Vardenafil and Bromocriptine: Can They Be Taken Together?

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Key takeaways

• No major interaction is commonly reported between vardenafil and bromocriptine
• Both medicines can lower blood pressure, so your prescriber may start vardenafil at a lower dose
• Always declare all current medicines during your online consultation for safe treatment
• Seek urgent help for erections lasting over four 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 licensed in the UK to treat erectile dysfunction [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.

The usual starting dose is 10 mg, taken about 25 to 60 minutes before sexual activity [5]. Your prescriber may adjust the dose to 5 mg or 20 mg depending on how well it works and whether you experience any side effects. You should take vardenafil no more than once a day. Common side effects include headache, flushing, indigestion, and nasal congestion, which are usually mild and temporary.

Vardenafil is broken down in the body by liver enzymes, particularly one called CYP3A4. This means that medicines which affect this enzyme can change how vardenafil works or increase the risk of side effects, which is why your prescriber reviews all your current medicines before prescribing it.

What Is Bromocriptine and Why Is It Prescribed?

Bromocriptine is a prescription medicine that mimics the action of dopamine, a natural chemical messenger in the brain. It is used to treat several conditions, including Parkinson's disease, high levels of the hormone prolactin (hyperprolactinaemia), and certain types of pituitary tumours. High prolactin levels can sometimes contribute to erectile dysfunction in men, so bromocriptine may occasionally be part of the treatment plan for ED when prolactin is elevated.

Bromocriptine works by stimulating dopamine receptors, which helps to reduce prolactin production and improve symptoms of Parkinson's disease. Common side effects include nausea, dizziness, headache, and low blood pressure, especially when standing up. Because bromocriptine can lower blood pressure, it is important to consider this when taking other medicines that also affect blood pressure.

The dose of bromocriptine varies depending on the condition being treated and is usually started low and increased gradually. Your doctor will monitor your response and adjust the dose as needed. It is typically taken with food to reduce nausea.

Bromocriptine and Erectile Function

Interestingly, bromocriptine can sometimes help improve erectile function in men with high prolactin levels, as elevated prolactin can suppress testosterone and reduce libido. By lowering prolactin, bromocriptine may restore normal sexual function in these cases. However, if ED persists despite normal prolactin levels, a PDE5 inhibitor such as vardenafil may be prescribed alongside bromocriptine.

At a glance

Can You Take Vardenafil and Bromocriptine Together?

There is no major interaction commonly reported between vardenafil and bromocriptine, and many men take both medicines together without problems. However, both medicines can lower blood pressure, so there is a theoretical risk that taking them together might increase the chance of dizziness or light-headedness, particularly when standing up quickly. This is why your prescriber will carefully review your medical history and current medicines during your consultation.

Your prescriber will check whether you have any history of low blood pressure, fainting, or dizziness, and will advise you on the safest dose of vardenafil to start with. If you are already stable on bromocriptine and have not experienced significant blood pressure problems, adding vardenafil is usually straightforward. However, it is important to report any new symptoms such as dizziness, fainting, or feeling unusually unwell.

Never start, stop, or change the dose of any prescribed medicine without consulting your doctor or pharmacist. If you are taking bromocriptine for high prolactin and your doctor has recommended vardenafil for ED, both medicines can usually be used together under medical supervision. Always declare all your current medicines, including over-the-counter products and supplements, during your online consultation.

What Your Prescriber Checks Before Prescribing Vardenafil

Before prescribing vardenafil, your prescriber will ask about your full medical history and all current medicines, including bromocriptine. They will check for any conditions that make vardenafil unsuitable, such as recent heart attack or stroke, unstable angina, severe heart failure, very low blood pressure, or previous sudden vision loss (NAION) [5]. They will also ask about any medicines that must not be taken with vardenafil, such as nitrates (GTN spray, isosorbide mononitrate), nicorandil, riociguat, or recreational drugs called 'poppers'.

Your prescriber will also review any medicines that can interact with vardenafil by affecting how it is broken down in the body. Potent CYP3A4 inhibitors, such as ritonavir, ketoconazole, itraconazole, and clarithromycin, can raise vardenafil levels significantly, and vardenafil is contraindicated or requires dose adjustment with these medicines [5]. Bromocriptine does not significantly affect CYP3A4, so this is not a concern with this combination.

If you are taking other blood-pressure-lowering medicines, including bromocriptine, your prescriber may recommend starting with a lower dose of vardenafil (5 mg) to minimise the risk of dizziness. They will also advise you to avoid heavy alcohol, which can worsen ED and add to the blood-pressure-lowering effect. Grapefruit juice should also be avoided, as it can raise vardenafil levels.

Declaring All Your Medicines

It is essential to list every medicine you take during your consultation, including prescription medicines, over-the-counter products, herbal remedies, and supplements. Even if you think a medicine is unrelated to ED, it may interact with vardenafil or affect your suitability for treatment. Your prescriber uses this information to ensure vardenafil is safe and effective for you.

Practical Advice for Taking Vardenafil and Bromocriptine

If you are prescribed vardenafil while taking bromocriptine, take each medicine exactly as directed by your prescriber. Vardenafil is usually taken about 25 to 60 minutes before sexual activity, no more than once a day [5]. Bromocriptine is typically taken daily, often with food to reduce nausea. There is no need to separate the doses of these two medicines, but if you experience dizziness or light-headedness, sit or lie down until you feel better.

Avoid drinking large amounts of alcohol when taking vardenafil, as alcohol can make it harder to get an erection and can add to the blood-pressure-lowering effect of both medicines. Stand up slowly from sitting or lying positions, especially in the first few weeks of treatment, to reduce the risk of dizziness. If you feel faint, dizzy, or unwell after taking vardenafil, do not drive or operate machinery.

If vardenafil does not work as well as expected, do not take more than the prescribed dose or take it more often than once a day. Speak to your prescriber, who may adjust the dose or suggest an alternative PDE5 inhibitor such as sildenafil or tadalafil. Remember that vardenafil only works when you are sexually aroused, so relaxation and foreplay are important.

Warning Signs and When to Seek Help with Vardenafil and Bromocriptine

Most men tolerate vardenafil and bromocriptine together without serious problems, but it is important to know the warning signs that need urgent medical attention. If you develop an erection that lasts longer than four hours (priapism), seek emergency help immediately, as this can cause permanent damage if not treated promptly. Priapism is rare but requires urgent treatment in A&E.

Sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing (sometimes with ringing in the ears or dizziness), are rare but serious side effects of PDE5 inhibitors [5]. Stop taking vardenafil and seek medical help straight away if this happens. If you experience chest pain during or after sex, do not use nitrate medicines such as GTN spray—seek urgent medical help and tell the healthcare professional that you have taken vardenafil.

Severe dizziness, fainting, or a very fast or irregular heartbeat should also prompt you to seek medical advice. If you develop signs of an allergic reaction, such as swelling of the face, lips, tongue, or throat, or difficulty breathing, call 999 immediately. For less urgent concerns, such as persistent side effects or questions about your treatment, contact your prescriber or pharmacist for advice.

Monitoring Your Response

Keep track of how well vardenafil works for you and any side effects you experience. If you notice new or worsening symptoms after starting vardenafil, or if your bromocriptine dose is changed, let your prescriber know. Regular reviews help ensure both medicines continue to work safely and effectively for you.

When to get urgent help

• Erection lasting longer than four hours (priapism)—go to A&E immediately
• Sudden loss of vision or hearing—stop vardenafil and seek urgent medical help
• Chest pain during or after sex—do not use nitrate medicines; call 999
• Severe dizziness, fainting, or very fast/irregular heartbeat—seek medical advice
• Swelling of face, lips, tongue, or throat, or difficulty breathing—call 999

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