Quick Summary
Vardenafil can interact with certain medications and substances, which may increase side effects or reduce safety. The most important interactions involve nitrates, alpha-blockers, and strong CYP3A4 inhibitors.
- High-risk: nitrates (dangerous blood pressure drop)
- Moderate risk: alpha-blockers, antihypertensives
- Other: alcohol, grapefruit, CYP3A4 inhibitors
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Danger Never Combine With Nitrates
Vardenafil must NOT be taken with nitrate medications used for chest pain (angina). This combination can cause a severe and potentially life-threatening drop in blood pressure.
- Nitroglycerin
- Isosorbide dinitrate
- Isosorbide mononitrate
Caution Alpha-Blockers & Blood Pressure Drugs
- Doxazosin
- Tamsulosin
- Other antihypertensives
Combining may increase risk of dizziness or low blood pressure. Dose adjustment is often required.
Other Drug Interactions
- CYP3A4 inhibitors: ketoconazole, ritonavir (increase vardenafil levels)
- Antibiotics: erythromycin (may increase effect)
- Other PDE5 inhibitors: do not combine
Food & Alcohol Interactions
- High-fat meals may delay absorption
- Alcohol increases risk of dizziness and low blood pressure
- Grapefruit juice may increase drug levels
See how vardenafil compares with sildenafil and tadalafil.
How to Reduce Interaction Risks
- Tell your doctor all medications you use
- Avoid nitrates completely
- Limit alcohol intake
- Start with lower dose if at risk
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