: if you've taken tadalafil, nitrates should generally not be given for at least 48 hours afterward, and if they are medically necessary, this should be done under close medical supervision. D DailyMed If you give me a list of the medicines you currently take, I can check them one by one for interactions with Vidalista 20.