Vardenafil and Secukinumab: Can They Be Taken Together?

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Key takeaways

• No major interaction between vardenafil and secukinumab is commonly reported in clinical practice.
• Vardenafil is a PDE5 inhibitor for erectile dysfunction; secukinumab is a biologic for inflammatory conditions.
• Your prescriber checks all medicines during consultation to ensure vardenafil is safe for you.
• Never take vardenafil with nitrates, nicorandil, riociguat, poppers, or another PDE5 inhibitor.
• Seek urgent help for an erection lasting over 4 hours or sudden vision or hearing loss.

What is vardenafil and how does it work?

Vardenafil, also known by the brand name Levitra, is a prescription medicine used to treat erectile dysfunction (ED) in adult men [5]. It belongs to a group of medicines called PDE5 inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused [1].

Vardenafil is typically taken about 25 to 60 minutes before sexual activity, and its effects can last for several hours [5]. It comes in doses of 5mg, 10mg, and 20mg, and your prescriber will recommend the right dose based on your individual circumstances. It's important to remember that vardenafil only works when you are sexually stimulated—it does not cause an automatic erection [1].

Like all PDE5 inhibitors, vardenafil can interact with certain other medicines, particularly those that affect blood pressure or are metabolised by the same liver enzymes. This is why a thorough medication review is essential before starting treatment [5].

What is secukinumab and what is it used for?

Secukinumab, marketed under the brand name Cosentyx, is a biologic medicine used to treat several inflammatory conditions, including plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis [12]. It is given as an injection under the skin, either by a healthcare professional or self-administered at home after training.

Secukinumab works by targeting a specific protein in the immune system called interleukin-17A (IL-17A), which plays a key role in inflammation. By blocking this protein, secukinumab helps reduce the symptoms of these conditions, such as skin plaques, joint pain, and stiffness [12].

Because secukinumab affects the immune system, it can increase the risk of infections, and patients are monitored regularly by their specialist. However, it does not directly affect blood pressure, heart function, or the liver enzymes that metabolise most erectile dysfunction medicines, which is why interactions with vardenafil are not commonly reported [12].

How secukinumab is different from other medicines

Unlike many oral medicines that are broken down by the liver, secukinumab is a large protein molecule that is processed differently by the body. This means it does not typically interfere with the liver enzymes (such as CYP3A4) that metabolise vardenafil and other PDE5 inhibitors [12]. This is one reason why a direct drug interaction between vardenafil and secukinumab is unlikely.

At a glance

Can vardenafil and secukinumab be taken together?

Based on current evidence, there is no major known interaction between vardenafil and secukinumab, and they can generally be taken together [5][12]. Secukinumab does not affect the way vardenafil is absorbed, broken down, or eliminated from the body, and vardenafil does not interfere with the immune-modulating effects of secukinumab.

However, it is essential that your prescriber is aware of all medicines you are taking, including biologics like secukinumab. During your online consultation at Cured Pharmacy, you will be asked to list all current medicines, supplements, and health conditions. This allows the prescriber to check for any individual factors that might affect the safety or effectiveness of vardenafil in your case [2].

While the combination is not contraindicated, some patients with inflammatory conditions may have other health issues—such as cardiovascular disease or diabetes—that can affect erectile function and the suitability of PDE5 inhibitors. Your prescriber will take all of these factors into account before approving treatment [1][2].

What your prescriber checks before approving vardenafil

Before prescribing vardenafil, a UK prescriber will review your full medical history and current medicines to ensure the treatment is safe and appropriate for you [2]. This includes checking for contraindications—medicines or conditions that mean vardenafil should not be used.

Vardenafil must never be taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites). Combining vardenafil with any of these can cause a dangerous drop in blood pressure [5]. You should also not take vardenafil alongside another PDE5 inhibitor, such as sildenafil or tadalafil.

Your prescriber will also check whether you take alpha-blockers (such as tamsulosin or doxazosin) for prostate symptoms, as these can lower blood pressure when combined with vardenafil. If you are on an alpha-blocker, you may be started on a lower dose of vardenafil and advised to take it at a different time of day [5]. Potent CYP3A4 inhibitors—such as ritonavir, ketoconazole, or clarithromycin—can raise vardenafil levels, and vardenafil is contraindicated with these medicines [5]. Your prescriber will review all of these factors during your consultation.

Cardiovascular and other health checks

Erectile dysfunction can be an early warning sign of cardiovascular disease or diabetes, so if you are experiencing ED for the first time, it is important to see your GP for a full health check [1][2]. Your prescriber will also ask about recent heart attacks, strokes, unstable angina, or severe heart failure, as sexual activity may not be advisable in these situations [5]. If you have a history of sudden vision loss (NAION) or certain inherited retinal disorders, vardenafil may not be suitable [5].

Practical advice for taking vardenafil and secukinumab together

If you are prescribed both vardenafil and secukinumab, there are some practical steps you can take to use them safely and effectively. First, take vardenafil as directed—usually about 25 to 60 minutes before sexual activity, and no more than once a day [5]. Secukinumab is typically given as a weekly or monthly injection, depending on your condition and treatment phase, and should be continued as prescribed by your specialist [12].

Avoid drinking large amounts of alcohol when taking vardenafil, as alcohol can worsen erectile dysfunction and increase the risk of dizziness or low blood pressure [1]. Grapefruit juice can also raise vardenafil levels in the blood, so it is best avoided [5]. If you experience dizziness or light-headedness, especially when standing up, sit or lie down until it passes.

Keep all your healthcare professionals informed about both medicines. If your rheumatologist or dermatologist prescribes a new medicine or changes your secukinumab dose, let your GP and the prescriber at Cured Pharmacy know. Similarly, if you start or stop any other medicine—including over-the-counter products or herbal supplements—inform your prescriber, as some can interact with vardenafil [5].

Warning signs and when to seek urgent help

While serious side effects are uncommon, it is important to know the warning signs that require urgent medical attention. If you experience an erection lasting more than four hours (priapism), you must go to A&E immediately, as this can cause permanent damage if not treated promptly [5]. Sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing (which may be accompanied by ringing in the ears or dizziness), also requires urgent medical help [5].

If you develop chest pain during or after sexual activity, do not take more vardenafil and seek medical advice straight away. Do not use nitrate medicines (such as GTN spray) to treat chest pain if you have taken vardenafil in the past 24 hours, as this combination can be dangerous [5]. If you experience severe dizziness, fainting, or an allergic reaction (such as swelling of the face, lips, or throat, or difficulty breathing), call 999 or go to A&E immediately.

For secukinumab, watch for signs of serious infection—such as high fever, persistent cough, or unusual tiredness—and contact your specialist or GP promptly if these occur [12]. While these side effects are rare, being aware of them helps you use both medicines safely.

Common side effects to be aware of

Common side effects of vardenafil include headache, flushing, nasal congestion, indigestion, and dizziness [5]. These are usually mild and temporary. Secukinumab can cause injection-site reactions, upper respiratory infections, and diarrhoea [12]. If any side effect becomes troublesome or does not go away, speak to your pharmacist or prescriber for advice. Never stop a prescribed medicine without consulting a healthcare professional.

When to get urgent help

• Erection lasting more than 4 hours (priapism)—go to A&E immediately
• Sudden loss of vision in one or both eyes—seek urgent medical help
• Sudden decrease or loss of hearing, possibly with ringing in the ears or dizziness
• Chest pain during or after sexual activity—do not take more vardenafil and seek medical advice
• Severe dizziness, fainting, or signs of allergic reaction (swelling of face, lips, throat, or difficulty breathing)—call 999

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

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