Vardenafil and Mebeverine: Can You Take Them Together?

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At a glance

What is vardenafil and how does it work?

Vardenafil is a prescription medicine licensed in the UK for the treatment of erectile dysfunction (ED) in adult men [5]. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors, which also includes sildenafil (Viagra), tadalafil (Cialis), and avanafil (Spedra). These medicines work by relaxing the blood vessels in the penis, allowing more blood to flow into the area when you are sexually aroused [1].

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—it does not cause an automatic erection. The effects can last for several hours, but you should not take more than one dose in any 24-hour period. Like all PDE5 inhibitors, vardenafil requires a prescription and is only supplied after a consultation with a UK-registered prescriber who will check your medical history and current medicines.

What is mebeverine and what is it used for?

Mebeverine is an antispasmodic medicine commonly used to relieve symptoms of irritable bowel syndrome (IBS) and similar bowel conditions. It works by relaxing the muscles in the wall of the intestine, which helps to ease painful stomach cramps, bloating, wind, and the urgent need to go to the toilet. Mebeverine is available over the counter in pharmacies (as Colofac IBS Relief) and on prescription in various strengths, typically 135mg tablets taken three times a day.

Unlike some other medicines for stomach problems, mebeverine does not usually cause significant drowsiness or affect your ability to drive. It acts locally on the gut muscles and is not known to have major effects on blood pressure or the cardiovascular system. This is important when considering how it might interact with other medicines, including those used for erectile dysfunction. Mebeverine is generally well tolerated, and serious side effects are uncommon.

Do vardenafil and mebeverine interact with each other?

No major interaction between vardenafil and mebeverine is commonly reported in clinical practice or in the British National Formulary [5]. The two medicines work in different parts of the body and by different mechanisms: vardenafil affects blood flow to the penis by inhibiting an enzyme called PDE5, while mebeverine relaxes smooth muscle in the gut wall without significant systemic effects. Because mebeverine does not substantially affect blood pressure, liver enzymes, or the pathways that break down vardenafil, the combination is not expected to cause problems for most men.

However, it is essential to understand that every person's medical situation is unique. During your online consultation at Cured Pharmacy, the prescriber will review all your current medicines, including over-the-counter treatments like mebeverine, to ensure that vardenafil is safe and appropriate for you. You should always declare every medicine you take—whether prescribed, bought from a pharmacy, or obtained elsewhere—so that the prescriber can make a fully informed decision about your treatment.

Why your prescriber still needs to know about mebeverine

Even though no major interaction is expected, your prescriber needs a complete picture of your health and all the medicines you take. This is because some people take mebeverine as part of a broader treatment plan that may include other medicines, and those other medicines might interact with vardenafil. For example, if you also take medicines for high blood pressure, heart conditions, or antifungal treatments, these could affect how vardenafil works or increase the risk of side effects. By declaring mebeverine and any other treatments, you help the prescriber ensure your safety and choose the most suitable dose of vardenafil for you.

What you need to know

• No major interaction between vardenafil and mebeverine is commonly reported in clinical practice
• Your prescriber reviews all your medicines during consultation to ensure vardenafil is safe for you
• Vardenafil must never be taken with nitrates, nicorandil, riociguat, or poppers due to dangerous blood pressure drop
• Declare all medicines including over-the-counter treatments so your prescriber can make a fully informed decision
• Seek urgent help for erections lasting over four hours or sudden vision or hearing loss

What does your prescriber check before prescribing vardenafil?

Before prescribing vardenafil, your prescriber will ask about your general health, any medical conditions you have, and all the medicines you currently take [2]. This includes prescription medicines, over-the-counter treatments, herbal remedies, and recreational substances. The prescriber is particularly interested in medicines that can interact dangerously with vardenafil, such as nitrates (GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, and amyl or alkyl nitrites (poppers). These combinations can cause a severe and dangerous drop in blood pressure and must never be taken together [5].

The prescriber will also check whether you take alpha-blockers for prostate symptoms or high blood pressure (such as doxazosin, tamsulosin, or alfuzosin), as these can add to the blood-pressure-lowering effect of vardenafil and cause dizziness. If you are on an alpha-blocker, you should be stable on that treatment, and the prescriber will usually start you on the lowest dose of vardenafil [5]. Medicines that affect liver enzymes—such as ritonavir, cobicistat, ketoconazole, itraconazole, or clarithromycin—can raise vardenafil levels in the blood, and vardenafil is often contraindicated or requires dose adjustment with these medicines [5]. Your prescriber will also ask about your heart health, blood pressure, and any history of stroke, as vardenafil is not suitable when sexual activity itself is inadvisable.

Medicines that can reduce vardenafil's effectiveness

Some medicines can make vardenafil less effective by speeding up how quickly your body breaks it down. These include enzyme-inducing medicines such as rifampicin (an antibiotic), carbamazepine and phenytoin (used for epilepsy), and the herbal remedy St John's wort. If you take any of these, the prescriber may discuss alternative ED treatments or adjust your dose. Always mention herbal supplements during your consultation, as they can interact with prescription medicines even though they are sold without a prescription.

Practical advice for taking vardenafil and mebeverine together

If your prescriber confirms that vardenafil is suitable for you and you also take mebeverine, you can usually take both medicines as directed without special timing restrictions. Mebeverine is typically taken three times a day, about 20 minutes before meals, while vardenafil is taken on demand, roughly 25 to 60 minutes before you plan to have sex [5]. There is no need to separate the doses by a specific number of hours, as the two medicines do not interfere with each other's absorption or action.

However, you should still follow the dosing instructions for each medicine carefully. Do not take more than one dose of vardenafil in any 24-hour period, and do not exceed the recommended dose of mebeverine. If you experience any unexpected side effects—such as dizziness, headache, flushing, indigestion, or changes in vision—contact your GP or pharmacist for advice. Remember that vardenafil only works when you are sexually aroused, so it will not cause an erection on its own. Avoid drinking large amounts of alcohol when taking vardenafil, as this can make erectile dysfunction worse and increase the risk of side effects such as dizziness and low blood pressure.

When to get urgent help

• Erection lasting longer than four hours (priapism)—go to A&E immediately to prevent permanent damage
• Sudden loss of vision in one or both eyes—stop vardenafil and seek urgent medical help
• Sudden decrease or loss of hearing, sometimes with ringing in the ears or dizziness
• Chest pain during or after sex—call 999 and tell the medical team you have taken vardenafil; do not use nitrate medicines
• Severe allergic reaction with difficulty breathing or swelling of face, lips, tongue, or throat

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

When to seek urgent medical help

While vardenafil is generally well tolerated, there are some rare but serious side effects that require urgent medical attention. If you develop an erection that lasts longer than four hours (a condition called priapism), you must go to A&E immediately, as this can cause permanent damage to the penis if not treated promptly [5]. Sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing (sometimes with ringing in the ears or dizziness), are also medical emergencies and you should stop taking vardenafil and seek help straight away [5].

If you experience chest pain during or after sex, do not use nitrate medicines (such as GTN spray) to relieve it, as the combination with vardenafil can be dangerous. Instead, call 999 or go to A&E and tell the medical team that you have taken vardenafil [1]. Severe allergic reactions (difficulty breathing, swelling of the face, lips, tongue, or throat) are rare but require immediate emergency treatment. If you have any concerns about side effects or interactions, contact your GP, pharmacist, or NHS 111 for advice.

Reporting side effects and staying safe

If you experience any side effects while taking vardenafil, whether or not they are listed in the patient information leaflet, you can report them via the Yellow Card Scheme at https://yellowcard.mhra.gov.uk/ or by searching for 'Yellow Card' in the Google Play or Apple App Store. Reporting side effects helps improve the safety information available for all patients. Never stop taking a medicine prescribed by your doctor without discussing it with them first, and do not change the dose of vardenafil or mebeverine on your own. If you have questions about your treatment, the pharmacist team at Cured Pharmacy is here to help.