Does Vardenafil Lower Blood Pressure? What You Need to Know
Yes, vardenafil can cause a modest drop in blood pressure. In studies at the 20mg dose, the average maximum fall in systolic blood pressure was about 6.9mmHg. For most people the effect is mild and causes no noticeable problems.
If you already have low or high blood pressure, take blood pressure treatment, or use medicines such as nitrates or alpha blockers, it matters to know where real caution is needed.
This guide explains how vardenafil affects blood pressure and why, which symptoms can occur, when existing conditions need extra assessment, and when vardenafil should not be used at all.
Key things to know
- Vardenafil causes a modest, measurable drop in blood pressure
- This happens because its effect on blood vessels is not limited to the penis
- It must never be combined with nitrate medicines, because of the risk of a dangerous fall in blood pressure
- Alpha blockers also lower blood pressure, so combining them with vardenafil needs particular caution
- Vardenafil is not a treatment for high blood pressure
Why Vardenafil Affects Blood Pressure
Vardenafil is a PDE5 inhibitor. During sexual stimulation, nitric oxide raises levels of a messenger called cGMP, which relaxes smooth muscle and increases blood flow to the penis. PDE5 is also present in blood vessels elsewhere in the body, so vardenafil causes some wider widening of blood vessels, which lowers blood pressure slightly.
Is It Dangerous for Most People?
Generally not. In most people who have been properly assessed, the fall is mild and has no clinical effect. It becomes important when vardenafil is combined with certain medicines, or used by people with relevant heart or blood pressure conditions.
The response can also vary between people and between occasions. Alcohol and other things that affect blood pressure may influence how you feel after taking it.
Does the Dose Make a Difference?
The effect can vary with dose, which is one of the things a prescriber weighs, alongside effectiveness and side effects, when choosing your dose. The usual starting dose is 10mg, and 5mg may be more appropriate for some people.
Can It Treat High Blood Pressure?
No. Vardenafil is licensed for erectile dysfunction, not high blood pressure. Its effect on blood pressure is a side effect of how it works, not a treatment for hypertension.
Nitrates: An Absolute No
This is the most serious interaction involving vardenafil's effect on blood pressure.
Nitrate medicines, commonly used for angina, also widen blood vessels through a related pathway. Taking vardenafil with a nitrate means two blood-pressure-lowering effects compounding each other, which can cause a sudden, severe and dangerous fall.
If you take a nitrate medicine, amyl nitrite or nicorandil, vardenafil is not an option, regardless of anything else. This is an absolute rule, not a general caution.
Alpha Blockers
Alpha blockers are commonly prescribed for high blood pressure or benign prostatic hyperplasia, an enlarged prostate. They also lower blood pressure, so taking them with vardenafil can increase the risk of symptomatic low blood pressure.
This is not an absolute contraindication in the way nitrates are, but it is exactly the kind of interaction an assessment needs to know about, including the specific alpha blocker, its dose and formulation. A lower starting dose of vardenafil may be considered.
If You Already Have Low or High Blood Pressure
Tell your prescriber. Very low blood pressure is a reason vardenafil may not be suitable, since it can lower blood pressure further. Uncontrolled high blood pressure and certain heart conditions also need assessing before treatment.
Other Medicines That Matter
A proper assessment covers your current medicines and medical conditions, because that is how the interactions above are identified and managed safely.
Some medicines increase vardenafil levels by blocking an enzyme called CYP3A4, including certain antifungal and antibiotic medicines and some HIV medicines. Grapefruit juice can also increase vardenafil levels, so avoid it.
Symptoms to Know About
For most men, the modest drop in blood pressure is not noticeable. Some people who are more sensitive may feel mild dizziness, particularly when standing up quickly. That is a recognised and usually temporary effect.
Vardenafil also carries warnings about rare problems with vision and hearing. Blurred vision or changes in colour vision can occur. A sudden decrease or loss of vision in one or both eyes, or a sudden decrease or loss of hearing, needs urgent medical attention.
Seek urgent medical attention for chest pain, fainting, sudden changes in vision or hearing, or an erection lasting four hours or longer.
How This Compares With Other PDE5 Inhibitors
Sildenafil, tadalafil and avanafil can also cause modest falls in blood pressure, although the measured effects differ between medicines and studies. All of them carry the same important warnings about nitrates and blood-pressure-lowering medicines.
Vardenafil is used to treat erectile dysfunction, and whether it is safe for you depends on your blood pressure, heart health and other medicines, all of which an assessment covers.
Medical Disclaimer
This page provides general information about vardenafil and blood pressure. It does not provide personalised prescribing or dosing instructions. Treatment suitability depends on an individual clinical assessment, and individual response varies.
