Vardenafil and Acitretin: Can You Take Them Together?

Takes less than 2 minutes to complete 100% online

Key takeaways

• No major direct interaction between vardenafil and acitretin is commonly reported in UK guidance
• Your prescriber will check liver function and lipid levels before approving vardenafil
• Declare all medicines including acitretin during your online consultation
• Never take vardenafil with nitrates, nicorandil, riociguat, or poppers
• Seek urgent help for erections lasting over 4 hours or sudden vision or hearing loss

What Is Vardenafil and How Does It Work?

Vardenafil (also known by the brand name Levitra) is a prescription medicine used to treat erectile dysfunction in men [5]. It belongs to a group of medicines called PDE5 inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused [5]. Vardenafil does not cause an erection on its own—sexual stimulation is still needed.

The usual starting dose is 10 mg, taken about 25 to 60 minutes before sexual activity, and it should not be used more than once a day [5]. Your prescriber may adjust the dose to 5 mg or 20 mg depending on how well it works and any side effects you experience. Vardenafil is broken down in the liver by enzymes, which is why medicines that affect liver function or liver enzymes need to be checked carefully before you start treatment.

What Is Acitretin and Why Is It Prescribed?

Acitretin is a prescription medicine from the retinoid family, used to treat severe psoriasis and other serious skin disorders that have not responded to other treatments [12]. It works by slowing down the growth of skin cells and reducing inflammation. Because acitretin is a powerful medicine, it is usually prescribed by a dermatologist and requires regular blood tests to monitor your liver function, cholesterol, and triglyceride levels.

Acitretin can stay in your body for a long time after you stop taking it, and it can cause serious birth defects, so it must never be taken during pregnancy or if there is any chance of pregnancy. Men taking acitretin should also follow contraception advice if their partner could become pregnant. The medicine can affect your liver and lipid (fat) levels in the blood, which is why regular monitoring is essential throughout treatment.

Common Side Effects of Acitretin

Acitretin commonly causes dry skin, dry lips, and dry eyes. You may also experience peeling skin, hair thinning, increased sensitivity to sunlight, and changes in your liver enzymes or blood lipids [12]. Less commonly, it can cause headaches, joint or muscle pain, and mood changes. Your prescriber will monitor you closely and may adjust your dose or recommend stopping treatment if side effects become troublesome or blood test results are concerning.

At a glance

Is There an Interaction Between Vardenafil and Acitretin?

No major direct interaction between vardenafil and acitretin is commonly reported in UK prescribing guidance or the British National Formulary [5][12]. This means that the two medicines do not typically interfere with each other's effectiveness or cause a dangerous reaction when taken together. However, this does not mean the combination is automatically suitable for everyone.

Both medicines are processed by the liver, and acitretin can affect liver function and lipid levels. While vardenafil itself does not usually cause liver problems, your prescriber will want to review your liver blood tests and overall health before prescribing vardenafil if you are taking acitretin. Additionally, acitretin can sometimes cause headaches or dizziness, and vardenafil can also cause headaches and a drop in blood pressure, so your prescriber will consider whether these effects might add together and cause discomfort.

It is essential to declare all your current medicines, including acitretin, during your online consultation. Your prescriber or pharmacist will check for any individual factors that might make the combination less suitable for you, such as other medicines you take, your blood pressure, liver function, and cardiovascular health.

What Does Your Prescriber Check Before Prescribing Vardenafil and Acitretin Together?

During your online consultation at Cured Pharmacy, a UK-registered prescriber will review your full medical history and current medicines to ensure vardenafil is safe and appropriate for you [5]. If you are taking acitretin, the prescriber will pay particular attention to your recent liver function tests and lipid levels, as acitretin can affect these and vardenafil is metabolised by the liver.

The prescriber will also check your cardiovascular health, because PDE5 inhibitors like vardenafil can lower blood pressure slightly, and sexual activity itself places demands on your heart [5]. You will be asked about any history of heart disease, stroke, very low blood pressure, or conditions affecting your eyes (such as previous sudden vision loss). If you take any other medicines that lower blood pressure or affect liver enzymes, the prescriber will assess whether vardenafil is suitable and may recommend a lower starting dose.

You should never take vardenafil if you are also taking nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs called 'poppers', because the combination can cause a dangerous drop in blood pressure [5]. Always be honest about all medicines, supplements, and recreational substances you use, so your prescriber can keep you safe.

Medicines That Require Extra Caution With Vardenafil

Vardenafil can interact with medicines that affect liver enzymes, particularly potent CYP3A4 inhibitors such as ritonavir, cobicistat, ketoconazole, itraconazole, and clarithromycin [5]. These medicines can raise vardenafil levels in your blood, increasing the risk of side effects. In many cases, vardenafil is contraindicated or requires a significant dose reduction if you take these medicines. Alpha-blockers (such as tamsulosin or doxazosin) can also interact with vardenafil, causing dizziness or low blood pressure, so you must be stable on the alpha-blocker and start vardenafil at the lowest dose [5]. Your prescriber will check every medicine during your consultation.

Practical Advice for Taking Vardenafil and Acitretin Safely

If your prescriber approves vardenafil while you are taking acitretin, take each medicine exactly as directed. Vardenafil is usually taken about 25 to 60 minutes before you plan to have sex, and you should not take it more than once in 24 hours [5]. Acitretin is typically taken once daily with food or milk, and you should continue your regular monitoring appointments and blood tests as arranged by your dermatologist.

Avoid drinking large amounts of alcohol, as heavy drinking can worsen erectile dysfunction and add to the blood-pressure-lowering effect of vardenafil, making you feel dizzy or faint [5]. Grapefruit juice can raise vardenafil levels in your blood, so it is best to avoid it while taking this medicine. If you experience a headache after taking vardenafil, a simple painkiller such as paracetamol may help, but check with your pharmacist first if you are unsure.

Do not stop or change your acitretin dose without speaking to your dermatologist, as stopping suddenly or changing the dose can affect your skin condition. If you develop new symptoms, side effects, or concerns about either medicine, contact your prescriber or pharmacist for advice. Never share your medicines with anyone else, even if they have similar symptoms.

When to Seek Urgent Medical Help While Taking Vardenafil and Acitretin

Although serious side effects are uncommon, you should seek urgent medical help if you experience an erection lasting longer than four hours (priapism), as this can cause permanent damage to the penis [5]. Stop taking vardenafil and seek immediate medical attention if you have sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing, which may be accompanied by ringing in the ears or dizziness [5].

If you develop chest pain during or after sexual activity, stop and seek urgent medical help—do not take nitrate medicines (such as GTN spray) if you have used vardenafil in the past 24 hours, as the combination can be dangerous [5]. While taking acitretin, contact your doctor urgently if you develop severe headaches, vision problems, nausea, or vomiting, as these can be signs of raised pressure inside the skull, a rare but serious side effect [12].

If you experience severe abdominal pain, yellowing of your skin or eyes, dark urine, or pale stools while taking acitretin, contact your doctor immediately, as these may be signs of liver problems [12]. Always attend your scheduled blood test appointments so your dermatologist can monitor your liver and lipid levels and adjust treatment if needed.

What to Do If You Miss a Dose

Vardenafil is taken only when needed before sexual activity, so there is no regular dosing schedule to miss [5]. If you forget to take your regular dose of acitretin, take it as soon as you remember on the same day. If it is nearly time for your next dose, skip the missed dose and continue as normal—do not take a double dose to make up for a forgotten one [12]. If you are unsure, contact your pharmacist or prescriber for advice.

When to get urgent help

• Erection lasting longer than 4 hours (priapism)—go to A&E immediately
• Sudden loss of vision in one or both eyes—stop vardenafil and seek urgent medical help
• Sudden decrease or loss of hearing, possibly with ringing in ears or dizziness
• Chest pain during or after sex—stop activity and call 999; do not use nitrates if you've taken vardenafil
• Severe headache, vision problems, nausea, or vomiting while on acitretin—contact your doctor urgently

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.

Ready to Speak to a Pharmacist?

Start your journey to better health today.

• Reviewed by UK-based prescribers
• Takes under 3 minutes
• Discreet Packaging