Tadalista CT 20, which contains Tadalafil (the same active ingredient as Tadalista), should not be used with nitrates under any circumstances. Here’s why: Nitrates are commonly used to treat chest pain (angina) and heart conditions by relaxing and widening blood vessels. When combined with Tadalafil (Tadalista CT 20), which also has a blood-pressure-lowering effect, it can cause a dangerous drop in blood pressure. This can lead to severe dizziness, fainting, or even a heart attack or stroke. When NOT to use Tadalista CT 20 with nitrates: Never combine Tadalista with any form of nitrate medication, including nitroglycerin, isosorbide dinitrate, or isosorbide mononitrate. This includes both prescription nitrates and some over-the-counter products used for chest pain relief. If you're prescribed Tadalista CT 20, be sure to inform your healthcare provider if you are taking any nitrate medications. It's important to avoid using both together to prevent potentially serious health risks.