Vardenafil and Omeprazole: Can You Take Them Together?

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Key takeaways

• Vardenafil and omeprazole do not have a significant interaction and can usually be taken together safely
• Your prescriber reviews all your medicines during consultation to check for other interactions
• Never take vardenafil with nitrates, nicorandil, riociguat, or poppers due to dangerous blood pressure drop
• Declare all medicines, including over-the-counter and herbal products, before starting vardenafil
• Seek urgent help for chest pain during sex, erections lasting over four hours, or sudden vision or hearing loss

What Is Vardenafil and How Does It Work?

Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in men [1]. It belongs to a group of medicines called PDE5 inhibitors, which work by relaxing the blood vessels in the penis, allowing more blood to flow in when you are sexually aroused [3]. This helps you get and keep 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 sex [5]. The effect can last for several hours, but you should only take it once in a 24-hour period. It is important to remember that vardenafil will not work without sexual stimulation—it does not cause an automatic erection.

Common brand names include Levitra, though generic vardenafil is widely available and just as effective. At Cured Pharmacy, vardenafil is available from £16.95 (£13.56 with code Ednew on your first order) after a consultation with a UK-registered prescriber.

What Is Omeprazole and Why Is It Prescribed?

Omeprazole is one of the most commonly prescribed medicines in the UK. It belongs to a class of drugs called proton pump inhibitors (PPIs), which reduce the amount of acid your stomach produces. Omeprazole is used to treat conditions such as heartburn, acid reflux, gastro-oesophageal reflux disease (GERD), stomach ulcers, and to protect the stomach lining when taking certain painkillers.

It is available on prescription and over the counter in lower strengths. Most people take omeprazole once a day, usually in the morning before food. The medicine works by blocking the enzyme in the stomach wall that produces acid, providing relief from symptoms and allowing damaged tissue to heal.

Omeprazole is generally well tolerated, with side effects being uncommon. Because it is so widely used, many men taking treatment for erectile dysfunction will also be on omeprazole for digestive health. Understanding how these medicines interact is important for safe and effective treatment.

At a glance

Do Vardenafil and Omeprazole Interact?

Vardenafil and omeprazole do not have a significant interaction that would prevent you from taking them together. Omeprazole is not known to affect the way vardenafil works, and there is no major risk of dangerous side effects when the two medicines are combined. This means that if you are already taking omeprazole for acid reflux or another stomach condition, you can usually take vardenafil safely.

However, it is still essential to declare all your current medicines—including over-the-counter treatments and supplements—when you complete your consultation for vardenafil. Your prescriber will review your full medication list to check for any other interactions or contraindications. Some medicines can affect vardenafil levels in the blood or increase the risk of side effects, so a thorough review is always carried out.

While omeprazole itself does not interfere with vardenafil, other medicines you may be taking could. For example, certain antibiotics, antifungals, and HIV medicines can raise vardenafil levels, requiring dose adjustments or making vardenafil unsuitable [5]. Your prescriber will ensure that your treatment plan is safe and tailored to your individual circumstances.

How Omeprazole and Vardenafil Are Processed in the Body

Understanding how medicines are broken down in the body can help explain why some combinations are safe and others are not. Vardenafil is metabolised (broken down) mainly by an enzyme in the liver called CYP3A4 [5]. Medicines that strongly inhibit this enzyme can increase vardenafil levels, leading to a higher risk of side effects.

Omeprazole is metabolised by different enzymes (mainly CYP2C19 and CYP3A4 to a lesser extent), and it does not significantly inhibit CYP3A4 at the doses used for stomach conditions. This is why omeprazole does not meaningfully affect vardenafil levels and the two can generally be taken together without concern.

Your prescriber will always check the specific enzymes involved when reviewing your medicines to ensure there are no hidden interactions. This careful assessment is part of the consultation process at Cured Pharmacy and helps keep your treatment safe.

What Your Prescriber Checks Before Prescribing Vardenafil

Before vardenafil is prescribed, a UK-registered prescriber will carry out a thorough assessment of your health and current medicines. This includes checking your blood pressure, heart health, and any conditions that might make vardenafil unsuitable. You will be asked about any history of heart attack, stroke, angina, or severe liver or kidney problems [5].

Your prescriber will also review every medicine you are currently taking, including prescription drugs, over-the-counter treatments, and herbal supplements. This is to identify any interactions that could make vardenafil unsafe or less effective. For example, vardenafil must never be taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers', as this combination can cause a dangerous drop in blood pressure [5].

If you are taking medicines such as alpha-blockers for an enlarged prostate (e.g. tamsulosin or doxazosin), your prescriber will ensure you are stable on that treatment and may start you on a lower dose of vardenafil to reduce the risk of dizziness or low blood pressure. The consultation process is designed to ensure that vardenafil is both safe and effective for you, taking into account your full medical picture.

Practical Advice for Taking Vardenafil and Omeprazole Together

If you are taking both vardenafil and omeprazole, there are a few practical tips to help you get the best results from your treatment. First, take each medicine as directed by your prescriber or as stated on the label. Omeprazole is usually taken once daily in the morning, ideally before food, while vardenafil is taken about 25 to 60 minutes before sexual activity [5].

You do not need to time the two medicines around each other, as they do not interact. However, be mindful of other factors that can affect vardenafil's effectiveness. Heavy meals, especially those high in fat, can delay how quickly vardenafil works. Excessive alcohol can also make it harder to get an erection and may increase the risk of side effects such as dizziness or headache.

If you experience any new or unusual symptoms after starting vardenafil, contact your prescriber or pharmacist for advice. Common side effects of vardenafil include headache, flushing, nasal congestion, and indigestion [5]. These are usually mild and short-lived. However, if you develop chest pain during sex, a prolonged erection lasting more than four hours, or sudden loss of vision or hearing, seek urgent medical help immediately.

When to Speak to Your Prescriber

Always inform your prescriber if you start any new medicines, including those bought over the counter or prescribed by another doctor. Even though omeprazole and vardenafil can be taken together, adding a third medicine could change the safety profile of your treatment.

If your omeprazole dose changes, or if you switch to a different proton pump inhibitor such as lansoprazole or esomeprazole, mention this during your next consultation. While these medicines are similar to omeprazole and are not expected to interact with vardenafil, it is good practice to keep your prescriber informed of any changes.

Never stop taking a prescribed medicine without speaking to a healthcare professional first. If you are concerned about any aspect of your treatment, your pharmacist or prescriber is there to help and can answer your questions in confidence.

Other Medicines and Vardenafil: What You Need to Know

While vardenafil and omeprazole can be taken together, it is important to be aware of other medicines that do interact with vardenafil. As mentioned, you must never take vardenafil with nitrates, nicorandil, riociguat, or poppers, as this can cause a severe and potentially life-threatening drop in blood pressure [5].

Certain antibiotics (such as clarithromycin and erythromycin), antifungals (such as ketoconazole and itraconazole), and HIV medicines (such as ritonavir and cobicistat) are potent inhibitors of the CYP3A4 enzyme and can significantly increase vardenafil levels in the blood [5]. In many cases, vardenafil is contraindicated or requires careful dose adjustment when taken with these medicines. Your prescriber will review this during your consultation.

Medicines that lower blood pressure, such as calcium channel blockers, ACE inhibitors, or diuretics, can add to the blood-pressure-lowering effect of vardenafil, potentially causing dizziness. This does not mean you cannot take vardenafil, but your prescriber will assess the combination carefully. Grapefruit juice can also raise vardenafil levels and is best avoided. Always declare everything you are taking, including herbal remedies such as St John's wort, which can reduce vardenafil's effectiveness.

Vardenafil and Other Proton Pump Inhibitors

If you are taking a different proton pump inhibitor instead of omeprazole—such as lansoprazole, esomeprazole, pantoprazole, or rabeprazole—the same principles apply. These medicines work in a similar way to omeprazole and do not have a significant interaction with vardenafil.

Your prescriber will still review your full medication list to ensure there are no other concerns. It is always best to be open and thorough when listing your medicines, as this helps your prescriber make the safest and most effective treatment decision for you.

If you have any questions about your specific combination of medicines, the pharmacist team at Cured Pharmacy is available to provide advice and support throughout your treatment journey.

When to get urgent help

• Chest pain during or after sexual activity—call 999 immediately
• An erection lasting more than four hours (priapism)—go to A&E
• Sudden loss of vision in one or both eyes—seek urgent medical attention
• Sudden decrease or loss of hearing, possibly with ringing in the ears or dizziness—contact a doctor urgently
• Severe dizziness, fainting, or signs of a severe allergic reaction (swelling of face, lips, or throat)—call 999

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