Vardenafil and Perindopril: Can They Be Taken Together?
Learn how these medicines interact and what your UK prescriber checks to keep you safe.
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Vardenafil and Perindopril: Understanding the Interaction
Published: 3 November 2026
Many men taking perindopril for high blood pressure or heart conditions wonder whether vardenafil and perindopril can be taken together safely. The good news is that this combination is not contraindicated, but it does require careful assessment by a prescriber because both medicines can lower blood pressure. Understanding how they interact and what precautions to take will help you use vardenafil safely and effectively.
Top tip for safe use
When you first take vardenafil with perindopril, pay attention to how you feel and avoid standing up quickly. If you experience dizziness, sit down until it passes, and contact your pharmacist if it persists.
What is vardenafil and perindopril?
Vardenafil (generic Levitra) is a prescription medicine used to treat erectile dysfunction in men [5]. It belongs to a group of medicines called PDE5 inhibitors, which work by relaxing blood vessels in the penis during sexual stimulation, allowing increased blood flow to help achieve and maintain an erection. Vardenafil is available in 5mg, 10mg, and 20mg tablets and is usually taken about 25 to 60 minutes before sexual activity, with effects lasting for several hours [5].
Perindopril is an ACE inhibitor (angiotensin-converting enzyme inhibitor) prescribed to treat high blood pressure, heart failure, and to reduce the risk of heart attack and stroke [12]. It works by relaxing and widening blood vessels throughout the body, making it easier for the heart to pump blood and lowering overall blood pressure. Perindopril is typically taken once daily as a long-term treatment for cardiovascular conditions.
Both medicines affect blood vessels and blood pressure, which is why their interaction needs to be understood and monitored by a healthcare professional. While they work through different mechanisms, the combined effect on blood pressure is the key consideration when taking them together.
How do vardenafil and perindopril interact?
The interaction between vardenafil and perindopril is classified as additive rather than dangerous [5]. This means that both medicines can lower blood pressure, and when taken together, their blood-pressure-lowering effects may add up. Perindopril lowers blood pressure throughout the body as its main therapeutic action, while vardenafil can cause a modest drop in blood pressure as a side effect, particularly when blood vessels dilate.
In plain English, if you are already taking perindopril to control your blood pressure, adding vardenafil may cause your blood pressure to drop a little more than usual. For most men who are stable on perindopril and whose blood pressure is well controlled, this additional effect is usually mild and manageable. However, it can occasionally cause symptoms such as dizziness, light-headedness, or feeling faint, especially when standing up quickly.
It is important to understand that this interaction does not mean the combination is unsafe or forbidden. Unlike nitrates, nicorandil, or riociguat—which must never be taken with vardenafil—perindopril can be used alongside vardenafil provided your prescriber has assessed your individual circumstances and confirmed it is appropriate for you [5]. The key is ensuring your blood pressure is stable and that you are monitored appropriately.
Why the interaction matters
The reason prescribers pay attention to this interaction is that a significant drop in blood pressure can reduce blood flow to vital organs, potentially causing dizziness, fainting, or—in rare cases—more serious cardiovascular events. Men with already low blood pressure, those taking multiple blood-pressure medicines, or those with certain heart conditions need particularly careful assessment before starting vardenafil [5].
When to get urgent help
- Chest pain during or after sexual activity—call 999 and do not take more vardenafil
- Severe dizziness, fainting, or feeling like you might pass out—seek immediate medical 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 attention
- Allergic reaction (swelling of face, lips, tongue, or difficulty breathing)—call 999
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
What your prescriber checks before prescribing vardenafil with perindopril
When you request vardenafil through an online consultation at Cured Pharmacy, the UK-registered prescriber will review your full medical history and current medicines, including perindopril. They will check several important factors to ensure vardenafil is safe and appropriate for you. First, they will confirm that your blood pressure is stable and well controlled on perindopril, as uncontrolled high blood pressure or very low blood pressure can affect whether vardenafil is suitable [2][5].
The prescriber will also ask about any cardiovascular conditions, such as angina, heart failure, or a history of heart attack or stroke, because these conditions may make sexual activity inadvisable or require extra caution when using ED medicines [2]. They will check whether you are taking any other medicines that could interact with vardenafil, including other blood-pressure tablets, alpha-blockers, or medicines that affect how vardenafil is broken down in the body [5].
If the prescriber determines that vardenafil is appropriate for you, they may recommend starting with the lowest effective dose (usually 5mg or 10mg) to minimise the risk of side effects, including any additional blood-pressure-lowering effect [5]. They will also provide advice on warning signs to watch for and when to seek medical help. This careful assessment ensures that the combination of vardenafil and perindopril is used safely and effectively.
Practical advice for taking vardenafil and perindopril together
If your prescriber has confirmed that vardenafil is suitable for you while taking perindopril, there are several practical steps you can take to use it safely. Take vardenafil exactly as prescribed, usually about 25 to 60 minutes before sexual activity, and do not take more than one dose in 24 hours [5]. Continue taking your perindopril as normal—do not stop or change the dose without speaking to your doctor, as this could cause your blood pressure to rise.
Be aware of how you feel when you first use vardenafil with perindopril. Some men may notice mild dizziness or light-headedness, particularly if they stand up quickly. If this happens, sit or lie down until the feeling passes, and avoid driving or operating machinery if you feel dizzy. Drinking plenty of water and avoiding heavy alcohol can help, as alcohol can worsen both erectile dysfunction and low blood pressure [1].
Avoid grapefruit juice while taking vardenafil, as it can increase the level of the medicine in your blood and raise the risk of side effects [5]. If you experience persistent dizziness, fainting, chest pain during sex, or any other concerning symptoms, stop taking vardenafil and contact your GP or pharmacist for advice. Most men tolerate the combination well, but it is important to listen to your body and seek help if something does not feel right.
When to contact your doctor
Contact your GP if you experience repeated episodes of dizziness or light-headedness, if your blood pressure readings at home are unusually low, or if you have any concerns about how the medicines are working together. Your doctor may want to check your blood pressure or adjust your treatment. Never stop taking perindopril suddenly without medical advice, as this can cause a rebound increase in blood pressure [12].
At a glance
Other blood pressure medicines and vardenafil interactions
Perindopril is just one of many blood-pressure medicines, and it is helpful to understand how vardenafil interacts with other types. ACE inhibitors (like perindopril, ramipril, and lisinopril) and angiotensin receptor blockers (ARBs, such as losartan and candesartan) work similarly and have the same additive blood-pressure-lowering interaction with vardenafil [5]. These combinations are generally manageable with appropriate prescriber assessment.
Calcium-channel blockers (such as amlodipine and diltiazem) and diuretics (water tablets like bendroflumethiazide) can also add to the blood-pressure-lowering effect of vardenafil. Again, these are not contraindicated, but your prescriber must know about them. Alpha-blockers (such as doxazosin and tamsulosin, often used for prostate symptoms) require particular caution, as the combination with vardenafil can cause more pronounced low blood pressure and dizziness [5]. If you take an alpha-blocker, your prescriber will ensure you are stable on it and may start you on the lowest dose of vardenafil.
It is essential to declare all your current medicines during your consultation, including over-the-counter treatments and herbal supplements. Some medicines, such as St John's wort, can reduce the effectiveness of vardenafil, while others may increase the risk of side effects [5]. Your prescriber and pharmacist are there to check every medicine and ensure the combination is safe for you.
Alternatives to vardenafil if you take perindopril
If vardenafil is not suitable for you, or if you experience side effects, there are other licensed ED treatments available. Sildenafil (generic Viagra) and tadalafil (generic Cialis) are also PDE5 inhibitors and have the same type of interaction with perindopril as vardenafil [3][4]. The choice between them often depends on how quickly you want the medicine to work and how long you want the effect to last. Sildenafil works in about an hour and lasts for around four to six hours, while tadalafil can be taken on-demand (working in about 30 minutes and lasting up to 36 hours) or as a low daily dose [3][4].
Avanafil (Spedra) is another PDE5 inhibitor that works more quickly, often within 15 to 30 minutes, and may suit men who prefer a faster-acting option [6]. All PDE5 inhibitors have similar interactions with blood-pressure medicines, so the same precautions apply. Your prescriber will help you choose the most appropriate option based on your health, preferences, and how well your blood pressure is controlled.
For men who cannot use PDE5 inhibitors at all, alternatives include alprostadil cream (Vitaros) or alprostadil injections (Caverject), which work locally rather than affecting blood pressure throughout the body [7]. Vacuum erection devices and psychological therapies such as cognitive behavioural therapy (CBT) or sex therapy can also be helpful, particularly if anxiety or relationship issues contribute to ED [2]. Speak to your GP or pharmacist about the full range of options available.
Choosing the right ED treatment for you
At Cured Pharmacy, all prescription ED medicines are supplied only after an online consultation reviewed by a UK-registered prescriber. The consultation allows the prescriber to assess your medical history, current medicines (including perindopril), and overall health to recommend the safest and most effective treatment for you. You can discuss your preferences, ask questions, and receive personalised advice to help you make an informed decision.
In summary
- Vardenafil and perindopril can usually be taken together after a prescriber assessment
- Both medicines can lower blood pressure, so the combination needs careful monitoring
- Most men tolerate the combination well if blood pressure is stable and controlled
- Never stop perindopril without medical advice, even if starting vardenafil
- Declare all your medicines during your consultation to ensure safe prescribing
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 3 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 3 November 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 3 November 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 3 November 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 3 November 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 3 November 2026]
- Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 3 November 2026]
- Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 3 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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Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)