Vardenafil and Mesalazine: Can You Take Them Together?

Vardenafil and Mesalazine: Understanding the Interaction

Published: 1 November 2026

Many men wonder whether vardenafil and mesalazine can be taken together safely. The good news is that no major interaction is commonly reported between vardenafil (Levitra) and mesalazine (Asacol, Pentasa, Salofalk), which is used to treat inflammatory bowel disease (IBD) such as ulcerative colitis and Crohn's disease. However, your prescriber will still review all your current medicines during your consultation to ensure vardenafil is suitable for you overall.

What Is Vardenafil and How Does It Work?

Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in 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 in when you are sexually aroused [5].

Vardenafil is available in 5 mg, 10 mg, and 20 mg tablets. It is usually taken about 25 to 60 minutes before sexual activity, and the effect can last for several hours [5]. You should not take vardenafil more than once a day. It is important to remember that vardenafil will only work when you are sexually stimulated—it does not cause an automatic erection.

Like all PDE5 inhibitors, vardenafil can interact with certain medicines, particularly those that affect blood pressure or are broken down by the same liver enzymes. Your prescriber will check your full medication list during your consultation to ensure vardenafil is safe for you.

What Is Mesalazine and Why Is It Prescribed?

Mesalazine (also called mesalamine or 5-aminosalicylic acid) is a medicine used to treat and prevent flare-ups of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease. It works by reducing inflammation in the lining of the gut. Mesalazine is available under several brand names in the UK, including Asacol, Pentasa, Salofalk, Octasa, and Mezavant.

Mesalazine is usually taken as tablets, capsules, granules, or suppositories, depending on which part of the bowel is affected. It is often used as a long-term treatment to keep IBD under control and reduce the risk of relapse. The dose and formulation are tailored to each person's condition.

Because mesalazine acts mainly in the gut and is not known to significantly affect blood pressure or the liver enzymes that break down vardenafil, it does not usually interfere with ED treatments. However, it is still important to tell your prescriber about all your medicines, including those for IBD, so they can assess your overall health and suitability for vardenafil.

Living with IBD and ED

Men with inflammatory bowel disease may experience erectile dysfunction for several reasons, including the physical and emotional impact of a chronic condition, fatigue, or concerns about symptoms during intimacy. Some studies suggest that chronic inflammation and certain IBD medications may also play a role, though mesalazine itself is not commonly linked to ED. If you are experiencing ED and have IBD, it is worth discussing with your GP or specialist, as effective treatments are available and can significantly improve quality of life.

Vardenafil and Mesalazine: Is There an Interaction?

No major interaction is commonly reported between vardenafil and mesalazine. Mesalazine works locally in the gut to reduce inflammation and does not significantly affect the cardiovascular system or the liver enzymes (CYP3A4) that metabolise vardenafil [5]. This means that taking mesalazine is not expected to increase or decrease the levels of vardenafil in your body, nor does vardenafil interfere with how mesalazine works.

However, your prescriber will still review your complete medication list during your online consultation. This is because other medicines you may be taking—for example, for blood pressure, heart conditions, or infections—can interact with vardenafil. It is also important to check that you do not have any health conditions that make vardenafil unsuitable, such as recent heart attack or stroke, severe heart failure, very low blood pressure, or use of nitrate medicines [5].

Always be honest and thorough when listing your current medicines and health conditions. Even if mesalazine itself does not interact with vardenafil, other factors in your medical history may need to be considered to ensure safe and effective treatment for erectile dysfunction.

What Your Prescriber Checks Before Approving Vardenafil

When you request vardenafil through Cured Pharmacy, a UK-registered prescriber will review your online consultation to ensure the medicine is safe and suitable for you. They will check your current medicines, including mesalazine and any other treatments for IBD or other conditions. They will also ask about your cardiovascular health, blood pressure, and any history of heart disease, stroke, or liver or kidney problems [5].

Certain medicines must never be taken with vardenafil because they can cause a dangerous drop in blood pressure. These include nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, and recreational drugs called 'poppers' (amyl or alkyl nitrites) [5]. If you are taking any of these, you cannot use vardenafil or any other PDE5 inhibitor.

If you take alpha-blockers (such as tamsulosin or doxazosin) for an enlarged prostate or high blood pressure, your prescriber will check that you are stable on that medicine and may start you on a lower dose of vardenafil to reduce the risk of dizziness or fainting [5]. Potent CYP3A4 inhibitors (such as ritonavir, ketoconazole, or clarithromycin) can raise vardenafil levels and may mean vardenafil is not suitable or requires dose adjustment [5].

Declaring All Your Medicines

It is essential to list every medicine you take during your consultation, including prescription medicines, over-the-counter treatments, herbal remedies, and supplements. Even if you think a medicine is unrelated to ED, it may still affect how vardenafil works or whether it is safe for you. For example, St John's wort (a herbal remedy for low mood) can reduce the effectiveness of vardenafil, and some antibiotics or antifungals can increase its levels in your blood [5]. Your prescriber is there to help, so be open and thorough.

Practical Advice for Taking Vardenafil and Mesalazine Together

If your prescriber approves vardenafil and you are already taking mesalazine, you can take both medicines as prescribed. There is no need to separate the doses or avoid taking them on the same day. Continue taking your mesalazine exactly as your doctor has instructed to keep your IBD under control, and take vardenafil about 25 to 60 minutes before you plan to have sex [5].

Vardenafil works best on an empty stomach or after a light meal. A heavy or high-fat meal can delay how quickly it works. Avoid drinking large amounts of alcohol when using vardenafil, as alcohol can make it harder to get an erection and may increase the risk of side effects such as dizziness, headache, or flushing [5]. Grapefruit juice can also raise vardenafil levels in your blood, so it is best to avoid it.

If you experience any side effects from vardenafil—such as headache, flushing, indigestion, nasal congestion, or dizziness—these are usually mild and short-lived. However, if you develop chest pain during sex, an erection lasting more than four hours, or sudden loss of vision or hearing, stop taking vardenafil and seek urgent medical help [5]. Always read the patient information leaflet that comes with your medicine.

Other ED Treatments Available at Cured Pharmacy

If vardenafil is not suitable for you, or if you would like to try a different PDE5 inhibitor, Cured Pharmacy offers a range of licensed ED treatments. Sildenafil (generic Viagra) is available from £0.45 per tablet and is taken about one hour before sex [3]. Tadalafil (generic Cialis) is available from £7.95 and can be taken on-demand (effect lasts up to 36 hours) or as a daily low dose [4]. Avanafil (Spedra) works in as little as 15 to 30 minutes and is available from £20.95 [6].

All PDE5 inhibitors work in a similar way and have similar interactions and precautions. If mesalazine does not interact with vardenafil, it is also unlikely to interact with sildenafil, tadalafil, or avanafil. However, you should still complete a full consultation for any ED medicine, as your prescriber will assess your overall health, current medicines, and any conditions that might affect suitability.

If oral ED medicines are not suitable or effective for you, other options include Eroxon gel (a topical medical device available without prescription), Vitaros cream (alprostadil, prescription-only), or Caverject injections (alprostadil, prescription-only) [7]. Your GP or a specialist can discuss these alternatives with you. Remember, ED can be an early warning sign of heart disease or diabetes, so it is always worth seeing your GP if you develop new or worsening erection problems [1][2].

Choosing the Right ED Treatment for You

The best ED treatment depends on your individual circumstances, including how quickly you want the medicine to work, how long you want the effect to last, other medicines you take, and any health conditions you have. During your consultation, you can discuss your preferences with the prescriber. Many men find that trying more than one PDE5 inhibitor helps them discover which works best for them. All treatments available at Cured Pharmacy are supplied following a consultation reviewed by a UK-registered prescriber, ensuring safety and suitability.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 1 November 2026]
2. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 1 November 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 1 November 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 1 November 2026]
5. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 1 November 2026]
6. Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 1 November 2026]
7. Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 1 November 2026]

Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.

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