Vardenafil and Tofacitinib: Can They Be Taken Together?

Vardenafil and Tofacitinib: Understanding the Interaction

Published: 5 November 2026

If you're prescribed vardenafil (generic Levitra) for erectile dysfunction and tofacitinib for conditions such as rheumatoid arthritis or ulcerative colitis, you may wonder whether vardenafil and tofacitinib can be taken together safely. The good news is that no major direct interaction between these two medicines is commonly reported in clinical practice [2][5]. However, every person's situation is unique, and your prescriber will review all your current medicines during your consultation to ensure the combination is appropriate for you.

What Is Vardenafil and How Does It Work?

Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in adult men [5]. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused [1][5]. Vardenafil does not cause an erection on its own—sexual stimulation is still needed for it to work.

In the UK, vardenafil is available in 5mg, 10mg, and 20mg tablets. It is usually taken about 25 to 60 minutes before sexual activity, and the effect can last for several hours [5]. You should not take vardenafil more than once a day. Common side effects include headache, flushing, indigestion, and nasal congestion, which are usually mild and temporary [5].

Vardenafil is only supplied after an online or face-to-face consultation with a UK-registered prescriber, who will check your medical history, current medicines, and overall health to ensure it is safe and suitable for you.

What Is Tofacitinib and What Is It Used For?

Tofacitinib is a prescription medicine known as a Janus kinase (JAK) inhibitor [12]. It is used to treat certain inflammatory conditions, including moderate to severe rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, and ankylosing spondylitis [12]. Tofacitinib works by reducing the activity of the immune system, which helps to control inflammation and relieve symptoms such as joint pain, swelling, and bowel inflammation.

Tofacitinib is usually taken as a tablet, either once or twice a day depending on the condition being treated and the dose prescribed [12]. Because it affects the immune system, tofacitinib can increase the risk of infections, and your doctor will monitor you regularly with blood tests. It is important not to stop or change your dose without medical advice, as this could cause your condition to flare up.

Tofacitinib does not directly affect erectile function, but chronic inflammatory conditions and their treatments can sometimes contribute to ED. If you have concerns about sexual health while taking tofacitinib, speak to your GP or specialist—they can help address both your underlying condition and any related issues.

Does Tofacitinib Cause Erectile Dysfunction?

Erectile dysfunction is not listed as a common side effect of tofacitinib [12]. However, living with a chronic inflammatory condition such as rheumatoid arthritis or ulcerative colitis can affect quality of life, energy levels, and mood, all of which may indirectly impact sexual function [1][2]. Pain, fatigue, and the psychological burden of long-term illness are recognised contributors to ED [10]. If you are experiencing ED, it is worth discussing with your doctor, as effective treatments are available and the underlying cause can often be addressed.

Vardenafil and Tofacitinib: Is There an Interaction?

No major direct interaction between vardenafil and tofacitinib is commonly reported in clinical practice or prescribing guidance [2][5]. These two medicines work through different mechanisms in the body: vardenafil acts on blood vessels in the penis to improve erectile function, while tofacitinib modulates the immune system to reduce inflammation. They are not known to interfere with each other's effectiveness or significantly increase the risk of side effects when taken together.

However, it is important to remember that every person's medical history is different. Your prescriber will review all your current medicines, including tofacitinib, during your consultation for vardenafil to ensure there are no individual concerns. For example, if you are taking other medicines alongside tofacitinib—such as blood pressure tablets or medicines that affect liver enzymes—these may need to be considered when prescribing vardenafil [2][5].

Always declare every medicine you are taking, including over-the-counter products and supplements, when you request a prescription for ED treatment. Do not stop or change any prescribed medicine, including tofacitinib, without advice from your doctor or specialist.

What Does Your Prescriber Check Before Prescribing Vardenafil?

Before prescribing vardenafil, your prescriber will carry out a thorough assessment to ensure it is safe and appropriate for you [2][5]. This includes reviewing your medical history, current medicines, and any conditions that might make vardenafil unsuitable. For example, vardenafil must not be taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers', as the combination can cause a dangerous drop in blood pressure [5].

Your prescriber will also check whether you are taking medicines that can interact with vardenafil, such as alpha-blockers (e.g. tamsulosin, doxazosin) or potent CYP3A4 inhibitors (e.g. ritonavir, ketoconazole, clarithromycin) [5]. Vardenafil is broken down in the liver by an enzyme called CYP3A4, and medicines that strongly inhibit this enzyme can raise vardenafil levels in the blood, increasing the risk of side effects. In such cases, vardenafil may be contraindicated or require dose adjustment [5].

If you have cardiovascular conditions, very low blood pressure, severe liver or kidney problems, or a history of sudden vision loss (non-arteritic anterior ischaemic optic neuropathy, or NAION), your prescriber will assess whether vardenafil is suitable [2][5]. Tofacitinib itself does not usually affect these checks, but your overall health picture—including your inflammatory condition and any other medicines—will be taken into account.

Starting Vardenafil While Taking Tofacitinib

If you are already taking tofacitinib and wish to start vardenafil for erectile dysfunction, the process is straightforward. During your consultation, you will be asked to list all your current medicines, including tofacitinib, and provide details about your medical history [2]. The prescriber will confirm that there are no contraindications and that vardenafil is appropriate for you. If approved, you will usually start on the lowest effective dose, which can be adjusted if needed. Always follow the dosing instructions provided and do not take vardenafil more than once a day [5].

Practical Advice for Taking Vardenafil and Tofacitinib Together

If you have been prescribed both vardenafil and tofacitinib, there is no need to separate the doses or take them at different times of day, as no direct interaction is expected. However, it is sensible to take each medicine as directed by your prescriber. Vardenafil is taken on demand, about 25 to 60 minutes before sexual activity, and should not be used more than once in 24 hours [5]. Tofacitinib is usually taken regularly, once or twice daily, as prescribed for your inflammatory condition [12].

Be mindful of factors that can affect how well vardenafil works. Heavy alcohol can worsen erectile dysfunction and add to the blood-pressure-lowering effect of vardenafil, increasing the risk of dizziness [5]. Grapefruit juice can raise vardenafil levels in the blood and should be avoided [5]. A high-fat meal may delay the absorption of vardenafil, so it may work more slowly if taken after a large meal.

If you experience any new or unusual symptoms after starting vardenafil—such as dizziness, chest pain, or visual disturbances—stop taking the medicine and seek medical advice promptly. If you develop an erection lasting more than four hours (priapism), sudden loss of vision or hearing, or chest pain during sexual activity, seek urgent medical help [5]. Continue taking tofacitinib as prescribed unless your doctor advises otherwise.

When to Seek Further Advice About Vardenafil and Tofacitinib

While no major interaction between vardenafil and tofacitinib is commonly reported, you should seek further advice if your health or medicines change. For example, if your doctor adds a new medicine to your treatment plan—such as an antibiotic, antifungal, or blood pressure tablet—let your prescriber know before taking vardenafil again, as some medicines can interact [2][5]. Similarly, if your dose of tofacitinib is changed or if you start a new treatment for your inflammatory condition, it is worth checking that vardenafil remains suitable.

If you experience side effects from either medicine, or if vardenafil does not seem to be working as expected, speak to your prescriber or pharmacist. Erectile dysfunction can sometimes be a sign of an underlying health issue, such as cardiovascular disease or diabetes, so it is important to see your GP if ED is new or worsening [1][2]. Your GP can investigate possible causes and ensure your overall health is being managed effectively.

Remember, you should never stop taking tofacitinib or any other prescribed medicine without medical advice, even if you are concerned about interactions. Your doctor or specialist can review your treatment plan and make any necessary adjustments safely. At Cured Pharmacy, our UK-registered prescribers are available to answer questions about ED treatment and medicine interactions during your online consultation.

Other ED Treatments Available

If vardenafil is not suitable for you, or if you would like to explore other options, several other PDE5 inhibitors are available in the UK [1][2]. These include sildenafil (generic Viagra), tadalafil (generic Cialis), and avanafil (Spedra), each with slightly different characteristics in terms of how quickly they work and how long they last [3][4][6]. Your prescriber can help you choose the most appropriate treatment based on your preferences, lifestyle, and medical history. All ED medicines require a consultation and are only supplied after a clinical assessment by a UK-registered prescriber.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 5 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 5 November 2026]
3. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 5 November 2026]
4. 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 5 November 2026]
5. Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 5 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.