Vardenafil and Mefenamic Acid: Safe to Take Together?

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Key takeaways

• No major direct interaction is reported between vardenafil and mefenamic acid in clinical practice.
• Both medicines can affect blood pressure and circulation, so your prescriber will review your full health profile.
• Always declare all medicines, including occasional painkillers, during your online consultation.
• Take mefenamic acid with food, stay hydrated, and avoid excessive alcohol when using either medicine.
• Seek urgent help if you experience chest pain, prolonged erection, sudden vision loss, or signs of stomach bleeding.

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) [3][5]. Vardenafil works by relaxing the blood vessels in the penis, allowing more blood to flow into the area 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 medicine does not work automatically—you need sexual stimulation for it to be effective. The effect can last for several hours, but you should not take vardenafil more than once in a 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 mefenamic acid and what is it used for?

Mefenamic acid is a non-steroidal anti-inflammatory drug (NSAID) commonly prescribed to relieve pain and inflammation. It is often used to treat period pain (dysmenorrhoea), heavy menstrual bleeding, and other types of mild to moderate pain such as headaches, dental pain, and musculoskeletal pain. Mefenamic acid works by blocking the production of certain natural chemicals (prostaglandins) in the body that cause pain, inflammation, and fever.

This medicine is usually taken with or after food to reduce the risk of stomach upset. Like other NSAIDs, mefenamic acid can cause side effects including indigestion, stomach pain, nausea, and in some cases more serious effects such as stomach ulcers or bleeding, particularly with long-term use or in people with certain risk factors. Your doctor or pharmacist will assess whether mefenamic acid is suitable for you based on your medical history, including any history of stomach problems, heart disease, kidney problems, or high blood pressure.

How NSAIDs like mefenamic acid affect the body

NSAIDs can have effects beyond pain relief. They may increase blood pressure slightly in some people and can affect kidney function, particularly in those who are dehydrated or have existing kidney problems. Some NSAIDs have also been associated with a small increased risk of cardiovascular events such as heart attack or stroke, especially when used at high doses or for prolonged periods. These effects are important to consider when taking any additional medicine, including treatments for erectile dysfunction.

At a glance

Do vardenafil and mefenamic acid interact with each other?

There is no well-documented direct pharmacological interaction between vardenafil and mefenamic acid. This means that mefenamic acid does not significantly alter the way vardenafil is broken down in the body, nor does vardenafil interfere with how mefenamic acid works. In clinical practice, men taking mefenamic acid occasionally for pain relief are not generally advised to avoid vardenafil solely because of this combination.

However, both medicines can have effects on blood pressure and circulation. Vardenafil can cause a mild drop in blood pressure, which is usually not a problem for most men but can cause dizziness or light-headedness in some cases [5]. NSAIDs like mefenamic acid can, in some people, raise blood pressure slightly or interfere with blood pressure control, and they may also affect kidney function, which in turn can influence how medicines are processed and eliminated from the body.

For these reasons, your prescriber or pharmacist will always review your complete medication list—including any painkillers you take regularly or occasionally—during your consultation. They will check whether the combination is safe for you based on your individual health profile, including your blood pressure, kidney function, heart health, and any other conditions or medicines. If you are taking mefenamic acid regularly or have any concerns, mention this during your consultation so that the prescriber can make an informed decision.

What does your prescriber check before prescribing vardenafil?

Before prescribing vardenafil, a UK prescriber will carry out a thorough assessment to ensure the medicine is safe and suitable for you. They will ask about your medical history, including any heart or blood vessel problems, high or low blood pressure, liver or kidney disease, blood disorders, stomach ulcers, and any history of stroke or heart attack [5]. They will also ask about any eye problems, particularly a condition called non-arteritic anterior ischaemic optic neuropathy (NAION), which is a rare cause of sudden vision loss.

Crucially, the prescriber will review all your current medicines, including prescription drugs, over-the-counter medicines, and herbal supplements. Vardenafil must never be taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites), because the combination can cause a dangerous drop in blood pressure [5]. Vardenafil can also interact with certain other medicines, including some used to treat HIV, fungal infections, and bacterial infections, as well as alpha-blockers used for prostate problems or high blood pressure.

If you are taking mefenamic acid or any other NSAID, the prescriber will consider this as part of their overall assessment. They will check whether you have any conditions that might make the combination less suitable, such as poorly controlled high blood pressure, significant kidney impairment, or a history of cardiovascular disease. The prescriber may also advise starting on a lower dose of vardenafil or monitoring your response more closely.

Declaring all your medicines during the consultation

It is essential to list every medicine you take during your online consultation, even if you only use it occasionally. This includes painkillers like mefenamic acid, ibuprofen, or aspirin; medicines for high blood pressure, diabetes, or cholesterol; and any herbal remedies or supplements. The prescriber uses this information to check for interactions and to ensure vardenafil is safe for you. Never stop or change a prescribed medicine without speaking to your doctor or pharmacist first.

Practical advice for taking vardenafil and mefenamic acid together

If your prescriber has approved vardenafil for you and you occasionally take mefenamic acid for pain relief, there are some practical steps you can take to use both medicines safely. First, always take each medicine exactly as prescribed or as directed on the label. Do not exceed the recommended dose of either medicine. Take mefenamic acid with or after food to reduce the risk of stomach upset, and swallow vardenafil tablets whole with water about 25 to 60 minutes before sexual activity [5].

Stay well hydrated, especially if you are taking mefenamic acid regularly, as NSAIDs can affect kidney function and dehydration increases this risk. Avoid drinking large amounts of alcohol, as alcohol can worsen erectile dysfunction, increase the risk of side effects from both medicines (such as dizziness or low blood pressure), and irritate the stomach lining when combined with NSAIDs.

Be aware of how you feel after taking the medicines. If you experience unusual dizziness, light-headedness, fainting, or any new symptoms, stop taking the medicines and seek medical advice. If you develop stomach pain, black or tarry stools, or vomit blood or material that looks like coffee grounds (signs of stomach bleeding), seek urgent medical help. Similarly, if you experience chest pain during sexual activity, an erection lasting more than four hours, or sudden loss of vision or hearing, call 999 or go to A&E immediately [5].

When to speak to your doctor or pharmacist about vardenafil and mefenamic acid

You should speak to your doctor or pharmacist before starting vardenafil if you are taking mefenamic acid regularly, especially if you have any other health conditions such as high blood pressure, heart disease, kidney problems, or a history of stomach ulcers. Your doctor may want to check your blood pressure and kidney function before prescribing vardenafil, and they may recommend a lower starting dose or closer monitoring.

If you are already taking vardenafil and your doctor prescribes mefenamic acid (or you buy it over the counter for occasional use), let the pharmacist know you are taking an ED medicine. The pharmacist can check for any concerns and advise you on safe use. Similarly, if you experience any new or worsening symptoms after starting either medicine—such as persistent headaches, dizziness, swelling of the ankles, shortness of breath, or stomach pain—contact your GP or pharmacist for advice.

Remember that erectile dysfunction can sometimes be an early warning sign of underlying health problems such as heart disease, diabetes, or high blood pressure [1][2]. If you are experiencing ED for the first time, it is important to see your GP for a full assessment. They can check for any underlying causes and discuss the most appropriate treatment options for you. At Cured Pharmacy, our online consultations are reviewed by UK-registered prescribers, but we always encourage you to maintain regular contact with your GP, especially if you have ongoing health concerns or take multiple medicines.

Reporting side effects

If you experience side effects from vardenafil, mefenamic acid, or any other medicine, you can report them via the Yellow Card Scheme at 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 medicines.

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 sexual activity – call 999
• Black or tarry stools, vomiting blood, or severe stomach pain – seek urgent help (possible stomach bleeding)
• Severe dizziness, fainting, or signs of allergic reaction (swelling, difficulty breathing) – call 999

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

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