Vardenafil and Lansoprazole: Can They Be Taken Together?

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What Is Vardenafil and How Does It Work?

Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in adult men [5]. 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 into the area when you are sexually aroused [5]. This increased blood flow 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 medicine only works when you are sexually stimulated, so it will not cause an erection on its own. The effect can last for several hours, but you should not take more than one dose in a 24-hour period. Vardenafil is broken down in the body mainly by liver enzymes, particularly one called CYP3A4, which is important when considering interactions with other medicines [5].

What Is Lansoprazole and Why Is It Prescribed?

Lansoprazole is a proton pump inhibitor (PPI) commonly prescribed to reduce stomach acid production. It is used to treat conditions such as gastro-oesophageal reflux disease (GORD), stomach ulcers, duodenal ulcers, and Helicobacter pylori infection. Lansoprazole works by blocking the enzyme in the stomach wall that produces acid, providing relief from heartburn, acid reflux, and allowing ulcers to heal.

Lansoprazole is usually taken once daily, often in the morning before food, and is available in 15mg and 30mg capsules. It is one of the most widely prescribed medicines in the UK for acid-related conditions. Many people take lansoprazole long-term to manage chronic reflux or to protect the stomach lining when taking other medicines such as non-steroidal anti-inflammatory drugs (NSAIDs). Because it is so commonly prescribed, questions about interactions with other medicines, including erectile dysfunction treatments, are frequently asked.

How Lansoprazole Is Processed in the Body

Lansoprazole is broken down in the liver by several enzymes, including CYP3A4 and CYP2C19. While lansoprazole does interact with the CYP enzyme system, it is not considered a potent inhibitor of CYP3A4 at the doses normally used for acid reflux and ulcer treatment. This means it is unlikely to significantly increase the levels of vardenafil in your bloodstream, which is why no major interaction is commonly reported between vardenafil and lansoprazole.

When to get urgent help

• An erection lasting more than 4 hours (priapism) – go to A&E immediately
• Sudden loss of vision or hearing – stop vardenafil and seek urgent medical help
• Chest pain during or after sex – call 999 and do not take more vardenafil
• Severe dizziness, fainting, or difficulty breathing – seek urgent medical attention
• Allergic reaction (swelling of face, lips, tongue, or throat) – call 999

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

The Interaction Between Vardenafil and Lansoprazole

No major interaction is commonly reported between vardenafil and lansoprazole, and the two medicines are often prescribed together without significant problems [3][5]. Lansoprazole is not a potent inhibitor of the CYP3A4 enzyme that breaks down vardenafil, so it does not usually cause a clinically significant increase in vardenafil levels. This means that taking lansoprazole alongside vardenafil is not expected to increase the risk of side effects or require a dose adjustment in most cases.

However, it is essential to declare all medicines you are taking, including over-the-counter treatments and supplements, during your consultation. Your prescriber will review your full medication list to check for any potential interactions and to ensure that vardenafil is safe and appropriate for you. While lansoprazole itself does not pose a major concern, other medicines you may be taking could interact with vardenafil, so a thorough review is always necessary [5].

Why Your Prescriber Checks Every Medicine

Even when no major interaction is expected, your prescriber will assess your overall health, current medicines, and any underlying conditions before prescribing vardenafil. Some medicines can interact dangerously with PDE5 inhibitors, such as nitrates, nicorandil, riociguat, and potent CYP3A4 inhibitors like ritonavir or ketoconazole [3][5]. Your prescriber will also check for medicines that lower blood pressure, as combining them with vardenafil can increase the risk of dizziness or fainting. This careful review ensures that vardenafil is both safe and effective for you.

What Your Prescriber Checks Before Prescribing Vardenafil

Before prescribing vardenafil, your prescriber will ask about your medical history, current medicines, and any underlying health conditions. They will check whether you have cardiovascular disease, high or low blood pressure, liver or kidney problems, or a history of stroke or heart attack [5]. Sexual activity places extra strain on the heart, so vardenafil is not suitable if your doctor has advised you to avoid sexual activity due to heart problems.

Your prescriber will also ask about any medicines you are taking, including prescription drugs, over-the-counter treatments, and herbal supplements. Certain medicines are absolutely contraindicated with vardenafil, meaning you must not take them together. These include nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, and amyl or alkyl nitrites (poppers), as the combination can cause a dangerous drop in blood pressure [5]. You must also not take vardenafil with another PDE5 inhibitor, such as sildenafil or tadalafil.

If you are taking alpha-blockers for prostate problems or high blood pressure, such as tamsulosin or doxazosin, your prescriber will ensure you are stable on that treatment and may start you on a lower dose of vardenafil to reduce the risk of low blood pressure and dizziness [5]. Potent CYP3A4 inhibitors, including some HIV medicines and antifungal drugs, can significantly increase vardenafil levels and may mean vardenafil is not suitable for you. Your prescriber will review the Summary of Product Characteristics to make an informed decision.

At a glance

Practical Advice When Taking Vardenafil and Lansoprazole Together

If you have been prescribed both vardenafil and lansoprazole, you can usually take them together without concern, as no major interaction is commonly reported [3][5]. Take each medicine as directed by your prescriber or pharmacist. Lansoprazole is typically taken once daily in the morning before food, while vardenafil is taken on demand, about 25 to 60 minutes before sexual activity [5]. You do not need to separate the doses or avoid taking them on the same day.

Always swallow vardenafil tablets whole with water, and do not take more than one dose in 24 hours. Avoid drinking large amounts of alcohol when taking vardenafil, as alcohol can make erectile dysfunction worse and increase the risk of side effects such as dizziness, headache, and low blood pressure [5]. Grapefruit juice can also increase vardenafil levels in the blood, so it is best to avoid it while using this medicine.

If you experience any unusual symptoms after starting vardenafil, such as severe dizziness, chest pain during sex, or an erection lasting more than four hours, seek medical help immediately. Do not stop taking lansoprazole or any other prescribed medicine without speaking to your doctor or pharmacist first, as stopping suddenly can worsen your underlying condition.

When to Contact Your Prescriber or Pharmacist

Contact your prescriber or pharmacist if you start any new medicines, including over-the-counter treatments or herbal supplements, while taking vardenafil. Some medicines can interact even if they were not a concern when you first started treatment. If you develop new symptoms, such as chest pain, shortness of breath, or unexplained dizziness, seek medical advice promptly. Your pharmacist can also answer questions about timing, side effects, and how to get the best results from your treatment.

Other Medicines and Vardenafil: What Else to Watch For

While lansoprazole does not pose a major concern, other medicines can interact with vardenafil and must be carefully reviewed [5]. Never take vardenafil with nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or amyl/alkyl nitrites (poppers), as the combination can cause a dangerous drop in blood pressure [5]. Do not take vardenafil alongside another PDE5 inhibitor, such as sildenafil or tadalafil.

Potent CYP3A4 inhibitors, including ritonavir, cobicistat, ketoconazole, itraconazole, and clarithromycin, can significantly increase vardenafil levels and may mean vardenafil is contraindicated or requires careful dose adjustment [5]. CYP3A4 inducers, such as rifampicin, carbamazepine, phenytoin, and St John's wort, can reduce vardenafil levels and make it less effective. Alpha-blockers used for prostate problems or high blood pressure can increase the risk of dizziness and low blood pressure when combined with vardenafil, so your prescriber will ensure you are stable on the alpha-blocker and may start you on a lower dose of vardenafil [5].

Other blood-pressure-lowering medicines can add to the blood-pressure-lowering effect of vardenafil, increasing the risk of dizziness or fainting. This does not mean you cannot take vardenafil, but your prescriber will assess the overall risk and may adjust doses or provide additional advice. Always declare every medicine, supplement, and herbal remedy you are taking during your consultation, even if you think it is unrelated to erectile dysfunction.

In summary

• No major interaction is commonly reported between vardenafil and lansoprazole
• Always declare all medicines during your consultation for a full safety review
• Never take vardenafil with nitrates, nicorandil, riociguat, or poppers
• Your prescriber checks your full medication list and medical history before prescribing
• Contact your pharmacist if you start any new medicines while taking vardenafil

Frequently Asked Questions