Vardenafil and Adalimumab: Can They Be Taken Together?

Vardenafil and Adalimumab: Understanding the Interaction

Published: 27 October 2026

If you're taking adalimumab and considering vardenafil for erectile dysfunction, you may wonder whether vardenafil and adalimumab can be used together safely. The good news is that no major direct interaction is commonly reported between these two medicines, but your prescriber will still need to review your full medical history and current medications during a consultation to ensure vardenafil is suitable for you [2][12].

What is vardenafil and adalimumab?

Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in adult men. 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're sexually aroused [5]. Vardenafil is available in 5 mg, 10 mg, and 20 mg tablets and is usually taken about 25 to 60 minutes before sexual activity. It requires sexual stimulation to work and should not be taken more than once a day [5].

Adalimumab is a biologic medicine used to treat various inflammatory conditions, including rheumatoid arthritis, psoriatic arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis, and psoriasis [12]. It works by blocking tumour necrosis factor-alpha (TNF-alpha), a protein in your immune system that causes inflammation. Adalimumab is given as an injection under the skin, typically every one or two weeks depending on your condition [12].

These two medicines work on completely different systems in the body: vardenafil affects blood flow to the penis, while adalimumab modulates your immune response. Because they have different mechanisms of action and are metabolised differently, they do not directly interfere with each other [12].

Is there an interaction between vardenafil and adalimumab?

No major direct interaction between vardenafil and adalimumab is commonly reported in clinical practice or drug interaction databases [12]. Vardenafil is primarily broken down in the liver by enzymes called CYP3A4 and CYP2C9, while adalimumab is a large protein molecule that is broken down naturally by the body's protein degradation pathways, not by liver enzymes [5][12]. This means adalimumab does not affect how your body processes vardenafil.

However, it's important to understand that your prescriber will still need to assess your overall health and all your current medicines during a consultation. Some conditions treated with adalimumab, such as inflammatory bowel disease or rheumatoid arthritis, may be associated with cardiovascular risk factors that need to be considered before prescribing any ED treatment [2]. Additionally, if you take other medicines alongside adalimumab, those medicines may interact with vardenafil [5].

Your prescriber will check whether vardenafil is suitable for you based on your complete medical history, including your heart health, blood pressure, and any other medicines you're taking. This is why a full clinical assessment is required before vardenafil can be prescribed, even when no direct interaction with adalimumab is expected [2][12].

How vardenafil is processed in your body

Vardenafil is absorbed from your gut and broken down mainly by the liver enzyme CYP3A4, with a smaller contribution from CYP2C9 [5]. Medicines that strongly inhibit CYP3A4, such as ritonavir, ketoconazole, itraconazole, or clarithromycin, can significantly increase vardenafil levels in your blood, which is why vardenafil is contraindicated or requires dose adjustment with these medicines [5]. Conversely, medicines that induce CYP3A4, such as rifampicin, carbamazepine, phenytoin, or St John's wort, can reduce vardenafil levels and make it less effective [5]. Adalimumab does not affect these liver enzymes, so it does not alter how vardenafil is metabolised [12].

What your prescriber checks before prescribing vardenafil and adalimumab together

Even though vardenafil and adalimumab do not interact directly, your prescriber will conduct a thorough assessment before prescribing vardenafil. This includes reviewing your cardiovascular health, as PDE5 inhibitors like vardenafil can lower blood pressure slightly and are not suitable for men with certain heart conditions, such as recent heart attack or stroke, unstable angina, or severe heart failure [2][5].

Your prescriber will ask about all your current medicines, not just adalimumab. Vardenafil must never be taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs called 'poppers' (amyl or alkyl nitrites), as the combination can cause a dangerous drop in blood pressure [5]. If you take alpha-blockers for an enlarged prostate or high blood pressure (such as doxazosin or tamsulosin), you may be at increased risk of dizziness or fainting, and your prescriber will start you on the lowest dose of vardenafil and ensure you are stable on the alpha-blocker first [5].

Your prescriber will also check for any other medicines that might interact with vardenafil, including potent CYP3A4 inhibitors, other blood pressure medicines, and any over-the-counter or herbal products you may be taking. They will assess whether sexual activity is safe for you based on your overall health and fitness level [2][5].

Conditions treated with adalimumab and cardiovascular risk

Some inflammatory conditions treated with adalimumab, such as rheumatoid arthritis and psoriasis, are associated with an increased risk of cardiovascular disease [2]. Your prescriber will take this into account when assessing your suitability for vardenafil. Erectile dysfunction itself can be an early warning sign of heart disease or diabetes, so if you have new or worsening ED, it's important to see your GP for a full cardiovascular assessment [1][2]. Your prescriber will also check your blood pressure and may ask about your cholesterol levels, smoking status, and exercise tolerance to ensure that sexual activity and vardenafil are safe for you [2].

Practical advice for taking vardenafil with adalimumab

If your prescriber confirms that vardenafil is suitable for you, you can take it as directed while continuing your adalimumab injections as normal. Vardenafil is usually taken about 25 to 60 minutes before you plan to have sex, and it works only when you are sexually stimulated [5]. The effect can last for several hours, but you should not take more than one dose in 24 hours [5].

Continue to take your adalimumab exactly as prescribed by your rheumatologist or gastroenterologist. Do not stop or change your adalimumab dose without consulting the doctor who prescribed it, as this could lead to a flare-up of your underlying condition [12]. If you develop any new symptoms or side effects after starting vardenafil, contact your prescriber or GP for advice.

Avoid drinking large amounts of alcohol when taking vardenafil, as alcohol can make erectile dysfunction worse and increase the risk of dizziness or low blood pressure [5]. Grapefruit juice can also increase vardenafil levels in your blood, so it's best to avoid it [5]. If you experience an erection lasting more than four hours, sudden loss of vision or hearing, or chest pain during sex, seek urgent medical help [5].

Other medicines to watch for with vardenafil and adalimumab

While adalimumab itself does not interact with vardenafil, many people taking adalimumab also take other medicines that may interact with vardenafil. For example, if you take methotrexate alongside adalimumab for rheumatoid arthritis or psoriasis, there is no known interaction between methotrexate and vardenafil, but your prescriber will still review all your medicines during the consultation [12].

If you take corticosteroids such as prednisolone, these do not interact directly with vardenafil, but long-term steroid use can affect cardiovascular health and bone health, which your prescriber will consider [12]. If you are prescribed antibiotics such as clarithromycin or antifungals such as ketoconazole or itraconazole for an infection, these are potent CYP3A4 inhibitors and can significantly increase vardenafil levels, so you must tell your prescriber before taking vardenafil [5].

If you take any medicines for high blood pressure, heart disease, or an enlarged prostate, these may interact with vardenafil and require dose adjustments or additional monitoring [5]. Always tell your prescriber about every medicine you take, including over-the-counter medicines, vitamins, and herbal supplements, so they can check for interactions and ensure vardenafil is safe for you [2][5].

Medicines that must never be taken with vardenafil

Do not take vardenafil if you are taking nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or recreational drugs called 'poppers' (amyl or alkyl nitrites). The combination can cause a dangerous drop in blood pressure that may be life-threatening [5]. Do not take vardenafil with another PDE5 inhibitor such as sildenafil, tadalafil, or avanafil, as this increases the risk of side effects [5]. If you are unsure whether any of your medicines interact with vardenafil, ask your prescriber or pharmacist before taking it [5].

Getting vardenafil and adalimumab prescribed safely in the UK

Vardenafil is a prescription-only medicine in the UK and can only be supplied after a consultation with a UK-registered prescriber [5]. At Cured Pharmacy, you can complete an online consultation that will be reviewed by a UK prescriber, who will check your medical history, current medicines, and overall health to ensure vardenafil is safe and suitable for you. If approved, your medicine will be dispensed by our GPhC-registered pharmacy and delivered discreetly to your door.

Adalimumab is also a prescription-only medicine and is usually prescribed and monitored by a hospital specialist, such as a rheumatologist or gastroenterologist [12]. You should continue to attend your regular appointments with your specialist and report any new symptoms or concerns. If you have new or worsening erectile dysfunction, it's important to see your GP for a full assessment, as ED can be an early sign of cardiovascular disease or diabetes [1][2].

During your online consultation for vardenafil, you will be asked to list all your current medicines, including adalimumab and any other prescription or over-the-counter medicines you take. Be as accurate and complete as possible, as this helps the prescriber assess your suitability for vardenafil and check for any potential interactions. If you have any questions about taking vardenafil with adalimumab or any other medicine, you can ask the prescriber during the consultation or contact our pharmacy team for advice [2][5].

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 27 October 2026]
2. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 27 October 2026]
3. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 27 October 2026]
4. Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 27 October 2026]

Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.