Vardenafil and Quinapril: Can They Be Taken Together?

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What is vardenafil and how does it work?

Vardenafil (also known by the brand name Levitra) is a prescription medicine licensed in the UK to treat erectile dysfunction [5]. It belongs to a group of medicines called PDE5 inhibitors, which work by relaxing blood vessels in the penis, allowing more blood to flow in when you are sexually aroused. This helps you get and maintain an erection suitable for sexual activity.

Vardenafil is available in 5mg, 10mg, and 20mg tablets. You take it about 25 to 60 minutes before sexual activity, and it works only when you are sexually stimulated [5]. The effects can last for several hours, but you should not take it more than once a day. Like all PDE5 inhibitors, vardenafil also has a mild blood-pressure-lowering effect throughout the body, which is why interactions with other blood pressure medicines need careful consideration.

What is quinapril and why is it prescribed?

Quinapril is an angiotensin-converting enzyme (ACE) inhibitor, a type of medicine commonly prescribed to treat high blood pressure (hypertension) and heart failure. ACE inhibitors work by blocking the action of an enzyme that produces a substance called angiotensin II, which normally narrows blood vessels. By blocking this enzyme, quinapril helps blood vessels relax and widen, which lowers blood pressure and reduces the workload on the heart.

Many men with erectile dysfunction also have high blood pressure or other cardiovascular conditions, so it is quite common to be prescribed both an ACE inhibitor like quinapril and an ED treatment. In fact, treating high blood pressure properly can sometimes improve erectile function, as good blood flow is essential for erections [1][2]. Your GP or prescriber will consider your full medical history and current medicines when deciding whether vardenafil is suitable for you.

How do vardenafil and quinapril interact?

Vardenafil and quinapril can both lower blood pressure, so when taken together there is a potential for an additive effect—meaning your blood pressure might drop more than it would with either medicine alone. This can occasionally cause symptoms such as dizziness, light-headedness, or feeling faint, especially when standing up quickly. However, this interaction is usually manageable and does not mean the medicines cannot be used together [5].

The interaction is not in the same category as the dangerous combinations with nitrates, nicorandil, or riociguat, which are absolutely contraindicated with all PDE5 inhibitors. Instead, the combination of vardenafil and quinapril requires careful assessment by your prescriber to ensure your blood pressure is stable and that you start on an appropriate dose of vardenafil. Most men who are stable on an ACE inhibitor like quinapril can safely use vardenafil, provided their cardiovascular health is otherwise suitable for sexual activity [2][5].

The mechanism in plain English

Both medicines cause blood vessels to relax, but they do so through different mechanisms. Quinapril blocks a hormone system that tightens blood vessels, while vardenafil increases a natural chemical (called cGMP) that relaxes the smooth muscle in blood vessel walls. When both effects happen at the same time, the overall relaxation of blood vessels can be greater, leading to a more pronounced drop in blood pressure. This is why your prescriber will check your current blood pressure readings and may start you on a lower dose of vardenafil if you are taking quinapril or another blood pressure medicine.

What you need to know

• Vardenafil and quinapril can usually be taken together safely if your blood pressure is stable.
• Both medicines lower blood pressure, so your prescriber may start you on a lower vardenafil dose.
• Watch for dizziness or light-headedness and avoid standing up quickly.
• Never take vardenafil with nitrates, nicorandil, or riociguat—this is dangerous.
• Declare all current medicines during your online consultation for a safe assessment.

What your prescriber will check before approving vardenafil and quinapril together

When you request vardenafil through an online consultation at Cured Pharmacy, our UK-registered prescribers will review your full medical history and all current medicines, including quinapril. They will check that your blood pressure is well controlled and stable on your current treatment, as poorly controlled high blood pressure or very low blood pressure can make PDE5 inhibitors unsuitable [2][5].

The prescriber will also assess whether your cardiovascular health is suitable for sexual activity. Conditions such as recent heart attack or stroke (within the past six months), unstable angina, severe heart failure, or very low blood pressure mean that sexual activity itself may carry risks, and ED medicines would not be appropriate [2][5]. If you are stable on quinapril and your heart health is otherwise good, vardenafil can usually be prescribed safely, often starting at a lower dose such as 5mg or 10mg to minimise the risk of dizziness.

You must declare all medicines you take—prescription, over-the-counter, and herbal—during your consultation. Never take vardenafil if you are also using nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers', as these combinations can cause a dangerous drop in blood pressure [5].

Practical advice for taking vardenafil and quinapril safely

If your prescriber approves vardenafil while you are taking quinapril, follow these practical steps to use both medicines safely. Take quinapril exactly as your GP has prescribed—do not stop or change the dose without medical advice. Take vardenafil about 25 to 60 minutes before you plan to have sex, and remember it works only with sexual stimulation [5]. Start with the lowest effective dose, which your prescriber will recommend based on your individual circumstances.

Be aware of the signs of low blood pressure: dizziness, light-headedness, fainting, or feeling unusually tired. These symptoms are more likely when you first start vardenafil or if the dose is increased. Avoid standing up too quickly, especially after lying down or sitting for a while. Limit alcohol when taking vardenafil, as heavy drinking can worsen erectile dysfunction and add to the blood-pressure-lowering effect, increasing the risk of dizziness [5].

If you experience chest pain during or after sexual activity, do not take a nitrate medicine (such as GTN spray) without telling the doctor or paramedic that you have taken vardenafil. The combination can be dangerous. Instead, seek urgent medical help and make sure healthcare professionals know you have used a PDE5 inhibitor [5]. Keep all your regular GP appointments to monitor your blood pressure and heart health.

When to contact your GP or pharmacist

Contact your GP or pharmacist if you notice new or worsening dizziness, fainting episodes, or if your blood pressure readings at home are consistently lower than usual. Also get in touch if vardenafil does not seem to be working after trying it on several occasions, as your prescriber may need to adjust the dose or consider an alternative ED treatment. Never increase the dose yourself or take vardenafil more than once a day [5].

When to get urgent help

• Chest pain during or after sex—call 999 and tell them you have taken vardenafil; do not use GTN spray
• 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 help
• Severe dizziness, fainting, or signs of very low blood pressure—contact your GP urgently or call 111
• 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.

Other ED treatment options available at Cured Pharmacy

If you are taking quinapril and vardenafil is not suitable or not effective for you, there are other licensed PDE5 inhibitors available through Cured Pharmacy after a prescriber consultation. Sildenafil (generic Viagra) is taken about one hour before sex and is available from £0.45 per tablet (£0.36 with first-order code Ednew). Tadalafil (generic Cialis) can be taken on-demand at least 30 minutes before sex, with effects lasting up to 36 hours, or as a lower daily dose; prices start at £7.95 (£6.36 with code Ednew) [3][4].

Avanafil (Spedra) is a newer PDE5 inhibitor that can work in as little as 15 to 30 minutes and is available at £20.95 (£16.76 with code Ednew) [6]. All these medicines have similar interactions with blood pressure treatments like quinapril, so the same precautions apply. Your prescriber will help you choose the most suitable option based on your lifestyle, how quickly you want the medicine to work, and how long you want the effect to last.

If PDE5 inhibitors are not suitable, other prescription options include Vitaros (alprostadil cream applied to the tip of the penis) or Caverject (alprostadil injection), though these require specialist assessment [7]. Eroxon is a topical gel medical device available without prescription. Always discuss new or worsening erectile dysfunction with your GP, as it can be an early warning sign of cardiovascular disease or diabetes [1][2].

Why see your GP about erectile dysfunction

Erectile dysfunction is common—it affects about half of men aged 40 to 70 to some degree—and it is often an early sign of underlying health conditions such as heart disease, diabetes, or high cholesterol [1][10]. If you have not already done so, book an appointment with your GP for a full assessment. Your GP can check your cardiovascular risk, review all your medicines (as some can contribute to ED), and ensure any underlying conditions are well managed. Treating the root cause can sometimes improve erectile function on its own, and your GP can refer you for specialist support if needed [2].