Vardenafil and COVID: Is It Safe?

Takes less than 2 minutes to complete 100% online

Choose your treatment

Select from our recommended UK-licensed medications.

Answer quick questions

Select safe UK treatments. Quick answers.

Get it delivered fast

We will deliver direct to you as quickly as tomorrow.

At a glance

Is Vardenafil Safe During COVID-19 Infection?

Vardenafil does not make COVID-19 worse, nor does having COVID-19 automatically mean you cannot take vardenafil [5]. However, during acute COVID infection—especially if you have fever, fatigue, breathing difficulties, or feel generally unwell—sexual activity may not be advisable, and you're unlikely to feel like it anyway. The main concern is not the virus itself, but rather your overall fitness for sexual activity and any COVID treatments you may be taking.

If you are taking Paxlovid (nirmatrelvir/ritonavir), you must not take vardenafil at the same time. Ritonavir is a potent CYP3A4 inhibitor that dramatically increases vardenafil levels, raising the risk of serious side effects including dangerously low blood pressure, prolonged erections (priapism), and visual disturbances [5]. Vardenafil is contraindicated with potent CYP3A4 inhibitors, so you should stop vardenafil for the duration of Paxlovid treatment (typically five days) and for at least 48 hours after the last dose, though your prescriber will advise the exact timing based on your circumstances.

Other COVID treatments—such as molnupiravir (Lagevrio) or monoclonal antibodies—do not have known major interactions with vardenafil, but you should always declare all current medications during your online consultation so the prescriber can check the latest guidance [12]. If you're recovering from COVID and feel well enough for sexual activity, and you're not on interacting medications, vardenafil can usually be resumed safely.

Vardenafil and COVID Treatments: Key Interactions

The most significant interaction between vardenafil and COVID treatments involves Paxlovid. Ritonavir, one of the two active ingredients in Paxlovid, is a powerful enzyme inhibitor that blocks the breakdown of vardenafil in the liver [5]. This can cause vardenafil to accumulate to unsafe levels, increasing the risk of side effects such as severe headache, flushing, dizziness, fainting, visual changes, and priapism (a painful erection lasting more than four hours). For this reason, vardenafil is contraindicated during Paxlovid treatment.

If you are prescribed Paxlovid, stop taking vardenafil immediately and do not restart until at least 48 hours after your last Paxlovid dose—your prescriber may recommend waiting longer depending on your kidney and liver function [12]. Molnupiravir, another oral COVID antiviral, does not share this interaction and is not known to affect vardenafil levels. Similarly, other supportive COVID treatments (paracetamol, ibuprofen, antihistamines) do not interact with vardenafil.

Always inform your GP or pharmacist if you are taking vardenafil when being assessed for COVID treatment, and likewise declare any COVID medications during your erectile dysfunction consultation. The prescriber will review your full medication list and medical history to ensure vardenafil is safe for you [2].

What About Long COVID and Erectile Dysfunction?

Some men report new or worsening erectile dysfunction after recovering from COVID-19, a symptom sometimes associated with 'long COVID' [1]. The exact mechanism is not fully understood, but may involve inflammation of blood vessels, reduced oxygen levels during illness, psychological stress, or fatigue. If you develop ED after COVID, it's important to see your GP to rule out other causes such as diabetes or cardiovascular disease, which COVID can sometimes unmask [2]. Vardenafil and other PDE5 inhibitors can be effective for ED related to long COVID, provided there are no contraindications and you are medically fit for sexual activity.

How Does Vardenafil Work for Erectile Dysfunction?

Vardenafil belongs to a class of medicines called PDE5 inhibitors, which also includes sildenafil (Viagra), tadalafil (Cialis), and avanafil (Spedra) [5]. It works by relaxing the smooth muscle in the blood vessels of the penis, allowing increased blood flow when you are sexually aroused. Vardenafil does not cause an erection on its own—sexual stimulation is still required [5].

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 [5]. The effect can last for around four to five hours, though this varies between individuals. You should not take vardenafil more than once in 24 hours. If the 10 mg dose is effective but causes side effects, your prescriber may reduce the dose to 5 mg; if it is not effective enough, the dose may be increased to 20 mg, provided it is safe to do so [5].

Common side effects include headache, flushing, nasal congestion, indigestion, and dizziness [5]. These are usually mild and temporary. Serious side effects are rare but include prolonged erections (priapism), sudden vision or hearing loss, and chest pain during sex—all require urgent medical attention [5]. Vardenafil is not suitable for everyone, particularly men taking nitrates, those with severe heart or liver disease, or those who have had a recent stroke or heart attack [5].

What you need to know

• Vardenafil does not worsen COVID-19, but must not be taken with Paxlovid due to a serious drug interaction.
• Stop vardenafil during Paxlovid treatment and wait at least 48 hours after the last dose before restarting.
• Long COVID can cause or worsen erectile dysfunction; see your GP for assessment and treatment options.
• Other COVID treatments like molnupiravir do not interact with vardenafil, but always declare all medications.
• Vardenafil can be resumed once you have recovered and are medically fit for sexual activity.

When Can I Restart Vardenafil After COVID or Paxlovid?

If you have stopped vardenafil because of a COVID infection or because you were prescribed Paxlovid, you can usually restart once you have recovered and are no longer taking interacting medications. For Paxlovid, wait at least 48 hours after your last dose before restarting vardenafil, though your prescriber may advise a longer interval depending on your kidney or liver function and other medications [12].

Before resuming vardenafil, consider whether you are well enough for sexual activity. The UK guidance is that sexual activity is not advisable if you have unstable angina, severe heart failure, a recent heart attack or stroke (within the last six months), very low blood pressure, or uncontrolled high blood pressure [2][5]. If your COVID infection was severe, caused heart or lung complications, or if you are still experiencing significant fatigue or breathlessness, discuss with your GP whether it is safe to resume sexual activity and erectile dysfunction treatment.

If you are using the Cured Pharmacy online service, you can request a new prescription or restart your existing treatment plan once you are ready. The online consultation will ask about recent illnesses, current medications, and your fitness for sexual activity, and a UK prescriber will review your answers to ensure vardenafil is safe and appropriate for you.

What If I'm on Other Long-Term Medications?

Many men take regular medications for conditions such as high blood pressure, diabetes, or prostate problems. Vardenafil can usually be taken alongside most of these, but some combinations require caution [5]. Alpha-blockers (such as tamsulosin or doxazosin, used for prostate enlargement or blood pressure) can add to the blood-pressure-lowering effect of vardenafil, causing dizziness or fainting. If you take an alpha-blocker, you should be stable on it before starting vardenafil, and your prescriber will usually start you on the lowest dose [5]. Other blood pressure medicines can also add to this effect, but are usually manageable. The online consultation will check all your current medicines to ensure vardenafil is safe for you.

Vardenafil and COVID: Practical Advice for Safe Use

To use vardenafil safely during or after COVID-19, follow these practical steps. First, if you develop COVID symptoms or test positive, assess whether you feel well enough for sexual activity—if you have fever, severe fatigue, breathing difficulties, or chest discomfort, it's best to wait until you have recovered [1]. Second, check all your current medications, especially any new COVID treatments. If you are prescribed Paxlovid, stop vardenafil immediately and do not restart until at least 48 hours after finishing the course, or as advised by your prescriber [5][12].

Third, if you develop new or worsening erectile dysfunction after COVID, see your GP. ED can be an early warning sign of cardiovascular disease or diabetes, and COVID can sometimes unmask these conditions [1][2]. Your GP can arrange blood tests and a cardiovascular assessment. Fourth, when you are ready to restart or start vardenafil, complete an online consultation with Cured Pharmacy or another registered service. Declare your recent COVID infection, any treatments you received, and all current medications. The prescriber will review your answers and ensure vardenafil is safe and appropriate.

Finally, take vardenafil as directed: usually 10 mg about 25 to 60 minutes before sexual activity, no more than once a day [5]. Avoid heavy alcohol, which can worsen ED and add to the blood-pressure-lowering effect. Do not take vardenafil with grapefruit juice, which can raise levels in the blood. If you experience chest pain during sex, stop immediately and seek urgent medical help—do not take GTN spray or any nitrate if you have used vardenafil in the last 24 hours, as the combination can cause a dangerous drop in blood pressure [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 attention.
• Chest pain during sex—stop immediately; do not take GTN or nitrates if you have used vardenafil in the last 24 hours; call 999.
• Severe dizziness, fainting, or very low blood pressure—especially if taking Paxlovid or other interacting medicines; seek urgent help.
• Severe breathlessness or chest pain after COVID—see your GP urgently before resuming sexual activity or vardenafil.

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

Alternatives to Vardenafil for Erectile Dysfunction

If vardenafil is not suitable for you—for example, because you are taking Paxlovid or another potent CYP3A4 inhibitor—there are other licensed treatments for erectile dysfunction. Sildenafil (generic Viagra) is another PDE5 inhibitor that works in a similar way; it is taken about one hour before sex and lasts for around four hours [3]. Tadalafil (generic Cialis) has a longer duration of action, up to 36 hours, and can also be taken daily at a lower dose for continuous effect [4]. Avanafil (Spedra) works faster, often within 15 to 30 minutes, and may be a good choice if you want a quick-acting option [6].

All PDE5 inhibitors share similar contraindications and interactions, including the interaction with Paxlovid, so switching between them during COVID treatment is not a solution [3][4][5][6]. However, if you have a contraindication specific to vardenafil (such as a previous adverse reaction), your prescriber may recommend trying a different PDE5 inhibitor once it is safe to do so. For men who cannot use PDE5 inhibitors at all, other options include alprostadil cream (Vitaros) applied to the tip of the penis, or alprostadil injections (Caverject), both of which work locally rather than systemically and do not have the same drug interactions [7].

Cured Pharmacy offers a range of erectile dysfunction treatments, all available after an online consultation reviewed by a UK prescriber. These include Sildenafil from £0.45 per tablet (first order with code Ednew: £0.36), Tadalafil from £7.95 (first order: £6.36), Vardenafil at £16.95 (first order: £13.56), and Spedra at £20.95 (first order: £16.76). The prescriber will help you choose the most suitable treatment based on your medical history, current medications, and personal preferences.

Non-Medicine Approaches to Erectile Dysfunction

Lifestyle changes can improve erectile function and overall cardiovascular health, which is especially important after COVID-19 [2]. Regular exercise, a healthy diet, maintaining a healthy weight, reducing alcohol intake, stopping smoking, and managing stress can all help [1][2]. Psychological factors such as anxiety, depression, or relationship difficulties can contribute to ED, and talking therapies or counselling may be beneficial [2]. Your GP can refer you to appropriate services. Combining lifestyle changes with medication often gives the best results.

Start Your Assessment For Erectile Dysfunction

Start your journey to better health today.

• Reviewed by UK-based prescribers
• Takes under 3 minutes
• Discreet Packaging