Vardenafil and Indometacin: Can They Be Taken Together?

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What Is Vardenafil and How Does It Work?

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

Vardenafil is available in 5mg, 10mg, and 20mg tablets and is usually taken about 25 to 60 minutes before sexual activity [5]. The effect can last for several hours, but you should not take it more than once in 24 hours. Like all PDE5 inhibitors, vardenafil requires sexual stimulation to work—it will not cause an erection on its own.

Your prescriber will assess whether vardenafil is suitable for you based on your medical history, current medicines, and cardiovascular health. It is not appropriate for everyone, particularly those taking certain medicines such as nitrates or riociguat, or those for whom sexual activity is inadvisable [5].

What Is Indometacin and What Is It Used For?

Indometacin (also spelled indomethacin) is a non-steroidal anti-inflammatory drug (NSAID) used to reduce pain, swelling, and inflammation. It is commonly prescribed for conditions such as rheumatoid arthritis, osteoarthritis, gout, ankylosing spondylitis, and acute musculoskeletal pain. Indometacin works by blocking enzymes (cyclooxygenase-1 and cyclooxygenase-2) that produce prostaglandins, chemicals in the body that cause inflammation and pain.

Like other NSAIDs, indometacin can have side effects, particularly affecting the stomach and cardiovascular system. It may increase the risk of stomach ulcers, bleeding, and cardiovascular events such as heart attack or stroke, especially with long-term use or in people with existing heart conditions. Your doctor will weigh these risks when prescribing indometacin.

Because indometacin can affect blood pressure and kidney function, it is important to tell your prescriber about all medicines you are taking, including treatments for erectile dysfunction. This allows them to assess whether the combination is safe and whether any dose adjustments or additional monitoring are needed.

Common Uses of Indometacin

Indometacin is prescribed for inflammatory conditions including rheumatoid arthritis, osteoarthritis, acute gout, ankylosing spondylitis, and soft tissue injuries. It may also be used for period pain and other acute pain conditions. The medicine is available as capsules, modified-release capsules, and suppositories, with doses tailored to the condition being treated.

When to get urgent help

• Erection lasting more than 4 hours (priapism) – go to A&E immediately
• Sudden loss of vision or hearing – seek urgent medical help
• Chest pain during sexual activity – stop and call 999 if pain does not resolve quickly
• Severe stomach pain, black stools, or vomiting blood while taking indometacin – seek urgent help
• Signs of allergic reaction (swelling of face, lips, tongue, or throat, difficulty breathing) – call 999

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

The Interaction Between Vardenafil and Indometacin

No major direct interaction is commonly reported between vardenafil and indometacin. These medicines work through different mechanisms in the body: vardenafil affects blood flow to the penis by inhibiting PDE5, while indometacin reduces inflammation by blocking prostaglandin production. Neither medicine is known to significantly alter the metabolism or effectiveness of the other.

However, both medicines can have effects on the cardiovascular system that your prescriber will consider. Vardenafil can cause a modest reduction in blood pressure, particularly when you stand up quickly [5]. NSAIDs like indometacin can sometimes raise blood pressure or worsen existing high blood pressure, and they may also increase the risk of cardiovascular events in some people.

During your online consultation, the prescriber will review your full medical history, including any heart conditions, blood pressure problems, and all current medicines. They will assess whether the combination of vardenafil and indometacin is appropriate for you, taking into account your individual cardiovascular risk factors. If you are taking indometacin long-term for a chronic condition, this will be part of the overall safety assessment.

It is important to declare all medicines you are taking, including over-the-counter NSAIDs, when requesting a prescription for vardenafil. This ensures the prescriber can make an informed decision about your treatment.

What Your Prescriber Checks Before Approving Vardenafil

When you complete an online consultation for vardenafil at Cured Pharmacy, a UK-registered prescriber will review your medical history and current medicines to ensure the treatment is safe and appropriate for you. They will check for contraindications such as use of nitrates, nicorandil, riociguat, or another PDE5 inhibitor, as these combinations can cause a dangerous drop in blood pressure [5].

The prescriber will also assess your cardiovascular health, including any history of heart attack, stroke, angina, heart failure, or abnormal heart rhythms. They will review your blood pressure and check whether you are taking medicines that could interact with vardenafil, such as alpha-blockers (used for prostate problems or high blood pressure) or potent CYP3A4 inhibitors (certain antifungals, antibiotics, or HIV medicines) [5].

If you are taking indometacin or another NSAID, the prescriber will consider this as part of the overall assessment. They will evaluate your cardiovascular risk, kidney function (if relevant information is available), and whether the combination is appropriate. In most cases, men taking indometacin can safely use vardenafil, but the decision is individualised based on your complete medical picture.

If the prescriber approves your treatment, they will recommend the most suitable dose of vardenafil for you, which may be the standard starting dose or a lower dose depending on your circumstances.

Medicines That Cannot Be Taken with Vardenafil

Do not take vardenafil if you are using nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or recreational drugs called 'poppers' (amyl or alkyl nitrites). The combination can cause a severe and potentially life-threatening drop in blood pressure [5]. You must also not take vardenafil with another PDE5 inhibitor such as sildenafil, tadalafil, or avanafil.

At a glance

Practical Advice When Taking Vardenafil and Indometacin

If your prescriber approves vardenafil and you are also taking indometacin, 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]. Take indometacin as prescribed by your doctor, usually with or after food to reduce the risk of stomach upset.

Be aware of how each medicine might affect you individually. Vardenafil can cause side effects such as headache, flushing, indigestion, nasal congestion, or dizziness [5]. Indometacin may cause stomach discomfort, nausea, headache, or dizziness. If you experience dizziness from either medicine, avoid driving or operating machinery until you know how you react.

Avoid drinking large amounts of alcohol when taking vardenafil, as alcohol can worsen erectile dysfunction and increase the risk of side effects such as dizziness and low blood pressure. Alcohol may also increase the risk of stomach irritation when taking indometacin.

Do not stop taking indometacin or change the dose without consulting your doctor, even if you are starting vardenafil. If you develop new symptoms or side effects after starting the combination, contact your GP or pharmacist for advice. Always inform any healthcare professional treating you that you are taking both medicines.

When to Seek Medical Help and Alternative ED Treatments

Seek urgent medical help if you experience an erection lasting more than four hours (priapism), sudden loss of vision or hearing, or chest pain during sexual activity while taking vardenafil [5]. These are rare but serious side effects that require immediate attention. If you develop severe stomach pain, black or bloody stools, or vomit blood while taking indometacin, seek urgent medical help as these may indicate a serious stomach problem.

If vardenafil is not suitable for you, or if you experience troublesome side effects, other PDE5 inhibitors may be an option. Sildenafil (generic Viagra) is available from £0.45 per tablet at Cured Pharmacy, while tadalafil (generic Cialis) offers a longer duration of action, with effects lasting up to 36 hours [3][4]. Avanafil (Spedra) works more quickly, often within 15 to 30 minutes [6].

For men who cannot take PDE5 inhibitors at all, alternatives include alprostadil cream (Vitaros) or alprostadil injections (Caverject), both of which work locally rather than affecting the whole body [7]. A vacuum erection device is a non-drug option. Your prescriber can discuss which treatment is most appropriate for your individual circumstances.

Remember that erectile dysfunction can be an early warning sign of cardiovascular disease or diabetes [1][2]. If you have not already done so, see your GP for a full health check, particularly if you have risk factors such as high blood pressure, high cholesterol, diabetes, or a history of heart disease.

Getting Vardenafil from Cured Pharmacy

Vardenafil is available from Cured Pharmacy at £16.95 (£13.56 for first orders with code Ednew) following an online consultation reviewed by a UK-registered prescriber. The consultation asks about your medical history, current medicines (including indometacin), and cardiovascular health to ensure vardenafil is safe and appropriate for you. If approved, your medicine is dispensed by our GPhC-registered pharmacy and delivered discreetly to your door.

In summary

• No major interaction is commonly reported between vardenafil and indometacin
• Your prescriber will assess your cardiovascular health and all current medicines
• Both medicines can affect blood pressure, so individual risk is evaluated
• Always declare all medicines, including NSAIDs, during your consultation
• Most men taking indometacin can safely use vardenafil after prescriber approval

Frequently Asked Questions