Vardenafil and Aripiprazole: Can They Be Taken Together?

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Key takeaways

• No major direct interaction is commonly reported between vardenafil and aripiprazole
• Both medicines can affect blood pressure, so individual assessment by a prescriber is essential
• Most men taking aripiprazole can use vardenafil safely after a full consultation
• Always inform all your healthcare providers about every medicine you take
• Seek urgent help if you experience chest pain, severe dizziness, or an erection lasting over four hours

What Is Vardenafil and How Does It Work?

Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in men [5]. It belongs to a group of medicines called PDE5 inhibitors, which also includes sildenafil (Viagra) and tadalafil (Cialis). Vardenafil works by relaxing the blood vessels in the penis, allowing more blood to flow in when you are sexually aroused [5].

Vardenafil is available in 5mg, 10mg and 20mg tablets, and you typically take it 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 a day. Like all PDE5 inhibitors, vardenafil only works when you are sexually stimulated—it does not cause an automatic erection.

Because vardenafil affects blood vessels throughout the body, it can lower blood pressure slightly. This is usually not a problem, but it means your prescriber must check that it is safe for you, especially if you take other medicines that also affect blood pressure or heart function [5].

What Is Aripiprazole and Why Is It Prescribed?

Aripiprazole is an antipsychotic medicine used to treat conditions such as schizophrenia, bipolar disorder, and sometimes as an add-on treatment for depression. It works by helping to balance certain natural chemicals (neurotransmitters) in the brain, particularly dopamine and serotonin.

Aripiprazole can cause side effects that affect sexual function, including erectile dysfunction, reduced libido, and difficulty reaching orgasm. These effects are thought to be related to changes in dopamine and prolactin levels. If you have developed ED since starting aripiprazole, it is important to discuss this with your GP or psychiatrist, as they may be able to adjust your treatment.

Like vardenafil, aripiprazole can also affect blood pressure and heart rhythm in some people. It may cause dizziness, especially when standing up, and very rarely it can affect the electrical activity of the heart (QT prolongation). These effects are why your prescriber needs to know about all your medicines before prescribing vardenafil.

Can Aripiprazole Cause Erectile Dysfunction?

Yes, aripiprazole and other antipsychotic medicines can contribute to erectile dysfunction. The exact mechanism is not fully understood, but it may involve changes in dopamine signalling, which plays a role in sexual arousal and function. Some antipsychotics also raise prolactin levels, which can reduce testosterone and affect erections.

If you think your ED started or worsened after beginning aripiprazole, do not stop taking it without medical advice. Your psychiatrist may be able to adjust the dose or consider an alternative medicine. In many cases, ED treatment with a PDE5 inhibitor can be used alongside aripiprazole, provided your prescriber confirms it is safe for you.

At a glance

The Interaction Between Vardenafil and Aripiprazole

There is no major direct pharmacological interaction commonly reported between vardenafil and aripiprazole. They work on different systems in the body: vardenafil primarily affects blood vessels, while aripiprazole acts on brain neurotransmitters. Neither medicine is known to significantly alter the blood levels of the other through liver enzyme interactions.

However, both medicines can independently affect your cardiovascular system. Vardenafil lowers blood pressure by dilating blood vessels, and aripiprazole can cause postural hypotension (a drop in blood pressure when you stand up) and, very rarely, affect heart rhythm [5]. When taken together, there is a theoretical risk that these effects could add up, leading to dizziness, light-headedness, or fainting.

For this reason, your prescriber will carefully review your medical history, current medicines, and any heart or blood pressure problems before approving vardenafil. They will also check that you are on a stable dose of aripiprazole and that you have not experienced significant cardiovascular side effects from it. Most men taking aripiprazole can use vardenafil safely, but individual assessment is essential.

What Your Prescriber Will Check Before Approving Vardenafil and Aripiprazole Together

When you request vardenafil through an online consultation at Cured Pharmacy, the UK-registered prescriber will ask detailed questions about your health and current medicines. They will want to know the dose of aripiprazole you take, how long you have been on it, and whether you have experienced any side effects, particularly dizziness, fainting, or heart palpitations.

The prescriber will also check for any other medicines you take that could interact with vardenafil, such as nitrates (used for angina), alpha-blockers (used for prostate or blood pressure problems), or other medicines that affect blood pressure or heart rhythm. They will ask about any history of heart disease, stroke, very low blood pressure, or conditions that make sexual activity inadvisable [5].

If you have any concerns about your mental health medication or have noticed changes in your sexual function since starting aripiprazole, mention this in your consultation. The prescriber may recommend that you discuss your aripiprazole treatment with your GP or psychiatrist before starting an ED medicine, to ensure your overall treatment plan is coordinated and safe.

Starting Vardenafil While on Aripiprazole

If your prescriber approves vardenafil, they will usually recommend starting with the lowest effective dose (typically 10mg) to see how you respond. This cautious approach helps minimise the risk of side effects, especially if you are taking other medicines that affect blood pressure.

You should take vardenafil about 25 to 60 minutes before sexual activity, and avoid taking it more than once in 24 hours [5]. Do not take vardenafil with grapefruit juice, as this can raise the level of the medicine in your blood. Limit alcohol, as heavy drinking can worsen erectile dysfunction and increase the risk of dizziness or low blood pressure.

Practical Advice for Taking Vardenafil and Aripiprazole Safely

If you are prescribed vardenafil while taking aripiprazole, there are several practical steps you can take to use both medicines safely. First, always take vardenafil exactly as directed by your prescriber. Do not take more than the recommended dose, and do not combine it with any other ED medicine or with nitrates, nicorandil, riociguat, or recreational drugs called 'poppers' (amyl or alkyl nitrites), as these combinations can cause a dangerous drop in blood pressure [5].

Be aware of how you feel when you stand up, especially in the first few hours after taking vardenafil. Both aripiprazole and vardenafil can cause dizziness or light-headedness, particularly when moving from sitting or lying to standing. If you feel dizzy, sit or lie down until it passes, and avoid driving or operating machinery until you know how the combination affects you.

Keep your GP and psychiatrist informed about all the medicines you are taking, including ED treatment. If you experience any new or worsening symptoms—such as chest pain, severe dizziness, fainting, palpitations, or an erection lasting more than four hours—seek medical help immediately. Regular follow-up with your healthcare team ensures that both your mental health and sexual health are managed safely and effectively.

Other ED Treatment Options and Vardenafil Alternatives

Vardenafil is one of several PDE5 inhibitors available for erectile dysfunction. If you find that vardenafil does not suit you, or if your prescriber recommends an alternative, other options include sildenafil (Viagra), tadalafil (Cialis), and avanafil (Spedra) [3][4][6]. All of these medicines work in a similar way, but they differ in how quickly they start working and how long they last.

Sildenafil typically takes about one hour to work and lasts for around four to six hours, while tadalafil can last up to 36 hours, making it a good choice if you prefer more spontaneity [3][4]. Avanafil works faster than the others, often within 15 to 30 minutes [6]. Your prescriber can help you choose the medicine that best fits your lifestyle and health needs.

All PDE5 inhibitors have similar interactions and precautions, so if vardenafil and aripiprazole are considered safe for you, the same is likely true for the other PDE5 inhibitors. However, each medicine has slightly different dosing and timing, so always follow the specific instructions for the medicine you are prescribed. At Cured Pharmacy, all ED medicines are supplied only after an online consultation reviewed by a UK-registered prescriber, ensuring your treatment is safe and appropriate.

When to See Your GP About Erectile Dysfunction

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 problems such as heart disease, diabetes, or high blood pressure [1][2]. Your GP can carry out tests, review your medicines, and refer you to a specialist if needed.

If your ED started or worsened after beginning aripiprazole or another mental health medicine, discuss this with your GP or psychiatrist. They may be able to adjust your treatment or explore other options. Do not stop taking aripiprazole without medical advice, as this could affect your mental health.

When to get urgent help

• Chest pain during or after sexual activity—call 999 immediately
• An erection lasting more than four hours (priapism)—go to A&E
• Sudden loss of vision or hearing—seek urgent medical help
• Severe dizziness, fainting, or heart palpitations—contact your GP or call NHS 111
• Any new or worsening symptoms after starting vardenafil—speak to a healthcare professional promptly

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