Vardenafil and Bicalutamide: Can They Be Taken Together?
Learn about this interaction and how our UK prescribers ensure safe, personalised ED treatment.
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Vardenafil and Bicalutamide: Understanding the Interaction
Published: 28 October 2026
If you're considering vardenafil and bicalutamide together, it's important to understand how these medicines may interact. Vardenafil is a prescription treatment for erectile dysfunction (ED), whilst bicalutamide is an anti-androgen medicine used primarily in prostate cancer treatment. Although no major direct interaction between these two medicines is commonly reported in standard references, your prescriber will carefully review your full medication list and overall health during your consultation to ensure any ED treatment is safe and appropriate for you [2][5].
At a glance
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 adult men [5]. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused.
Vardenafil is available in 5 mg, 10 mg, and 20 mg tablets. The usual starting dose is 10 mg, taken about 25 to 60 minutes before sexual activity, and it should not be taken more than once a day [5]. The medicine only works when you are sexually stimulated—it does not cause an automatic erection.
Like other PDE5 inhibitors, vardenafil can cause side effects such as headache, flushing, indigestion, nasal congestion, and dizziness. It must not be taken with certain medicines, particularly nitrates (such as GTN spray), nicorandil, riociguat, or recreational drugs known as 'poppers', as this combination can cause a dangerous drop in blood pressure [5]. Your prescriber will check your medical history and current medicines to ensure vardenafil is safe for you.
What is bicalutamide and why is it prescribed?
Bicalutamide is an anti-androgen medicine used mainly to treat prostate cancer. It works by blocking the effects of male hormones (androgens) such as testosterone, which can fuel the growth of prostate cancer cells. Bicalutamide is usually prescribed alongside other treatments, such as a luteinising hormone-releasing hormone (LHRH) analogue or after surgical removal of the testes.
Common side effects of bicalutamide include hot flushes, breast tenderness or enlargement (gynaecomastia), reduced libido, and erectile dysfunction. Because bicalutamide lowers androgen levels, many men taking it experience sexual side effects, including difficulty achieving or maintaining an erection [2].
Bicalutamide is taken as a daily tablet, usually at the same time each day. It is processed (metabolised) in the liver, and your doctor will monitor your liver function regularly whilst you are on this treatment. If you are taking bicalutamide and experiencing erectile dysfunction, it is important to discuss this with your cancer specialist or GP, as ED treatments may be an option depending on your overall health and treatment plan.
Why does bicalutamide cause erectile dysfunction?
Bicalutamide reduces the activity of testosterone and other androgens, which play a key role in sexual desire and erectile function. Lower androgen levels can lead to reduced libido, difficulty achieving erections, and other sexual side effects. This is a recognised consequence of hormone therapy for prostate cancer, and many men on bicalutamide will experience some degree of ED [2].
Can you take vardenafil and bicalutamide together?
No major direct drug interaction between vardenafil and bicalutamide is commonly reported in standard UK prescribing references [5][12]. This means that, from a pharmacological standpoint, taking these two medicines together does not usually cause a dangerous reaction or significantly alter how either medicine works in the body.
However, this does not automatically mean vardenafil is suitable for everyone taking bicalutamide. Your prescriber will need to assess your individual circumstances, including your overall health, the stage and management of your prostate cancer, your cardiovascular fitness, and any other medicines you are taking. Men undergoing cancer treatment may have other health considerations that affect whether ED treatment is appropriate.
It is also important to recognise that bicalutamide itself can cause or worsen erectile dysfunction by lowering androgen levels. In some cases, a PDE5 inhibitor like vardenafil may help improve erectile function, but it will not address the underlying hormonal cause. Your cancer specialist and prescriber will work together to determine the best approach for managing ED in the context of your cancer treatment [2].
What you need to know
- No major direct interaction between vardenafil and bicalutamide is commonly reported in UK references.
- Your prescriber reviews your full medical history, cancer treatment, and all medicines before approving vardenafil.
- Bicalutamide lowers testosterone and can cause ED; vardenafil may help but won't reverse the hormonal cause.
- Never take vardenafil with nitrates, nicorandil, riociguat, or poppers—this can cause dangerous low blood pressure.
- Discuss ED treatment with your cancer specialist if you have concerns about safety or suitability.
What does your prescriber check before prescribing vardenafil with bicalutamide?
During your online consultation at Cured Pharmacy, the prescriber will review your full medical history and current medications to ensure vardenafil is safe for you. This includes checking for any contraindications (conditions or medicines that make vardenafil unsafe) and assessing your cardiovascular health, as sexual activity itself places demands on the heart [2][5].
The prescriber will specifically check that you are not taking nitrates, nicorandil, riociguat, or another PDE5 inhibitor, as these combinations can cause a dangerous fall in blood pressure. They will also review any blood pressure medicines, alpha-blockers (often used for urinary symptoms in prostate conditions), and medicines that affect how vardenafil is broken down in the body, such as certain antibiotics or antifungals [5].
If you are taking bicalutamide, the prescriber will want to know about your prostate cancer diagnosis, current treatment plan, and any other health conditions. They may also ask about your cardiovascular fitness and whether your cancer specialist has advised that sexual activity is safe for you. If there is any uncertainty, the prescriber may recommend that you discuss ED treatment with your oncologist or urologist before proceeding.
What if I take other medicines alongside bicalutamide?
Many men taking bicalutamide will also be on other medications, such as LHRH analogues (e.g. goserelin, leuprorelin), alpha-blockers for urinary symptoms (e.g. tamsulosin, doxazosin), or medicines for other health conditions. The prescriber will review every medicine you are taking to check for interactions. For example, alpha-blockers can lower blood pressure, and combining them with vardenafil requires careful dose adjustment and monitoring [5]. Always declare all your medicines, including over-the-counter products and supplements, during your consultation.
Practical advice for using vardenafil and bicalutamide safely
If your prescriber approves vardenafil whilst you are taking bicalutamide, follow the dosing instructions carefully. Take vardenafil about 25 to 60 minutes before you plan to have sex, and do not take more than one dose in 24 hours [5]. The medicine works only with sexual stimulation, so it will not cause an erection on its own.
Be aware of potential side effects such as headache, flushing, indigestion, or dizziness. If you feel dizzy or light-headed, sit or lie down until the feeling passes. Avoid drinking large amounts of alcohol, as this can make ED worse and increase the risk of side effects such as low blood pressure and dizziness [5].
Do not stop or change your bicalutamide or any other prescribed medicine without speaking to your doctor. If you experience new symptoms, worsening ED, or side effects from vardenafil, contact your prescriber or GP for advice. If you develop chest pain during sex, stop immediately and seek urgent medical help. If you have an erection lasting more than four hours, or sudden loss of vision or hearing, go to A&E straight away [5].
When to get urgent help
- Erection lasting more than 4 hours (priapism)—go to A&E immediately to prevent permanent damage
- Sudden loss of vision or hearing—stop vardenafil and seek urgent medical help
- Chest pain during or after sex—stop activity, call 999, and do not take more vardenafil
- Severe dizziness, fainting, or signs of very low blood pressure—seek same-day medical advice
- New or worsening symptoms related to your cancer or other health conditions—contact your GP or specialist promptly
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
Other erectile dysfunction treatment options at Cured Pharmacy
Cured Pharmacy offers a range of licensed ED treatments, all available after an online consultation reviewed by a UK prescriber. In addition to vardenafil, you can access sildenafil (generic Viagra), tadalafil (generic Cialis), and avanafil (Spedra), as well as branded options [1][3][4][6].
Sildenafil is taken about one hour before sex and works for up to four hours. Tadalafil can be taken on-demand (working for up to 36 hours) or as a lower daily dose for spontaneous activity. Avanafil works quickly, often within 15 to 30 minutes. Your prescriber will help you choose the most suitable option based on your health, preferences, and how you respond to treatment [2].
If PDE5 inhibitors are not suitable or effective for you, other options may include alprostadil (a cream or injection applied directly to the penis) or vacuum erection devices. Your GP or specialist can discuss these alternatives. Remember, ED can be an early warning sign of cardiovascular disease or diabetes, so if you have not already done so, see your GP for a full health check [1][2].
How do I start treatment at Cured Pharmacy?
To order ED treatment from Cured Pharmacy, complete a short online consultation. A UK-registered prescriber will review your answers, medical history, and current medicines. If treatment is approved, your medicine will be dispensed by our GPhC-registered pharmacy and delivered discreetly to your door. You can use the code Ednew on your first order for a discount on selected products. If you have any questions, our pharmacy team is here to help.
Always declare all your medicines
During your consultation, list every medicine you take—including bicalutamide, any hormone therapy, alpha-blockers, and over-the-counter products. This helps your prescriber ensure vardenafil is safe and choose the right dose for you.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 28 October 2026]
- National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 28 October 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 28 October 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 28 October 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 28 October 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 28 October 2026]
- Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 28 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.
Common Questions
Is it safe to take vardenafil if I'm on bicalutamide for prostate cancer?
No major direct interaction is commonly reported, but your prescriber will assess your overall health, cancer treatment, and other medicines to ensure vardenafil is safe and appropriate for you.
Will vardenafil help with ED caused by bicalutamide?
Vardenafil may help improve erectile function, but it will not reverse the hormonal cause of ED from bicalutamide. Your prescriber will discuss realistic expectations and whether ED treatment is suitable in your situation.
Do I need to tell my oncologist if I want to try vardenafil?
It is a good idea to discuss ED treatment with your cancer specialist, especially if you have other health conditions or are on multiple medications. Your Cured Pharmacy prescriber may also recommend this.
Can I take vardenafil if I also take tamsulosin for urinary symptoms?
Vardenafil can be used with alpha-blockers like tamsulosin, but you must be stable on the alpha-blocker first, and your prescriber will start vardenafil at the lowest dose to reduce the risk of low blood pressure.
What should I do if vardenafil doesn't work for me?
Speak to your prescriber or GP. They may adjust the dose, suggest a different PDE5 inhibitor, or discuss other ED treatments such as alprostadil or vacuum devices.
Are there any medicines I must not take with vardenafil?
Do not take vardenafil with nitrates, nicorandil, riociguat, poppers, or another PDE5 inhibitor, as this can cause a dangerous drop in blood pressure. Always declare all your medicines during your consultation.
How quickly does vardenafil work, and how long does it last?
Vardenafil usually works within 25 to 60 minutes and can last for several hours. Take it on an empty stomach for best results, and remember it only works with sexual stimulation.
Can I use the discount code Ednew if I order vardenafil?
Yes, you can use the code Ednew on your first order at Cured Pharmacy for a discount on selected ED treatments, including vardenafil, subject to prescriber approval.
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Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)