Vardenafil and Telmisartan: Can They Be Taken Together?
Learn how these medicines interact and what your prescriber checks during your UK pharmacist-led consultation.
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Vardenafil and Telmisartan: Understanding the Interaction
Published: 4 November 2026
Many men wonder whether vardenafil and telmisartan can be taken together safely. The good news is that vardenafil, a medicine used to treat erectile dysfunction (ED), can generally be used alongside telmisartan, a blood pressure medicine, but careful monitoring is needed because both can lower blood pressure. Your prescriber will check your current blood pressure control and overall health to ensure the combination is safe for you.
Key takeaways
- Vardenafil and telmisartan can usually be taken together safely if your blood pressure is well controlled.
- Both medicines can lower blood pressure, so your prescriber will check carefully and may start with a lower vardenafil dose.
- Never take vardenafil with nitrates, nicorandil, or poppers—this combination is dangerous.
- If you feel dizzy or faint after taking vardenafil, sit down and contact your prescriber if symptoms persist.
- All ED treatments at Cured Pharmacy require an online consultation reviewed by a UK prescriber.
What is vardenafil and telmisartan used for?
Vardenafil (also known by the brand name 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, allowing increased blood flow when you are sexually aroused. Vardenafil is available in 5mg, 10mg, and 20mg tablets and typically starts working within 25 to 60 minutes of taking it [5]. You should take it about an hour before sexual activity, and it will only work when you are sexually stimulated.
Telmisartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure (hypertension) and to help protect the heart and kidneys in people with certain cardiovascular conditions. By blocking the action of a hormone that narrows blood vessels, telmisartan helps blood vessels relax and widen, which lowers blood pressure. It is usually taken once daily and works continuously throughout the day. Many men with high blood pressure also experience erectile dysfunction, so it is common for these medicines to be prescribed together [1].
How do vardenafil and telmisartan interact?
Both vardenafil and telmisartan can lower blood pressure, so when taken together there is a potential for an additive effect—meaning your blood pressure may drop more than it would with either medicine alone [5]. This interaction is usually manageable and not dangerous for most men, but it does require careful assessment by your prescriber. The drop in blood pressure can occasionally cause symptoms such as dizziness, light-headedness, or feeling faint, particularly when standing up quickly.
The mechanism is straightforward: telmisartan lowers blood pressure by relaxing blood vessels throughout the body, while vardenafil causes blood vessels in the penis (and to a lesser extent elsewhere) to relax. When both effects occur together, the overall reduction in blood pressure can be more pronounced. However, this is very different from the dangerous interaction that occurs with nitrate medicines (such as GTN spray), which you must never take with vardenafil. With telmisartan, the interaction is about monitoring and dose adjustment, not an absolute contraindication [3][5].
Is the combination safe?
For most men whose blood pressure is well controlled on telmisartan, adding vardenafil is safe and effective. Your prescriber will check that your blood pressure is stable, that you are not experiencing symptoms of low blood pressure, and that your heart is healthy enough for sexual activity. They may start you on a lower dose of vardenafil (such as 5mg) to see how you respond before increasing if needed. It is important to be honest about all your medicines and any symptoms you experience so your prescriber can make the best decision for you [2][5].
At a glance
What does your prescriber check before combining vardenafil and telmisartan?
When you request vardenafil through an online consultation at Cured Pharmacy, the UK-registered prescriber will review your full medical history and current medicines. They will specifically check your current blood pressure readings, how long you have been taking telmisartan, and whether your blood pressure is well controlled. They will also ask about any symptoms of low blood pressure, such as dizziness or fainting, and whether you have any heart conditions that might make sexual activity inadvisable [2].
The prescriber will also confirm that you are not taking any medicines that must not be combined with vardenafil, such as nitrates (GTN spray, isosorbide mononitrate or dinitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites). These combinations can cause a dangerous drop in blood pressure and are absolutely contraindicated [5]. If you are taking any other blood pressure medicines in addition to telmisartan, such as an alpha-blocker (e.g. doxazosin or tamsulosin), the prescriber will take extra care, as these also interact with vardenafil and require a lower starting dose.
Your prescriber may also ask about other medicines that can affect how vardenafil works, such as certain antibiotics (e.g. clarithromycin), antifungals (e.g. ketoconazole), or HIV medicines. These can increase vardenafil levels in the blood, and in some cases vardenafil may not be suitable [5]. The online consultation is designed to capture all this information so the prescriber can make a safe, personalised decision.
Practical advice when taking vardenafil with telmisartan
If your prescriber approves the combination, there are some practical steps you can take to use vardenafil safely alongside telmisartan. First, take vardenafil exactly as prescribed—typically one tablet about 25 to 60 minutes before sexual activity, and no more than once in 24 hours [5]. Do not take a higher dose than prescribed, as this increases the risk of side effects including low blood pressure. If you feel dizzy or light-headed after taking vardenafil, sit or lie down until the feeling passes, and avoid driving or operating machinery.
Continue taking your telmisartan as usual; do not stop or change the dose without speaking to your GP or prescriber. If you experience persistent dizziness, fainting, or any new symptoms after starting vardenafil, contact your GP or the prescriber who issued your prescription. It is also sensible to avoid heavy alcohol when taking vardenafil, as alcohol can lower blood pressure further and make erectile dysfunction worse [1]. Grapefruit juice can increase vardenafil levels in the blood, so it is best avoided or limited.
Monitor your blood pressure at home if you have a monitor, especially in the first few weeks of using vardenafil. If your blood pressure drops significantly or you feel unwell, seek advice. Remember that vardenafil only works with sexual stimulation—it is not an aphrodisiac and will not cause an erection on its own. If vardenafil does not work for you, speak to your prescriber; they may adjust the dose or suggest an alternative PDE5 inhibitor such as sildenafil or tadalafil [2].
When to seek help
Seek urgent medical help if you experience an erection lasting more than four hours (priapism), sudden loss of vision or hearing, or chest pain during or after sexual activity. These are rare but serious side effects that require immediate attention [5]. If you feel very dizzy, faint, or unwell after taking vardenafil, especially in the first few times, contact your GP or call NHS 111 for advice. Do not take another dose until you have spoken to a healthcare professional.
Check your blood pressure
If you have a home blood pressure monitor, check your readings regularly when starting vardenafil with telmisartan. If your blood pressure drops significantly or you feel unwell, contact your GP or prescriber for advice.
Can vardenafil and telmisartan affect erectile dysfunction differently?
Interestingly, high blood pressure itself is a common cause of erectile dysfunction, because it can damage blood vessels and reduce blood flow to the penis over time [1][10]. By controlling your blood pressure with telmisartan, you may actually be helping to protect your erectile function in the long term. However, some blood pressure medicines (particularly older types such as beta-blockers and thiazide diuretics) can sometimes contribute to ED as a side effect. Telmisartan, an ARB, is generally considered to have a neutral or even slightly positive effect on erectile function compared to some other blood pressure medicines.
Vardenafil works by enhancing the natural erectile response when you are sexually aroused, so it addresses the immediate symptom of ED rather than the underlying cause [5]. If your ED is related to reduced blood flow due to high blood pressure or other cardiovascular risk factors, treating those underlying conditions with medicines like telmisartan—alongside lifestyle changes such as exercise, healthy eating, and stopping smoking—can improve your overall sexual health [1][2]. Vardenafil then provides additional support when needed.
It is worth noting that erectile dysfunction can be an early warning sign of heart disease or diabetes, so if you have new or worsening ED, it is important to see your GP for a full assessment [1]. They can check for underlying conditions and ensure your blood pressure and cardiovascular health are well managed. Treating ED is not just about improving your sex life; it is also about looking after your overall health.
Other ED treatments and telmisartan: what are the alternatives?
If vardenafil is not suitable for you, or if you would like to try a different option, there are several other PDE5 inhibitors available that also interact with telmisartan in a similar way. Sildenafil (generic Viagra) is the most well-known, taken about one hour before sex and effective for around four to six hours [3]. Tadalafil (generic Cialis) has a longer duration of action—up to 36 hours—so it offers more spontaneity; it can also be taken daily at a lower dose [4]. Avanafil (Spedra) is the fastest-acting, working in as little as 15 to 30 minutes [6][11].
All PDE5 inhibitors work in a similar way and have the same potential to lower blood pressure when combined with telmisartan, so the same precautions apply [3][4][5][6]. Your prescriber will help you choose the most suitable option based on your preferences, lifestyle, and how quickly you want the medicine to work. Some men prefer the flexibility of tadalafil's long duration, while others like the rapid onset of avanafil. At Cured Pharmacy, all these options are available after a clinical consultation reviewed by a UK prescriber.
If PDE5 inhibitors are not suitable or effective for you, other treatments for ED include alprostadil (available as a cream applied to the penis or as an injection) and vacuum erection devices [7]. Lifestyle changes—such as losing weight, exercising regularly, reducing alcohol, and stopping smoking—can also make a significant difference [1][2]. Your GP or a specialist can discuss all the options with you and tailor a treatment plan to your individual needs.
Comparing ED medicines with telmisartan
When choosing an ED medicine to use alongside telmisartan, consider factors such as how quickly you want it to work, how long the effect lasts, and how often you plan to have sex. Sildenafil and vardenafil are taken on-demand and last for a few hours, while tadalafil can be taken on-demand (lasting up to 36 hours) or daily at a lower dose for continuous readiness [3][4][5]. Avanafil offers the fastest onset if spontaneity is important [6]. All require a prescription and a consultation to ensure they are safe with your blood pressure medicine. Cured Pharmacy offers a straightforward online consultation, and your treatment can be delivered discreetly to your door.
When to get urgent help
- Erection lasting more than 4 hours (priapism)—go to A&E immediately
- Sudden loss of vision or hearing—seek urgent medical help
- Chest pain during or after sexual activity—call 999
- Severe dizziness, fainting, or feeling very unwell after taking vardenafil—contact your GP or call NHS 111
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 4 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 4 November 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 4 November 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 4 November 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 4 November 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 4 November 2026]
- Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54–61. https://pubmed.ncbi.nlm.nih.gov/8254833/ [accessed 4 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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Your Questions Answered
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Can I take vardenafil if I am on telmisartan for high blood pressure?
Yes, in most cases vardenafil can be taken safely with telmisartan, provided your blood pressure is well controlled and your prescriber has reviewed your medical history. Both medicines can lower blood pressure, so careful monitoring is needed.
Will vardenafil and telmisartan together make my blood pressure too low?
There is a potential for an additive blood pressure-lowering effect, but for most men this is manageable and not dangerous. Your prescriber will check your blood pressure is stable and may start you on a lower dose of vardenafil to minimise the risk of dizziness.
Do I need to stop telmisartan before taking vardenafil?
No, you should continue taking telmisartan as prescribed by your GP. Do not stop or change your blood pressure medicine without medical advice, as this could cause your blood pressure to rise.
What should I do if I feel dizzy after taking vardenafil with telmisartan?
Sit or lie down until the dizziness passes, and avoid standing up quickly. If dizziness is severe or persistent, contact your GP or the prescriber who issued your vardenafil prescription for advice.
Are there any blood pressure medicines I cannot take with vardenafil?
Yes, you must never take vardenafil with nitrate medicines (such as GTN spray, isosorbide mononitrate or dinitrate) or nicorandil, as this can cause a dangerous drop in blood pressure. Alpha-blockers require extra caution and a lower starting dose of vardenafil.
Can I drink alcohol while taking vardenafil and telmisartan?
It is best to limit alcohol, as it can lower blood pressure further and make erectile dysfunction worse. Heavy drinking should be avoided when taking vardenafil.
How long does vardenafil last, and how often can I take it with telmisartan?
Vardenafil typically works for around four to five hours and should be taken no more than once in 24 hours. The same dosing rules apply whether or not you are taking telmisartan.
What if vardenafil does not work for me while I am on telmisartan?
Speak to your prescriber; they may adjust the dose or suggest trying a different PDE5 inhibitor such as sildenafil, tadalafil, or avanafil. All work in a similar way but some men respond better to one than another.
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Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)