Vardenafil and Mirabegron: Can You Take Them Together?
Learn how these medicines interact and what your prescriber checks during your UK consultation.
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Vardenafil and Mirabegron: Understanding the Interaction
Published: 2 November 2026
Many men wonder whether vardenafil and mirabegron can be taken together safely. Vardenafil (generic Levitra) is a prescription medicine for erectile dysfunction, while mirabegron (Betmiga) treats overactive bladder. The good news is that no major direct interaction is commonly reported between these two medicines, but because both can affect blood pressure, your prescriber will carefully review your individual circumstances during your consultation [5][12].
Always Declare All Your Medicines
During your online consultation for vardenafil, list every medicine you take, including mirabegron, over-the-counter treatments, and herbal supplements. This ensures the prescriber can assess safety accurately and recommend the most suitable dose for you.
What Is Vardenafil and How Does It Work?
Vardenafil is a phosphodiesterase type 5 (PDE5) inhibitor licensed in the UK to treat erectile dysfunction (ED) [5]. It works by relaxing the blood vessels in the penis, allowing increased blood flow when you are sexually aroused. This helps you achieve and maintain an erection suitable for sexual activity [1].
Vardenafil is available in 5mg, 10mg, and 20mg tablets. You typically take one tablet about 25 to 60 minutes before sexual activity, and the effect can last for several hours [5]. It requires sexual stimulation to work and will not cause an erection on its own. The medicine is only available on prescription after a consultation with a UK-registered prescriber.
Common side effects include headache, flushing, nasal congestion, and indigestion [5]. Like all PDE5 inhibitors, vardenafil can lower blood pressure slightly, which is why your prescriber needs to know about all your current medicines and health conditions before prescribing it.
What Is Mirabegron and What Is It Used For?
Mirabegron (brand name Betmiga) is a prescription medicine used to treat the symptoms of overactive bladder syndrome [12]. It works by relaxing the bladder muscle, which helps reduce the urgent need to urinate, the frequency of urination, and episodes of urge incontinence.
Unlike older overactive bladder medicines (antimuscarinics such as oxybutynin or solifenacin), mirabegron is a beta-3 adrenergic receptor agonist. This means it works through a different mechanism and tends to cause fewer side effects such as dry mouth or constipation [12].
Mirabegron is usually taken once daily as a 25mg or 50mg modified-release tablet. Because it can cause a small increase in blood pressure and heart rate in some people, your doctor will monitor your blood pressure during treatment [12]. This blood-pressure effect is one reason why your prescriber will want to know if you are taking mirabegron when considering vardenafil for erectile dysfunction.
When to get urgent help
- Chest pain during or after sexual activity – call 999 and do not take nitrate sprays
- Erection lasting longer than four hours (priapism) – go to A&E immediately
- Sudden loss of vision in one or both eyes – seek urgent medical assessment
- Sudden decrease or loss of hearing, sometimes with ringing in the ears or dizziness
- Severe dizziness, fainting, or allergic reaction (rash, swelling, difficulty breathing) – call 999 or go to A&E
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
Do Vardenafil and Mirabegron Interact with Each Other?
There is no major direct pharmacological interaction between vardenafil and mirabegron that would make them unsafe to take together [5][12]. They work through different mechanisms in different parts of the body: vardenafil acts on blood vessels in the penis, while mirabegron acts on receptors in the bladder muscle.
However, both medicines can affect your cardiovascular system. Vardenafil can lower blood pressure slightly, while mirabegron may raise blood pressure or heart rate in some people [5][12]. When taken together, the overall effect on your blood pressure depends on your individual response to each medicine.
This is why your prescriber will carefully review your medical history, current blood pressure, and any other medicines you take during your consultation. If you are already stable on mirabegron and your blood pressure is well controlled, adding vardenafil is usually considered safe, but your prescriber must make that assessment based on your individual circumstances [12].
What Your Prescriber Will Check
During your online consultation for vardenafil, the prescriber will ask about all your current medicines, including mirabegron. They will want to know your current blood pressure readings, whether you have any heart conditions, and whether you experience dizziness or fainting [2][5]. If you have high blood pressure that is not well controlled, or if you take other medicines that lower blood pressure, the prescriber may recommend starting with a lower dose of vardenafil or may advise that ED treatment is not suitable at this time.
Practical Advice for Taking Vardenafil and Mirabegron Together
If your prescriber approves vardenafil while you are taking mirabegron, there are some practical steps you can take to use both medicines safely. Always take each medicine exactly as prescribed, at the dose and frequency your doctor or prescriber has recommended [5][12].
Be aware of how you feel when you stand up, especially in the first few days after starting vardenafil. Both medicines can contribute to dizziness or light-headedness, particularly if you stand up quickly from sitting or lying down. If you feel dizzy, sit or lie down until it passes, and let your prescriber know if it happens frequently.
Avoid drinking large amounts of alcohol when taking vardenafil, as alcohol can lower blood pressure further and make erectile dysfunction worse [1][5]. Grapefruit juice can increase the levels of vardenafil in your blood, so it is best to avoid it while using this medicine [5].
Keep your GP or prescriber informed if you start any new medicines, including over-the-counter treatments or herbal supplements. If your mirabegron dose changes or if you develop any new symptoms such as chest pain, severe dizziness, or palpitations, contact your doctor promptly.
At a glance
Other Medicines That Interact with Vardenafil
While vardenafil and mirabegron can usually be taken together, there are some medicines that must never be combined with vardenafil because they can cause a dangerous drop in blood pressure [5]. These include nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, and recreational drugs called 'poppers' (amyl or alkyl nitrites). Do not take vardenafil if you use any of these [5].
Alpha-blockers, used for prostate symptoms or high blood pressure (such as tamsulosin, doxazosin, or alfuzosin), can also lower blood pressure when combined with vardenafil [5]. If you take an alpha-blocker, your prescriber will usually start you on the lowest dose of vardenafil and ensure you are stable on the alpha-blocker first.
Some medicines that affect liver enzymes can increase vardenafil levels in your blood, including certain antifungals (ketoconazole, itraconazole), some antibiotics (clarithromycin), and HIV medicines (ritonavir, cobicistat) [5]. Vardenafil is often contraindicated or requires dose adjustment with these medicines, so your prescriber must review your full medication list.
Never take vardenafil at the same time as another PDE5 inhibitor (such as sildenafil, tadalafil, or avanafil), as this increases the risk of side effects without improving effectiveness [3][4][5][6].
Medicines That May Require Caution
Other blood-pressure-lowering medicines, such as ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, or diuretics, can add to the blood-pressure-lowering effect of vardenafil [5]. This does not mean you cannot take vardenafil, but your prescriber will check that your blood pressure is stable and that you do not experience symptoms such as dizziness or fainting. Always declare every medicine you take during your consultation, even if you think it is unrelated to erectile dysfunction.
When to Seek Medical Help and Warning Signs
Most men tolerate vardenafil well, even when taking other medicines such as mirabegron, but it is important to know the warning signs that require urgent medical attention [5]. If you develop chest pain during or after sexual activity, stop and seek immediate medical help. Do not take more vardenafil or use a nitrate spray, as this combination is dangerous [5].
If you have an erection that lasts longer than four hours (priapism), go to A&E immediately. Priapism is a medical emergency that requires prompt treatment to prevent permanent damage to the penis [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), also requires urgent medical assessment [5].
Less urgent but still important: if you experience severe dizziness, fainting, or palpitations after taking vardenafil, contact your GP or prescriber the same day. If you develop an allergic reaction (rash, swelling of the face or throat, difficulty breathing), call 999 or go to A&E [5].
Remember that erectile dysfunction can be an early warning sign of heart disease or diabetes [1][2]. If you have new or worsening ED, it is important to see your GP for a full health check, even if you are using treatment from an online pharmacy. Your GP can assess your cardiovascular risk and check for underlying conditions that may need treatment.
How Cured Pharmacy Can Help
Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering convenient access to erectile dysfunction treatments after a consultation with a UK-registered prescriber. Our online consultation asks about all your current medicines, including mirabegron, so the prescriber can assess whether vardenafil or another ED treatment is safe and suitable for you. We offer vardenafil at £16.95 (first order with code Ednew: £13.56), as well as other licensed ED treatments including sildenafil, tadalafil, and avanafil. All treatments are dispensed by our UK pharmacists and delivered discreetly to your door.
In summary
- Vardenafil and mirabegron can usually be taken together safely with no major direct interaction reported.
- Both medicines can affect blood pressure, so your prescriber will review your individual circumstances carefully.
- Never take vardenafil with nitrates, nicorandil, riociguat, or poppers – this combination is dangerous.
- Tell your prescriber about all current medicines, including mirabegron, during your online consultation.
- Seek urgent help if you have chest pain, an erection lasting over four hours, or sudden vision or hearing loss.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 2 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 2 November 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 2 November 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 2 November 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 2 November 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 2 November 2026]
- Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 2 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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