Vardenafil and Methyldopa: Can They Be Taken Together?
Learn how these medicines interact and what your UK pharmacist-led consultation will check for your safety.
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Vardenafil and Methyldopa: Understanding the Interaction
Published: 1 November 2026
If you're considering vardenafil and methyldopa together, you'll want to know whether it's safe and what precautions to take. Vardenafil is a prescription treatment for erectile dysfunction (ED), while methyldopa is used to manage high blood pressure. Both medicines can lower blood pressure, so when taken together there is a potential for an additive effect that may cause dizziness or light-headedness. This page explains how the interaction works, what your prescriber will check during your consultation, and practical steps to use these medicines safely.
At a glance
What Is Vardenafil and How Does It Work?
Vardenafil is a prescription medicine used to treat erectile dysfunction in men. It belongs to a group of medicines called PDE5 inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused [5]. Vardenafil is the generic version of Levitra and is available in 5 mg, 10 mg, and 20 mg tablets.
You typically take vardenafil about 25 to 60 minutes before sexual activity, and it can remain effective for several hours [5]. It does not cause an erection on its own—sexual stimulation is still needed. Like all PDE5 inhibitors, vardenafil can also lower blood pressure slightly because it relaxes blood vessels throughout the body, not just in the penis.
Common side effects include headache, flushing, nasal congestion, and indigestion. Vardenafil must not be taken with nitrates, nicorandil, riociguat, or poppers, as this combination can cause a dangerous drop in blood pressure [5]. It is only available on prescription after a clinical assessment by a UK-registered prescriber.
What Is Methyldopa and Why Is It Prescribed?
Methyldopa is a prescription medicine used to treat high blood pressure (hypertension). It works by acting on the central nervous system to reduce the signals that tighten blood vessels, which helps to lower blood pressure. Methyldopa is sometimes used during pregnancy because it has a well-established safety profile in this setting.
By lowering blood pressure, methyldopa reduces the strain on your heart and blood vessels, helping to prevent strokes, heart attacks, and kidney problems. However, like many blood-pressure medicines, methyldopa can occasionally cause side effects such as drowsiness, dizziness (especially when standing up), dry mouth, and fatigue.
Interestingly, methyldopa itself can sometimes contribute to erectile dysfunction. High blood pressure and the medicines used to treat it are both recognised risk factors for ED [1][2]. If you have noticed changes in your erections since starting methyldopa, it is worth discussing this with your GP, as there may be alternative blood-pressure treatments that are less likely to affect sexual function.
Can Methyldopa Cause Erectile Dysfunction?
Yes, methyldopa is one of the blood-pressure medicines that has been associated with erectile dysfunction. It can interfere with the nerve signals and blood flow needed for an erection. If you suspect your blood-pressure medication is affecting your sexual function, do not stop taking it without medical advice—uncontrolled high blood pressure is a serious health risk. Instead, speak to your GP, who may be able to adjust your dose or switch you to a different medicine.
How Do Vardenafil and Methyldopa Interact?
When vardenafil and methyldopa are taken together, the main concern is an additive blood-pressure-lowering effect. Methyldopa lowers blood pressure as its primary action, and vardenafil also causes a mild reduction in blood pressure by relaxing blood vessels. When combined, these effects can add up, potentially leading to symptoms such as dizziness, light-headedness, or even fainting, particularly when you stand up quickly.
This interaction is not an absolute contraindication—many men take vardenafil safely alongside blood-pressure medicines, including methyldopa. However, it does require careful assessment by a prescriber. Your doctor or pharmacist will review your current blood pressure control, your dose of methyldopa, any other medicines you take, and your overall cardiovascular health before deciding whether vardenafil is suitable for you [2][5].
The risk is generally higher if your blood pressure is not well controlled, if you are taking multiple blood-pressure medicines, or if you are prone to postural hypotension (a sudden drop in blood pressure when standing). Your prescriber may recommend starting vardenafil at a lower dose and monitoring how you respond. It is important to be honest during your consultation about all your current medicines and any symptoms you experience.
What you need to know
- Vardenafil and methyldopa can often be taken together, but both lower blood pressure so a prescriber must assess your suitability.
- Your prescriber will check your blood pressure control and may start vardenafil at a lower dose to reduce the risk of dizziness.
- Watch for dizziness or light-headedness, especially when standing up, and avoid heavy alcohol.
- Methyldopa itself can sometimes contribute to erectile dysfunction; discuss alternatives with your GP if this is a concern.
- Never take vardenafil with nitrates, nicorandil, riociguat, or poppers—this combination is dangerous.
What Will Your Prescriber Check Before Approving Vardenafil and Methyldopa?
Before prescribing vardenafil to someone taking methyldopa, a UK prescriber will carry out a thorough clinical assessment. This includes reviewing your full medication list to check for any medicines that must not be combined with vardenafil, such as nitrates, nicorandil, or riociguat [5]. They will also ask about your blood pressure readings, whether your hypertension is well controlled, and whether you experience dizziness or fainting.
Your prescriber will assess your cardiovascular health more broadly. Erectile dysfunction can be an early warning sign of heart disease or diabetes, so new ED should always be discussed with a GP [1][2]. If you have a history of heart attack, stroke, unstable angina, severe heart failure, or very low blood pressure, PDE5 inhibitors such as vardenafil may not be suitable.
If vardenafil is deemed appropriate, your prescriber may suggest starting with the lowest effective dose (usually 5 mg or 10 mg) and advising you to monitor for any symptoms of low blood pressure, such as dizziness, weakness, or fainting. You should report any concerning symptoms promptly so that your treatment can be reviewed.
What Information Should You Provide?
Be ready to share your current dose of methyldopa, any other blood-pressure or heart medicines you take, recent blood pressure readings if you have them, and any symptoms such as dizziness or erectile difficulties. Mention any other health conditions, particularly heart or kidney problems, and any allergies or previous reactions to medicines. This information helps your prescriber make a safe, individualised decision.
Practical Advice for Taking Vardenafil and Methyldopa Together
If your prescriber approves vardenafil while you are taking methyldopa, there are several practical steps you can take to minimise the risk of side effects. First, take vardenafil exactly as prescribed—do not take more than one dose in 24 hours, and do not exceed the recommended dose [5]. Taking vardenafil on an empty stomach or after a light meal may help it work more effectively.
Be cautious when standing up, especially in the first few hours after taking vardenafil, as this is when blood-pressure-lowering effects are most likely. Sit on the edge of the bed for a moment before standing, and rise slowly from a seated position. Avoid drinking large amounts of alcohol, as this can worsen both erectile dysfunction and low blood pressure. Grapefruit juice can increase vardenafil levels in your blood, so it is best avoided.
Monitor how you feel and keep a note of any dizziness, light-headedness, or other unusual symptoms. If you experience chest pain during sexual activity, stop immediately and seek urgent medical help. If you have an erection lasting more than four hours, or sudden loss of vision or hearing, call 999 or go to A&E straight away [5]. Do not stop taking methyldopa or adjust your dose without speaking to your doctor first, as this could cause your blood pressure to rise dangerously.
When to get urgent help
- Erection lasting more than 4 hours (priapism)—call 999 or go to A&E immediately
- Sudden loss of vision or hearing—seek urgent medical help
- Chest pain during or after sexual activity—stop and call 999
- Severe dizziness, fainting, or signs of very low blood pressure—seek same-day medical advice
- 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.
Alternatives to Vardenafil and When to Seek Further Advice
If vardenafil is not suitable for you, or if you experience troublesome side effects, there are other treatment options for erectile dysfunction. Other PDE5 inhibitors include sildenafil (Viagra), tadalafil (Cialis), and avanafil (Spedra) [3][4][6]. Each has a slightly different profile in terms of how quickly it works and how long it lasts, and your prescriber can help you choose the most appropriate one. The same caution about blood-pressure-lowering effects applies to all PDE5 inhibitors.
If oral tablets are not suitable or effective, other prescription options include alprostadil, which is available as a cream (Vitaros) applied to the tip of the penis or as an injection (Caverject) [7]. There are also non-prescription options such as Eroxon gel, a medical device that works by stimulating blood flow locally. Vacuum erection devices and penile implants are further alternatives that may be discussed with a specialist.
It is also worth revisiting your blood-pressure treatment with your GP. If methyldopa is contributing to your erectile difficulties, switching to a different class of blood-pressure medicine may improve both your blood pressure control and your sexual function. Lifestyle measures—such as losing weight if needed, exercising regularly, stopping smoking, and reducing alcohol—can improve both high blood pressure and erectile dysfunction [1][2]. Always consult a healthcare professional before making any changes to your prescribed treatment.
When Should You See Your GP?
See your GP if you have new or worsening erectile dysfunction, as it can be an early sign of cardiovascular disease or diabetes [1]. Also seek advice if you experience persistent dizziness, fainting, chest pain, or any other symptoms that concern you while taking vardenafil and methyldopa together. Your GP can review your medicines, check your blood pressure, and refer you to a specialist if needed.
Start Low, Go Slow
If your prescriber approves vardenafil while you're taking methyldopa, they will likely start you on the lowest effective dose and advise you to monitor for dizziness. Stand up slowly, especially in the first few hours after taking the tablet, and report any concerning symptoms promptly.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 1 November 2026]
- 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]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 1 November 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 1 November 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 1 November 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 1 November 2026]
- 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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Your Questions Answered
Can I take vardenafil if I'm on methyldopa for high blood pressure?
Many men take vardenafil safely with methyldopa, but it requires a prescriber's assessment. Both medicines can lower blood pressure, so your prescriber will check that your blood pressure is well controlled and may start you on a lower dose of vardenafil.
Will vardenafil and methyldopa together cause my blood pressure to drop too low?
There is a risk of an additive blood-pressure-lowering effect, which can cause dizziness or light-headedness. Your prescriber will assess this risk individually and advise you on the safest dose and what symptoms to watch for.
What should I do if I feel dizzy after taking vardenafil with methyldopa?
Sit or lie down until the dizziness passes, and avoid standing up quickly. If dizziness is severe, persistent, or accompanied by fainting or chest pain, seek medical advice promptly.
Can methyldopa itself cause erectile dysfunction?
Yes, methyldopa is one of the blood-pressure medicines that can contribute to erectile dysfunction. If you think your medication is affecting your erections, discuss this with your GP—do not stop taking it without medical advice.
Are there any blood-pressure medicines I absolutely cannot take with vardenafil?
Vardenafil must never be taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or poppers, as this can cause a dangerous drop in blood pressure. Other blood-pressure medicines require careful assessment but are not absolute contraindications.
How long after taking vardenafil should I watch out for low blood pressure symptoms?
Blood-pressure-lowering effects are most likely in the first few hours after taking vardenafil. Be particularly cautious when standing up during this time, and avoid heavy alcohol.
Can I drink alcohol while taking vardenafil and methyldopa?
Small amounts of alcohol are usually fine, but heavy drinking can worsen erectile dysfunction and add to the blood-pressure-lowering effects of both medicines, increasing the risk of dizziness or fainting.
What should I tell my prescriber during my online consultation?
List all your current medicines (including methyldopa and its dose), any other health conditions (especially heart or kidney problems), recent blood pressure readings if you have them, and any symptoms such as dizziness or erectile difficulties.
Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)