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Another concern is the potential interaction between ED pills and the alpha blockers used for benign prostatic hyperplasia (BPH). Although ED and BPH are separate entities, both conditions are common, especially in older men. The main worry is low blood pressure, but it’s a much greater concern with the older alpha blockers terazosin (Hytrin, generic) and doxazosin (Cardura, generic) than with the newer, uroselective medications tamsulosin (Flomax), alfuzosin (UroXatral), and silodosin (Rapaflo). The best advice for men with BPH and ED is to use a uroselective alpha blocker in the lowest dose that will control BPH symptoms, and then after a stable dose is established, to carefully begin using an ED pill, starting with the lowest dose and gradually increasing it if needed. Tadalafil appears less likely to interact with alpha blockers than other ED pills. It seems prudent for men who use both types of medications to take them at separate times, perhaps six hours apart.

A number of other medications can elevate blood levels of the ED pills by inhibiting the enzymes that normally remove the ED medication from the body. ...
... One is the popular acid-suppressing drug cimetidine (Tagamet, generic), which is available over the counter as well as by prescription. The others include several prescription antibiotics (erythromycin, clarithromycin) and HIV medications.
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