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In phase III studies evaluating the safety of tadalafil when taken with drugs that lower blood pressure (called antihypertensives), the combination only slightly increased the risk of low blood pressure. When taken with two or more antihypertensives, tadalafil did not increase the incidence of hypotension. The drugs work by boosting the natural release of nitric oxide (NO) in the body, a chemical normally released during sexual arousal. Nitric oxide in turn activates other substances to help relax the smooth muscle inside the penis, allowing for an increase in blood flow to the area, facilitating an erection.
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