Vardenafil and Cytisine: Can You Take Them Together?

Vardenafil and Cytisine: Understanding the Interaction

Published: 29 October 2026

If you're considering vardenafil and cytisine together, you'll be pleased to know that no major interaction between these two medicines is commonly reported. Vardenafil is a prescription treatment for erectile dysfunction (ED), while cytisine is a medicine used to help people stop smoking. Because smoking itself is a significant risk factor for ED, using cytisine to quit can actually improve your long-term erectile function [1][2]. However, every medicine you take—prescription, over-the-counter, or herbal—must be declared during your consultation so that your prescriber can check for any individual risks.

What Is Vardenafil and How Does It Work?

Vardenafil (also known by the brand name Levitra) is a phosphodiesterase type 5 (PDE5) inhibitor licensed in the UK to treat erectile dysfunction [5]. It works by relaxing the blood vessels in the penis, allowing more blood to flow in when you are sexually aroused. This helps you achieve and maintain an erection suitable for sexual activity.

Vardenafil is available in 5 mg, 10 mg, and 20 mg tablets and is usually taken about 25 to 60 minutes before sex [5]. The effect can last for several hours, but you should not take it more than once in 24 hours. Sexual stimulation is still needed—vardenafil will not cause an erection on its own.

Like all PDE5 inhibitors, vardenafil can interact with certain other medicines, particularly those that affect blood pressure or are metabolised by the same liver enzymes. That's why a full medication review is essential before starting treatment.

Who Can Take Vardenafil?

Vardenafil is suitable for most men over 18 with erectile dysfunction, but it is not appropriate for everyone [5]. You should not take vardenafil if you use nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers', because the combination can cause a dangerous drop in blood pressure. It is also not suitable if you have had a recent heart attack or stroke, have unstable angina, severe heart failure, very low blood pressure, or a history of sudden vision loss (non-arteritic anterior ischaemic optic neuropathy, or NAION) [5]. Your prescriber will check your full medical history and current medicines during your online consultation to ensure vardenafil is safe for you.

What Is Cytisine and Why Is It Used?

Cytisine is a plant-based medicine used to help people stop smoking. It works by binding to nicotine receptors in the brain, reducing cravings and withdrawal symptoms while also making smoking less rewarding. Cytisine has been used in Eastern Europe for decades and is now available in the UK as a smoking-cessation aid.

The usual course of cytisine lasts 25 days, with the dose gradually reduced over that period. It is taken as tablets, typically starting while you are still smoking, with a target quit date set within the first few days of treatment. Because it acts on nicotine receptors rather than affecting blood pressure or liver enzymes in the same way as many other medicines, cytisine has a different side-effect profile from nicotine replacement therapy or other stop-smoking drugs.

Quitting smoking is one of the most important steps you can take to improve your overall health, including your sexual health. Smoking damages blood vessels and reduces blood flow, both of which are key factors in erectile dysfunction [1][2].

Vardenafil and Cytisine: Is There an Interaction?

No major interaction between vardenafil and cytisine is commonly reported in the medical literature or standard drug-interaction databases. The two medicines work through different mechanisms and are processed differently by the body. Cytisine acts on nicotine receptors in the brain, while vardenafil works on blood vessels in the penis by inhibiting the PDE5 enzyme [5].

However, it is still essential to tell your prescriber that you are taking cytisine (or any other smoking-cessation medicine) when you request vardenafil. Your prescriber will review your full medication list, medical history, and any other risk factors to ensure the combination is safe for you personally. Individual factors—such as other medicines you take, underlying health conditions, or cardiovascular risk—can influence whether a particular combination is appropriate.

Remember that smoking itself significantly worsens erectile dysfunction by damaging blood vessels and reducing circulation [1][2]. Successfully quitting with the help of cytisine may improve your erectile function over time, making your ED treatment more effective in the long run.

How the Prescriber Checks Safety

During your online consultation at Cured Pharmacy, you will be asked to list all medicines you currently take, including prescription drugs, over-the-counter products, herbal remedies, and smoking-cessation treatments like cytisine. The prescriber will check for any known interactions, review your cardiovascular health, and assess whether vardenafil is suitable given your individual circumstances. This thorough review is a legal and clinical requirement before any prescription medicine can be supplied [12].

Important Interactions to Avoid with Vardenafil and Cytisine

While vardenafil and cytisine can generally be used together, there are some medicines and substances you must never take with vardenafil. Do not take vardenafil if you use nitrates (GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, or recreational nitrites ('poppers'), as the combination can cause a dangerous fall in blood pressure [5].

You should also avoid taking vardenafil with another PDE5 inhibitor (such as sildenafil, tadalafil, or avanafil) at the same time. If you take alpha-blockers for prostate symptoms or high blood pressure (such as doxazosin or tamsulosin), you may still be able to use vardenafil, but you must be stable on the alpha-blocker first and start on the lowest dose of vardenafil [5]. Your prescriber will check this carefully.

Potent CYP3A4 inhibitors—medicines such as ritonavir, cobicistat, ketoconazole, itraconazole, or clarithromycin—can raise vardenafil levels in the blood, increasing the risk of side effects. Vardenafil is often contraindicated or requires dose adjustment when these medicines are used [5]. Always declare every medicine, including recent courses of antibiotics or antifungals.

Practical Advice: Taking Vardenafil While Using Cytisine

If your prescriber confirms that vardenafil is safe for you while taking cytisine, follow the dosing instructions for both medicines 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]. Continue your cytisine course as directed—do not stop or change the dose without advice from the healthcare professional who prescribed it.

Avoid drinking large amounts of alcohol, as heavy drinking can worsen erectile dysfunction and add to the blood-pressure-lowering effect of vardenafil, increasing the risk of dizziness or fainting [5]. Grapefruit juice can also raise vardenafil levels, so it's best to avoid it while using this medicine.

If you experience any unusual symptoms—such as dizziness, chest pain during sex, sudden vision or hearing loss, or an erection lasting more than four hours—stop taking vardenafil and seek urgent medical help. These are rare but serious side effects that require immediate attention [5].

Monitoring and Follow-Up

Keep track of how well both medicines are working for you. If your erectile function improves as you progress through your smoking-cessation treatment, let your prescriber know—you may find that you need ED treatment less often or at a lower dose once you have quit smoking. Regular follow-up with your GP is also important to monitor your cardiovascular health, blood pressure, and overall progress [1][2].

Why Quitting Smoking Helps Erectile Dysfunction

Smoking is one of the most significant modifiable risk factors for erectile dysfunction. It damages the lining of blood vessels, reduces nitric oxide (a chemical needed for erections), and accelerates atherosclerosis (narrowing of the arteries) [1][2]. These changes reduce blood flow to the penis, making it harder to achieve and maintain an erection.

Studies show that men who quit smoking often see an improvement in erectile function within weeks to months, depending on how long and how heavily they smoked [10]. Using cytisine to help you quit can therefore have a direct, positive impact on your sexual health, as well as reducing your risk of heart disease, stroke, lung disease, and many cancers.

Combining smoking cessation with ED treatment like vardenafil gives you the best chance of long-term success. Vardenafil can help you maintain sexual activity and confidence while you work on quitting, and quitting will improve the underlying blood-vessel health that supports natural erections. This two-pronged approach addresses both the immediate symptom and the root cause [1][2].

Other Lifestyle Changes That Help

Alongside quitting smoking, other lifestyle changes can further improve erectile function. Maintaining a healthy weight, exercising regularly, eating a balanced diet, reducing alcohol intake, and managing stress all support better blood flow and hormone balance [1][2]. If you have diabetes, high blood pressure, or high cholesterol, keeping these conditions well controlled is also crucial for sexual health. Your GP can provide tailored advice and support.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 29 October 2026]
2. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 29 October 2026]
3. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 29 October 2026]
4. Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54–61. https://pubmed.ncbi.nlm.nih.gov/8254833/ [accessed 29 October 2026]
5. Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 29 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.