Vardenafil and Irbesartan: Can They Be Taken Together?

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Key takeaways

• Vardenafil and irbesartan can usually be taken together safely with prescriber approval
• Both medicines can lower blood pressure, so your prescriber checks it is stable first
• Never take vardenafil with nitrates, nicorandil, riociguat, or poppers
• Report dizziness or fainting to your GP or pharmacist promptly
• Continue your irbesartan as prescribed and do not stop without medical advice

What Is Vardenafil and How Does It Work?

Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in adult men. It belongs to a group of medicines called PDE5 inhibitors, which also includes sildenafil (Viagra) and tadalafil (Cialis). Vardenafil works by relaxing the blood vessels in the penis, allowing more blood to flow in when you are sexually aroused [5].

Vardenafil is available in 5mg, 10mg, and 20mg tablets. You take it about 25 to 60 minutes before sexual activity, and it works only when you are sexually stimulated. The effect can last for several hours, but you should not take it more than once a day [5]. Common brand names include Levitra, though generic vardenafil is widely available and more affordable.

Because vardenafil affects blood vessels, it can interact with other medicines that lower blood pressure or affect blood flow. That is why your prescriber needs to know about all your current medicines, including irbesartan, before prescribing vardenafil.

What Is Irbesartan and Why Is It Prescribed?

Irbesartan is a medicine used to treat high blood pressure (hypertension) and to protect the kidneys in people with type 2 diabetes. It belongs to a group of medicines called angiotensin II receptor blockers (ARBs), which work by blocking a hormone that narrows blood vessels, allowing the vessels to relax and blood pressure to fall [12].

Irbesartan is usually taken once a day, with or without food. It helps reduce the risk of heart attacks, strokes, and kidney problems by keeping blood pressure under control. Other ARBs include losartan, candesartan, and valsartan, and they all work in a similar way.

Because irbesartan lowers blood pressure, combining it with other medicines that also lower blood pressure—such as vardenafil—can sometimes cause dizziness or light-headedness. However, this does not mean the two medicines cannot be used together; it simply means your prescriber will check your blood pressure and overall health before prescribing vardenafil.

Can You Take Vardenafil and Irbesartan Together?

Yes, vardenafil and irbesartan can usually be taken together, but your prescriber will need to assess your individual situation. Both medicines can lower blood pressure, so there is a potential for an additive effect—meaning your blood pressure might drop more than it would with either medicine alone. This can lead to dizziness, light-headedness, or fainting, especially when you stand up quickly [5].

The interaction between vardenafil and irbesartan is not classified as dangerous or contraindicated, unlike the interaction between vardenafil and nitrates (such as GTN spray), which must never be combined. However, your prescriber will check that your blood pressure is stable on irbesartan before prescribing vardenafil, and they may start you on a lower dose of vardenafil to minimise the risk of low blood pressure.

During your online consultation at Cured Pharmacy, you will be asked about all your current medicines, including irbesartan, and any symptoms such as dizziness or fainting. A UK-registered prescriber will review your answers and decide whether vardenafil is suitable for you, and at what dose. If you experience dizziness or feel faint after taking vardenafil, sit or lie down and contact your GP or pharmacist for advice.

How the Interaction Works in Plain English

Vardenafil relaxes blood vessels in the penis to help with erections, but it also has a mild relaxing effect on blood vessels elsewhere in the body, which can lower blood pressure slightly. Irbesartan also relaxes blood vessels to lower blood pressure. When you take both medicines together, the blood-pressure-lowering effects can add up, making you more likely to feel dizzy or light-headed, especially in the first few hours after taking vardenafil. This is usually manageable, but it is why your prescriber needs to know about your irbesartan and check your blood pressure is well controlled before prescribing vardenafil.

What Your Prescriber Checks Before Prescribing Vardenafil

Before prescribing vardenafil to someone taking irbesartan, your prescriber will review your medical history and current medicines. They will check that your blood pressure is stable and not too low, as vardenafil can lower it further. They will also ask about any symptoms of low blood pressure, such as dizziness, fainting, or feeling weak when you stand up [5].

Your prescriber will also check for other medicines or conditions that might make vardenafil unsuitable. For example, vardenafil must never be taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs called poppers, as these combinations can cause a dangerous drop in blood pressure. If you take an alpha-blocker (such as doxazosin or tamsulosin) as well as irbesartan, extra caution is needed, and you may be started on a lower dose of vardenafil.

If you take any medicines that affect how the liver breaks down vardenafil—such as ritonavir, ketoconazole, or clarithromycin—your prescriber will check the dose carefully, as these can raise vardenafil levels in the blood. Always list every medicine, supplement, and herbal remedy you take during your consultation, even if you think it is not relevant.

Practical Advice for Taking Vardenafil with Irbesartan

If your prescriber approves vardenafil while you are taking irbesartan, follow these practical tips to use both medicines safely. Take vardenafil about 25 to 60 minutes before sexual activity, and do not take it more than once a day. Continue taking your irbesartan exactly as prescribed by your GP—do not stop or change the dose without medical advice [5].

Be aware of how you feel after taking vardenafil, especially in the first few hours. If you feel dizzy or light-headed, sit or lie down until the feeling passes. Avoid standing up quickly from a sitting or lying position, as this can make dizziness worse. Limit alcohol, as it can add to the blood-pressure-lowering effect and make ED worse.

If you experience chest pain during or after sex, stop and seek urgent medical help. Do not take a nitrate medicine (such as GTN spray) if you have taken vardenafil in the past 24 hours, as this combination can be dangerous. If you have an erection lasting more than four hours, or sudden loss of vision or hearing, go to A&E immediately. These are rare but serious side effects that need urgent treatment.

When to Contact Your GP or Pharmacist

Contact your GP or pharmacist if you experience persistent dizziness, fainting, or any new symptoms after starting vardenafil. If your blood pressure becomes difficult to control, or if you need to change your irbesartan dose, let your prescriber know before taking vardenafil again. Never adjust your blood pressure medicine on your own, and always declare any new medicines or supplements during your consultation.

Other Blood Pressure Medicines and Vardenafil Interactions

Irbesartan is just one of many blood pressure medicines, and vardenafil can interact with others in similar ways. If you take an ACE inhibitor (such as ramipril or lisinopril), a calcium channel blocker (such as amlodipine), a beta-blocker (such as bisoprolol), or a diuretic (such as bendroflumethiazide), the same principle applies: vardenafil can add to the blood-pressure-lowering effect, so your prescriber will check your blood pressure is stable before prescribing it [5].

Alpha-blockers, used for prostate symptoms or high blood pressure, require extra caution. Medicines such as doxazosin, tamsulosin, alfuzosin, and terazosin can cause a significant drop in blood pressure when combined with vardenafil. If you take an alpha-blocker, your prescriber will ensure you are stable on it and start you on the lowest dose of vardenafil. You should not start both medicines at the same time.

If you take more than one blood pressure medicine—for example, irbesartan plus amlodipine—your prescriber will take this into account when deciding whether vardenafil is suitable and at what dose. Always be honest about all your medicines during your consultation, as this helps your prescriber keep you safe.

Medicines That Must Never Be Taken with Vardenafil

Do not take vardenafil if you use nitrates (GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, or recreational drugs called poppers (amyl or alkyl nitrites). These combinations can cause a dangerous, life-threatening drop in blood pressure. Do not take vardenafil with another PDE5 inhibitor (such as sildenafil or tadalafil) at the same time. If you are unsure whether any of your medicines are nitrates or contain nitrates, ask your GP or pharmacist before taking vardenafil [5].

When to get urgent help

• Chest pain during or after sex—stop activity and call 999; do not take nitrates if you have used vardenafil in the past 24 hours
• Erection lasting more than 4 hours (priapism)—go to A&E immediately
• Sudden loss of vision or hearing—seek urgent medical help
• Severe dizziness, fainting, or collapse—call 999 or go to A&E
• 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.