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Use of CIALIS with alpha-blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5. CIALIS is not recommended in combination with alpha-blockers for the treatment of. Autonomic symptoms are rarely seen. If CIALIS is taken with certain alpha blockers, your blood pressure could suddenly drop. Read More Alpha-Blockers. ED — When Cialis is coadministered with an alpha-blocker in patients being treated for ED, patients should be stable on alpha-blocker therapy prior to initiating treatment, and Cialis should be initiated at the lowest recommended dose [see Warnings and Precautions , Drug Interactions , and Clinical Pharmacology ] The risk of hypotension with the use of Cialis and alpha blockers is far greater when compared to other blood pressure medications. PrivatMedical! 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