A PDE5 inhibitor for erectile dysfunction
Vardenafil
A PDE5 inhibitor taken before sex to help achieve an erection; it must never be combined with nitrates or GTN.
What is Vardenafil?
Vardenafil is a PDE5 inhibitor used to treat erectile dysfunction by improving blood flow to the penis when you are sexually aroused. It is taken before sexual activity and must never be combined with nitrate medicines or GTN, as the combination can cause a dangerous drop in blood pressure. It needs sexual stimulation to work.
Education and reference only. This is a plain-language guide to Vardenafil — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Vardenafil is a PDE5 inhibitor used in the UK to treat erectile dysfunction (difficulty getting or keeping an erection). It belongs to the same family as sildenafil and tadalafil and is taken before sexual activity rather than every day. It works only when you are sexually aroused, helping to achieve and maintain an erection; it does not increase desire and is not an aphrodisiac. It is available as ordinary tablets and as a tablet that melts on the tongue.
How it works
When you are sexually aroused, the body releases signals that relax the blood vessels in the penis and increase blood flow, producing an erection. Vardenafil blocks an enzyme called PDE5, which would otherwise break down the chemical messenger (cyclic GMP) responsible for this relaxation. By preventing that breakdown, vardenafil enhances and prolongs the natural blood-flow response, making it easier to get and keep an erection — but only when arousal is present. The same blood-vessel-relaxing effect is why it can dangerously lower blood pressure if combined with nitrates.
Company & origin
Originated / developed by: Developed by Bayer..
Vardenafil was developed by Bayer and introduced in the early 2000s for erectile dysfunction.
What it treats
Conditions Vardenafil is used for
Practical use
How to take Vardenafil
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it before planned sexual activity — it works only when you are sexually aroused, not on its own.
- Never take it with nitrate medicines or GTN sprays or tablets, as this can cause a dangerous drop in blood pressure.
- Tell your prescriber if you take an alpha-blocker (for blood pressure or prostate symptoms), as caution and spacing of doses may be needed.
- Be aware that a heavy, high-fat meal can delay how quickly it starts to work.
- Do not take more than the prescribed amount in a day, and do not combine it with other erectile-dysfunction medicines.
- Seek urgent help if an erection is painful or lasts for several hours, or if you get chest pain or sudden vision or hearing changes.
Weighing it up
Advantages & disadvantages of Vardenafil
Advantages
- Effective at helping achieve and maintain an erection when aroused.
- Taken on demand before sex rather than every day.
- Available as an ordinary tablet and as a tablet that melts on the tongue.
Disadvantages
- Must never be combined with nitrates or GTN because of a dangerous blood-pressure drop.
- Needs sexual stimulation to work and does not increase desire.
- Commonly causes headache, flushing, a blocked nose and indigestion.
- A heavy meal can delay its onset, and it needs caution with alpha-blockers.
Practical use
Good to know
It is taken before planned sexual activity and works only with sexual stimulation. It must never be taken with nitrate medicines (for angina) or GTN sprays/tablets, as the combination can cause a sudden, dangerous fall in blood pressure. It is used with caution with alpha-blockers (often prescribed for blood pressure or prostate symptoms), which can also lower blood pressure. A heavy or high-fat meal can delay how quickly it starts to work. Common side effects include headache, flushing, a blocked nose and indigestion. Rarely, an erection can last too long (priapism) — if an erection lasts several hours, seek urgent medical help, as a prolonged erection can damage the penis.
Who should not take it / use with caution
- Anyone taking nitrate medicines or GTN for angina, where the combination can cause a dangerous fall in blood pressure.
- Avoided in people with the inherited heart-rhythm problem long QT syndrome, or taking medicines that affect the heart's QT rhythm (including certain anti-arrhythmic and other drugs), because vardenafil can add to this.
- People for whom sexual activity is inadvisable on heart grounds, those who have recently had a heart attack or stroke, and those with very low or poorly controlled blood pressure.
- Used with caution with alpha-blockers, in significant liver or kidney impairment, certain inherited eye conditions, and in people with conditions that predispose to prolonged erections.
Monitoring
- Assessment of heart health and suitability for sexual activity before starting.
- Review of all medicines, particularly nitrates and alpha-blockers.
- Checking whether it is working and tolerated, and following up underlying causes of erectile dysfunction.
Side effects
- Headache, facial flushing and a blocked or runny nose.
- Indigestion and dizziness.
- Visual disturbances and, occasionally, back or muscle aches.
- Rare but serious: a prolonged, painful erection (priapism), or sudden changes in vision or hearing — both need urgent help.
Key interactions
- Nitrates and GTN — never combine; the result can be a dangerous fall in blood pressure.
- Alpha-blockers and other blood-pressure-lowering medicines — added lowering of blood pressure, so caution and spacing may be needed.
- Some medicines that strongly affect liver enzymes (certain antifungals, antibiotics and HIV medicines) can raise its levels; tell your pharmacist about all your medicines.
Available as: Available as tablets and as a tablet that melts on the tongue.
Answers
Vardenafil: frequently asked questions
Can I take vardenafil with my angina spray?
No. Vardenafil must never be combined with nitrates or GTN sprays or tablets, as together they can cause a dangerous drop in blood pressure. Tell your prescriber if you use these.
Does vardenafil work on its own?
No. It works only when you are sexually aroused. It improves blood flow in response to stimulation but does not increase desire or cause an automatic erection.
Does food affect vardenafil?
A heavy or high-fat meal can delay how quickly it starts to work. A lighter meal beforehand can help it act more predictably.
What if my erection lasts too long?
A prolonged erection (priapism) is rare but serious. If an erection lasts several hours or is painful, seek urgent medical help, as it can damage the penis.
Can I take it with my blood-pressure tablets?
Often yes, but with caution, especially with alpha-blockers, as the combination can lower blood pressure further. Your prescriber will check your other medicines first.
The wider class
About PDE5 inhibitors
Vardenafil belongs to the pde5 inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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