Vardenafil and Anastrozole: Can They Be Taken Together?

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What is vardenafil and how does it work?

Vardenafil is the generic name for Levitra, a prescription medicine used to treat erectile dysfunction (ED) 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. Vardenafil does not cause an erection on its own—sexual stimulation is still needed for it to work [5].

Vardenafil is available in 5mg, 10mg, and 20mg tablets and is usually taken about 25 to 60 minutes before sexual activity [5]. The effect can last for several hours, but you should not take it more than once in 24 hours. Common side effects include headache, flushing, indigestion, and nasal congestion. Like all PDE5 inhibitors, vardenafil can lower blood pressure slightly, which is why certain medicine combinations are not safe [5].

At Cured Pharmacy, vardenafil is available on prescription after an online consultation with a UK-registered prescriber. The consultation ensures the medicine is safe and suitable for your individual health circumstances.

What is anastrozole and why is it prescribed?

Anastrozole is a prescription medicine primarily used to treat hormone-receptor-positive breast cancer in postmenopausal women and, less commonly, in men [12]. It is an aromatase inhibitor, which means it works by blocking the enzyme aromatase, thereby reducing the amount of oestrogen the body produces. Lower oestrogen levels can help slow or stop the growth of certain types of breast cancer that need oestrogen to grow [12].

Some men are prescribed anastrozole off-label to manage oestrogen levels when using testosterone replacement therapy, or in cases of gynaecomastia (breast tissue enlargement). Anastrozole is usually taken as a daily tablet and is generally well tolerated, though side effects can include joint pain, hot flushes, fatigue, and bone thinning with long-term use [12].

Because anastrozole affects hormone levels rather than blood pressure or heart function directly, it does not share the same interaction pathways as medicines like nitrates or alpha-blockers, which are known to interact dangerously with PDE5 inhibitors.

When to get urgent help

• Chest pain or discomfort during or after sexual activity—call 999 immediately
• An erection lasting more than four hours (priapism)—go to A&E straight away
• Sudden loss of vision in one or both eyes—seek urgent medical attention
• Sudden decrease or loss of hearing, possibly with ringing in the ears or dizziness—contact your GP or call 111
• Severe dizziness, fainting, or signs of very low blood pressure—call 999 or go to A&E

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

Do vardenafil and anastrozole interact with each other?

There is no major direct pharmacological interaction reported between vardenafil and anastrozole [5][12]. Anastrozole works by inhibiting the aromatase enzyme to reduce oestrogen production, while vardenafil works by inhibiting the PDE5 enzyme to improve blood flow to the penis. These are entirely different mechanisms, and the two medicines do not significantly affect each other's metabolism or action in the body.

Vardenafil is primarily broken down in the liver by enzymes called CYP3A4 and, to a lesser extent, CYP2C9 [5]. Anastrozole is not a strong inhibitor or inducer of these enzymes, so it is unlikely to raise or lower vardenafil levels in your bloodstream in a clinically meaningful way [12]. This means the two medicines can generally be taken together without one affecting how well the other works.

However, every person's health situation is unique. Your prescriber will still review all your current medicines, including anastrozole, during your consultation to check for any individual factors that might affect your suitability for vardenafil. This is standard practice to ensure your safety and the effectiveness of your treatment.

What your prescriber will check

Even though vardenafil and anastrozole do not interact directly, your prescriber will assess your overall cardiovascular health, as PDE5 inhibitors like vardenafil can lower blood pressure slightly [5]. They will ask about any heart conditions, recent heart attack or stroke, blood pressure problems, and other medicines you take—especially nitrates, nicorandil, riociguat, alpha-blockers, or other blood-pressure medicines, which can interact with vardenafil [3][5]. If you are taking anastrozole for cancer treatment, your prescriber may also consider how your general health and energy levels might affect your ability to engage in sexual activity safely.

Practical advice for taking vardenafil and anastrozole together

If you have been prescribed both vardenafil and anastrozole, you can usually take them on the same day without concern, as there is no timing restriction between the two. Anastrozole is typically taken once daily, and vardenafil is taken on demand, about 25 to 60 minutes before sexual activity [5][12]. You do not need to separate the doses or avoid taking them together.

Always follow the dosing instructions given by your prescriber. For vardenafil, the usual starting dose is 10mg, though your prescriber may adjust this depending on your response and any other medicines you take [5]. Do not take more than one dose of vardenafil in 24 hours, and do not take it with another PDE5 inhibitor (such as sildenafil or tadalafil) on the same day.

If you experience any new or unusual symptoms after starting vardenafil—such as dizziness, chest pain during sex, sudden vision or hearing loss, or an erection lasting more than four hours—seek medical help immediately. These are rare but serious side effects that require urgent attention [5]. Continue taking your anastrozole as prescribed unless your doctor advises otherwise.

Lifestyle tips to support your treatment

Erectile dysfunction can be influenced by lifestyle factors such as smoking, heavy alcohol use, lack of exercise, and poor diet [1]. If you are taking anastrozole for cancer treatment, you may already be focusing on healthy habits to support your recovery. Reducing alcohol intake, staying physically active (as your health allows), and managing stress can all help improve your response to vardenafil [1]. Avoid drinking grapefruit juice, as it can raise vardenafil levels in your blood and increase the risk of side effects [5].

At a glance

Medicines that do interact with vardenafil

While anastrozole is safe to take with vardenafil, there are several other medicines that are not. Never take vardenafil if you are using nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or recreational drugs called 'poppers' (amyl or alkyl nitrites) [5]. Combining vardenafil with any of these can cause a dangerous drop in blood pressure that may be life-threatening.

Alpha-blockers (such as doxazosin, tamsulosin, or alfuzosin) are used for prostate problems and high blood pressure, and they can also lower blood pressure when taken with vardenafil [5]. If you take an alpha-blocker, your prescriber will usually start you on the lowest dose of vardenafil and ensure you are stable on the alpha-blocker first. Some medicines that strongly inhibit the liver enzyme CYP3A4—such as ritonavir, cobicistat, ketoconazole, itraconazole, and clarithromycin—can raise vardenafil levels significantly [5]. Vardenafil is often contraindicated or requires dose adjustment with these medicines, so your prescriber must check the summary of product characteristics.

Other blood-pressure medicines (such as ACE inhibitors, calcium-channel blockers, or diuretics) can add to the blood-pressure-lowering effect of vardenafil, potentially causing dizziness [5]. This is usually manageable, but you must declare all your medicines during your consultation. If you are taking any medicine not listed here, do not assume it is safe—your prescriber will check every current medicine during your assessment.

When to see your GP and how Cured Pharmacy can help

If you are experiencing erectile dysfunction for the first time, it is important to see your GP for a full assessment [1]. ED can be an early warning sign of underlying health conditions such as heart disease, diabetes, or high blood pressure, especially if you are also being treated for cancer or other serious conditions [1][2]. Your GP can arrange blood tests, check your cardiovascular health, and refer you to a specialist if needed.

Once your GP has assessed you, or if you have already been diagnosed with ED and are looking for convenient, discreet treatment, Cured Pharmacy offers a safe and straightforward online service. All ED medicines, including vardenafil, are prescription-only and are supplied only after an online consultation reviewed by a UK-registered prescriber. The consultation asks about your medical history, current medicines (including anastrozole), and any conditions that might make vardenafil unsuitable for you.

Cured Pharmacy is registered with the General Pharmaceutical Council (GPhC 9012511) and follows all UK regulations for online prescribing. If vardenafil is not suitable for you, the prescriber may suggest an alternative PDE5 inhibitor such as sildenafil or tadalafil, or recommend that you discuss other options with your GP. Your safety is always the priority.

Other ED treatments available at Cured Pharmacy

In addition to vardenafil, Cured Pharmacy offers a range of licensed ED treatments to suit different needs and preferences. These include sildenafil (generic Viagra), tadalafil (generic Cialis), avanafil (Spedra), and branded options such as Viagra and Cialis. All require a prescription following an online consultation. Your prescriber will help you choose the most appropriate treatment based on your health, lifestyle, and any interactions with your current medicines, including anastrozole.

In summary

• No major interaction is reported between vardenafil and anastrozole—they work on different body systems.
• Your prescriber will still review all your medicines and health conditions to ensure vardenafil is safe for you.
• Never take vardenafil with nitrates, nicorandil, riociguat, or poppers—this combination is dangerous.
• Seek urgent help if you have chest pain during sex, an erection lasting over four hours, or sudden vision loss.

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