Vardenafil and Entresto: Can They Be Taken Together?

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Vardenafil and Entresto: Understanding the Interaction

Published: 30 October 2026

If you're prescribed Entresto (sacubitril/valsartan) for heart failure and considering vardenafil for erectile dysfunction, you may be wondering whether vardenafil and Entresto can be taken together safely. The good news is that this combination is not absolutely contraindicated, but it does require careful prescriber assessment because both medicines can lower blood pressure. This page explains what each medicine does, how they may interact, what your doctor or pharmacist will check during your consultation, and practical advice to help you use them safely.

What is vardenafil and Entresto?

Vardenafil (sold as generic Levitra) is a prescription medicine used to treat erectile dysfunction in men. 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 [5]. Vardenafil is available in 5mg, 10mg, and 20mg tablets, and is usually taken about 25–60 minutes before sexual activity. It requires sexual stimulation to work and should not be taken more than once a day.

Entresto is the brand name for a combination medicine containing sacubitril and valsartan. It is prescribed to treat chronic heart failure by helping the heart pump blood more efficiently and reducing strain on the cardiovascular system. Valsartan is an angiotensin receptor blocker (ARB) that relaxes blood vessels, while sacubitril enhances the body's natural protective mechanisms. Because Entresto lowers blood pressure as part of its therapeutic action, it's important to consider how it might interact with other medicines that also affect blood pressure, including vardenafil.

Both medicines are prescription-only in the UK and must be prescribed by a qualified healthcare professional after a thorough assessment of your medical history and current health status.

How do vardenafil and Entresto interact?

Vardenafil and Entresto are not contraindicated together—meaning they are not absolutely forbidden to be used at the same time—but there is a potential interaction that your prescriber must carefully evaluate. The interaction is additive: both medicines can lower blood pressure, and when taken together, this effect may be more pronounced [5].

Vardenafil works by inhibiting an enzyme called PDE5, which leads to relaxation of smooth muscle in blood vessels, including those in the penis and elsewhere in the body. This can cause a mild drop in blood pressure. Entresto, on the other hand, is specifically designed to lower blood pressure and reduce the workload on the heart in people with heart failure. When you combine two medicines that both lower blood pressure, there is a risk of excessive blood pressure reduction, which can cause dizziness, light-headedness, fainting, or in rare cases, more serious cardiovascular events.

It's important to note that this interaction is not the same as the dangerous interaction between vardenafil and nitrates (such as GTN spray or isosorbide mononitrate), which is absolutely contraindicated. With Entresto, the combination may be used, but only under close medical supervision and with appropriate dose adjustments.

Why the interaction matters

The additive blood-pressure-lowering effect is particularly important if you have heart failure, as your cardiovascular system may already be under strain. Your prescriber needs to ensure that your heart condition is stable, that your blood pressure is well controlled on Entresto, and that starting vardenafil will not cause symptoms such as dizziness or fainting that could increase your risk of falls or other complications. This is why an individualised assessment is essential before vardenafil is prescribed.

What will my prescriber check before prescribing vardenafil and Entresto together?

If you are taking Entresto and request treatment for erectile dysfunction, your prescriber (doctor or pharmacist prescriber) will carry out a detailed consultation to assess whether vardenafil—or another PDE5 inhibitor—is safe and appropriate for you. They will review your full medical history, current medicines, and recent blood pressure readings.

Key checks include: the severity and stability of your heart failure (sexual activity itself must be safe for you); your current blood pressure and whether it is well controlled on Entresto; any symptoms of low blood pressure such as dizziness or fainting; other medicines you are taking that might also lower blood pressure or interact with vardenafil (such as alpha-blockers for prostate symptoms); and whether you have any contraindications to PDE5 inhibitors, such as recent heart attack, stroke, unstable angina, or use of nitrate medicines [1][2][5].

Your prescriber may recommend starting on the lowest effective dose of vardenafil (usually 5mg or 10mg) and monitoring how you respond. They may also advise you to take vardenafil at a time when you can sit or lie down if you feel dizzy, and to avoid sudden changes in posture. If you experience significant dizziness, light-headedness, or fainting after taking vardenafil, you should contact your prescriber promptly.

Practical advice for taking vardenafil with Entresto

If your prescriber decides that vardenafil is suitable for you while you are on Entresto, there are several practical steps you can take to use both medicines safely. Always take vardenafil exactly as prescribed—do not take more than the recommended dose or use it more than once in 24 hours. Take it about 25–60 minutes before you plan to have sex, and remember that sexual stimulation is needed for it to work [5].

Monitor your blood pressure if you have a home monitor, especially when you first start vardenafil or if your dose is changed. If you feel dizzy, light-headed, or faint after taking vardenafil, sit or lie down until the symptoms pass, and avoid driving or operating machinery. Do not stand up quickly from a sitting or lying position, as this can worsen dizziness. Limit alcohol intake, as heavy drinking can make erectile dysfunction worse and add to the blood-pressure-lowering effect of both medicines.

Never take vardenafil with nitrate medicines (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites), as these combinations can cause a dangerous drop in blood pressure. Do not take vardenafil with another PDE5 inhibitor (such as sildenafil, tadalafil, or avanafil) at the same time. Always inform any healthcare professional you see—including your GP, cardiologist, or pharmacist—that you are taking both Entresto and vardenafil.

When to contact your doctor

Contact your GP or prescriber if you experience persistent dizziness, fainting, or any new or worsening symptoms after starting vardenafil. If you develop chest pain during or after sexual activity, stop and seek medical advice. If you have an erection lasting more than four hours (priapism), sudden loss of vision or hearing, or severe allergic reaction, seek urgent medical help by calling 999 or going to A&E.

Are there alternative ED treatments if vardenafil and Entresto are not suitable together?

If your prescriber feels that the interaction between vardenafil and Entresto poses too great a risk for you—perhaps because your blood pressure is difficult to control, your heart failure is unstable, or you have other complicating factors—they may suggest alternative treatments for erectile dysfunction. Other PDE5 inhibitors, such as sildenafil or tadalafil, have a similar interaction profile with Entresto, so switching to a different PDE5 inhibitor may not solve the problem [3][4].

However, your prescriber may consider a lower dose, a different dosing schedule, or additional monitoring. In some cases, non-oral treatments may be more appropriate. These include Eroxon, a topical gel that is applied to the head of the penis and works within 10 minutes without affecting blood pressure systemically; Vitaros, a prescription alprostadil cream applied inside the urethra; or Caverject, an alprostadil injection into the penis [7]. These options do not have the same blood-pressure interaction as PDE5 inhibitors, though they come with their own considerations and side effects.

Lifestyle changes can also help improve erectile function: losing weight if you are overweight, stopping smoking, reducing alcohol, exercising regularly (as advised by your cardiologist), and managing stress and anxiety. Psychological support or sex therapy may be beneficial if anxiety or relationship issues are contributing to ED. Your GP or a specialist can discuss all these options with you to find the safest and most effective treatment plan.

Getting vardenafil safely with Entresto through Cured Pharmacy

At Cured Pharmacy, we are a GPhC-registered online pharmacy (GPhC 9012511) offering convenient access to prescription erectile dysfunction treatments, including vardenafil. If you are taking Entresto and would like to explore ED treatment, you can complete a confidential online consultation on our website. Your answers will be reviewed by a UK-registered prescriber (doctor or pharmacist prescriber), who will assess whether vardenafil—or another ED medicine—is safe and suitable for you.

During the consultation, you will be asked detailed questions about your heart condition, current medicines (including Entresto), blood pressure, and any symptoms you experience. The prescriber will check for interactions and contraindications before making a decision. If vardenafil is approved, your prescription will be dispensed by our pharmacy team and dispatched in discreet, plain packaging with fast delivery across the UK. If vardenafil is not suitable, the prescriber may suggest an alternative treatment or advise you to see your GP or cardiologist for further assessment.

We stock vardenafil (generic Levitra) as well as other PDE5 inhibitors such as sildenafil, tadalafil, and Spedra (avanafil). All our medicines are sourced from licensed UK wholesalers and meet MHRA standards. Our pharmacists are available to answer any questions you have about your treatment, and we encourage you to reach out if you experience any side effects or concerns after starting vardenafil.

Why choose Cured Pharmacy?

We combine clinical expertise with convenience and discretion. Our prescribers take the time to review your full medical history and current medicines, ensuring that any treatment is safe and tailored to your individual needs. We understand that discussing erectile dysfunction can feel uncomfortable, and our service is designed to be supportive, non-judgemental, and confidential. If you have any questions about vardenafil and Entresto, our team is here to help.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 30 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 30 October 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 30 October 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 30 October 2026]
5. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 30 October 2026]
6. Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 30 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.