Vardenafil and Prucalopride: Can They Be Taken Together?

Vardenafil and Prucalopride: Understanding the Interaction

Published: 3 November 2026

If you've been prescribed vardenafil and prucalopride, you may be wondering whether these two medicines can be taken together safely. The good news is that no major interaction is commonly reported between vardenafil (a PDE5 inhibitor used for erectile dysfunction) and prucalopride (a medicine used to treat chronic constipation). However, both medicines can affect your heart rhythm and blood pressure in different ways, so your prescriber will need to check your full medical history and current medications before confirming they are suitable for you.

What Is Vardenafil and How Does It Work?

Vardenafil is the active ingredient in Levitra, a prescription medicine used to treat erectile dysfunction (ED) in men [5]. 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. This helps you get and keep an erection suitable for sexual activity [1].

Vardenafil is usually taken about 25 to 60 minutes before sex, and its effects can last for several hours. It comes in 5mg, 10mg, and 20mg tablets, and the dose is tailored to your needs and medical history [5]. Like all PDE5 inhibitors, vardenafil only works when you are sexually stimulated—it does not cause an automatic erection.

Because vardenafil affects blood vessels, it can lower your blood pressure slightly. This is usually not a problem, but it means your prescriber needs to check for any medicines or conditions that might make this effect more pronounced. At Cured Pharmacy, every prescription is reviewed by a UK-registered prescriber after an online consultation to ensure vardenafil is safe and suitable for you.

What Is Prucalopride and Why Is It Prescribed?

Prucalopride is a prescription medicine used to treat chronic constipation in adults when other laxatives have not worked well enough. It is sold under brand names such as Resolor. Prucalopride works by stimulating the muscles in your bowel, helping to move stools through more quickly and making bowel movements easier and more regular.

Prucalopride acts on serotonin receptors (specifically 5-HT4 receptors) in the gut. It is usually taken once daily, and most people notice an improvement in their bowel habits within a few days to a week. Common side effects include headache, nausea, and abdominal pain, especially in the first day or two of treatment.

One important consideration with prucalopride is that it can, in rare cases, affect your heart rhythm. For this reason, your doctor will check your medical history—particularly any heart problems—before prescribing it. If you are taking other medicines that can also affect your heart, including some used for erectile dysfunction, your prescriber will assess whether the combination is safe for you.

How Prucalopride Affects Your Heart

Prucalopride has been associated with a small risk of changes to the electrical activity of the heart, which can be seen on an ECG (electrocardiogram). In particular, it may prolong the QT interval, a measure of how long it takes for your heart to recharge between beats. A prolonged QT interval can, in very rare cases, lead to serious heart rhythm problems. For this reason, prucalopride is used with caution in people with existing heart conditions or those taking other medicines that affect the QT interval.

Can You Take Vardenafil and Prucalopride Together?

There is no well-documented major interaction between vardenafil and prucalopride, and many people may be able to take both medicines together under medical supervision. However, both medicines can have effects on your cardiovascular system—vardenafil lowers blood pressure, and prucalopride can, in rare cases, affect heart rhythm—so it is essential that your prescriber reviews your full medical history and current medications before confirming this combination is safe for you.

Your prescriber will pay particular attention to any history of heart problems, low blood pressure, or fainting. They will also check whether you are taking any other medicines that affect your heart rhythm or blood pressure, such as certain antibiotics, antidepressants, or medicines for irregular heartbeat. If you have risk factors for heart rhythm problems, your doctor may arrange an ECG before starting prucalopride.

During your online consultation at Cured Pharmacy, you will be asked about all your current medicines, including over-the-counter products and supplements. This allows the prescriber to identify any potential interactions and ensure that vardenafil is a safe choice for you. Never start, stop, or change the dose of any medicine without first speaking to your doctor or pharmacist.

What Your Prescriber Will Check Before Approving Vardenafil and Prucalopride

When you request vardenafil through Cured Pharmacy, a UK-registered prescriber will review your online consultation answers carefully. They will check for any conditions or medicines that could make vardenafil unsafe, including nitrates, nicorandil, riociguat, alpha-blockers, and potent CYP3A4 inhibitors [3][5]. If you are taking prucalopride, the prescriber will also consider your heart health and any other medicines that might affect your heart rhythm or blood pressure.

You will be asked about your cardiovascular history, including any heart attacks, strokes, angina, heart failure, or abnormal heart rhythms. You will also be asked about your blood pressure and whether you have ever fainted or felt dizzy when standing up. If you have a history of QT prolongation or are taking other medicines that can prolong the QT interval, your prescriber may advise caution or suggest an alternative treatment.

It is important to be honest and thorough when completing your consultation. If you are unsure whether a medicine you take might interact with vardenafil, list it anyway—your prescriber will check. If your medical history is complex or you have multiple conditions, your prescriber may recommend that you discuss ED treatment with your GP first, who can arrange any necessary tests such as an ECG or blood pressure monitoring.

Medicines That Must Not Be Taken with Vardenafil

Do not take vardenafil if you are using nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites). The combination can cause a dangerous drop in blood pressure [3][5]. You must also not take vardenafil at the same time as another PDE5 inhibitor (such as sildenafil, tadalafil, or avanafil). If you are taking any of these medicines, tell your prescriber immediately—they will suggest a safer alternative for managing your symptoms.

Practical Advice for Taking Vardenafil and Prucalopride Safely

If your prescriber approves the combination of vardenafil and prucalopride, there are some practical steps you can take to use both medicines safely. Take each medicine exactly as prescribed, at the times recommended. Vardenafil is usually taken about 25 to 60 minutes before sexual activity, and you should not take it more than once in 24 hours [5]. Prucalopride is usually taken once daily, in the morning, with or without food.

Be aware of how you feel, especially in the first few days of taking a new medicine or combination. If you feel dizzy, lightheaded, or faint—particularly when standing up—sit or lie down and tell your doctor. Avoid drinking large amounts of alcohol, as this can worsen dizziness and make erectile dysfunction worse. Grapefruit juice can increase the levels of vardenafil in your blood, so it is best to avoid it.

If you experience any unusual symptoms such as a fast or irregular heartbeat, chest pain, shortness of breath, or an erection lasting more than four hours, seek medical help immediately. These are rare but serious side effects that need urgent attention. Keep all your medicines in their original packaging, store them safely out of reach of children, and check the expiry dates regularly.

Other Medicines and Conditions That May Affect Vardenafil and Prucalopride Use

In addition to the medicines that must not be taken with vardenafil, there are other drugs and conditions that may require dose adjustments or extra monitoring. Alpha-blockers (such as tamsulosin, doxazosin, or alfuzosin) are commonly used for prostate problems and can lower blood pressure; if you take one, you should be stable on it before starting vardenafil, and your prescriber will usually recommend the lowest dose of vardenafil to start [3][5].

Potent CYP3A4 inhibitors—including some HIV medicines (ritonavir, cobicistat), antifungals (ketoconazole, itraconazole), and antibiotics (clarithromycin)—can increase vardenafil levels in your blood. Vardenafil is contraindicated or requires significant dose reduction with these medicines, so your prescriber will check the Summary of Product Characteristics (SmPC) to confirm safety [5]. CYP3A4 inducers such as rifampicin, carbamazepine, phenytoin, and St John's wort can make vardenafil less effective.

If you have severe kidney or liver disease, heart failure, a history of stroke or heart attack in the past six months, very low blood pressure, or a history of non-arteritic anterior ischaemic optic neuropathy (NAION, a type of sudden vision loss), vardenafil may not be suitable for you [5]. Your prescriber will assess your individual circumstances and may suggest an alternative treatment or refer you back to your GP for further investigation.

When to See Your GP About Erectile Dysfunction

If you are experiencing erectile dysfunction for the first time, it is a good idea to see your GP for a check-up. ED can be an early warning sign of underlying health problems such as heart disease, diabetes, or high blood pressure [1][2]. Your GP can arrange blood tests, check your cardiovascular health, and discuss any lifestyle changes that might help. They can also review all your current medicines to see if any might be contributing to ED, and refer you to a specialist if needed.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 3 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 3 November 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 3 November 2026]
4. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [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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