Vardenafil and Amitriptyline: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amitriptyline
Vardenafil
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
You've been prescribed amitriptyline (a medicine often used for depression, nerve pain, or sleep) and vardenafil (Levitra or Staxyn, used for erectile dysfunction). Here's the thing: both of these can slightly affect your heart's electrical rhythm, a change doctors call QT prolongation. When you take them together, those effects can add up and, in rare cases, lead to an irregular heartbeat.
This concern is mostly theoretical, meaning it's based on how the drugs work rather than lots of real-world reports. Still, it's worth taking seriously. Please don't stop either medicine on your own. Reach out to your pharmacist or doctor so they can look at your heart health and decide the safest plan for you.
Effect: Additive risk of QT interval prolongation with concomitant amitriptyline and vardenafil.
Mechanism: Both agents independently prolong the QT interval; combined use produces additive pharmacodynamic effect on cardiac repolarization. Neither is a prodrug in a way that alters this direction.
- Direction: Increased cumulative QT effect (PD interaction, not PK).
- Onset: Unspecified.
- Evidence: Theoretical.
- Severity: Major.
- Management: Avoid concomitant use where possible. If unavoidable, assess baseline ECG/QTc, correct electrolytes (K+, Mg2+), review other QT-prolonging drugs, and monitor.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
QT interval prolongation has been reported with each of these agents, amitriptyline and vardenafil31. Because their combined use may produce additive QT interval prolongation, taking amitriptyline together with vardenafil should be avoided2.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
The documented guidance is to avoid using amitriptyline and vardenafil together when possible, because their effects on heart rhythm can add up.
- Keep taking both as prescribed for now, and don't stop either one on your own.
- Ask your pharmacist or prescriber whether an alternative medication for either condition might be a safer fit for you.
- Let your care team know if you have a history of heart rhythm problems or take other medicines that affect the heart.
- Your team may check an ECG or monitor you more closely if both are needed.
- Seek prompt care for fainting, palpitations, or a racing/irregular heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a single-dose, double-blind, randomized, placebo- and active-controlled crossover trial, 59 male patients who received vardenafil 10 mg (therapeutic), vardenafil 80 mg (supratherapeutic), or moxifloxacin 400 mg showed comparable increases in QTc interval measured one hour following dosing. After single-dose administration, the placebo-subtracted mean change from baseline QT (uncorrected) was 3 msec (90% confidence interval [CI]: 1, 5) for moxifloxacin 400 mg and -2 msec (90% CI: -4, 0) for both vardenafil 10 mg and 80 mg. The mean change from baseline using Fridericia QT correction was 10 msec (90% CI: 8, 11) for vardenafil 80 mg, and 8 msec (90% CI: 6, 9) for both vardenafil 10 mg and moxifloxacin. Using individual QT correction, the mean change from baseline was 4 msec (90% CI: 3, 6) for vardenafil 10 mg, 6 msec (90% CI: 4, 7) for vardenafil 80 mg, and 7 msec (90% CI: 5, 8) for moxifloxacin. Compared with placebo, the mean increases in heart rate with vardenafil 10 mg and 80 mg were 5 and 6 beats per minute, respectively 12.
Common questions
Can I take Vardenafil and Amitriptyline together?
Amitriptyline and vardenafil can both affect your heart rhythm, and combining them may add up, so ask your pharmacist or doctor whether this combination is right for you or if a safer alternative exists. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Vardenafil and Amitriptyline interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Vardenafil and Amitriptyline interaction managed?
The documented guidance is to avoid using amitriptyline and vardenafil together when possible, because their effects on heart rhythm can add up. Keep taking both as prescribed for now, and don't stop either one on your own. Ask your pharmacist or prescriber whether an alternative medication for either condition might be a safer fit for you. Let your care team know if you have a history of heart rh… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Vardenafil or Amitriptyline need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: LEVITRA(R) oral tablets, vardenafil HCl oral tablets. Bayer Health Care Pharmaceuticals Inc (per FDA), Whippany, NJ, 2023. DailyMed
- Product Information: STAXYN(R) oral disintegrating tablets, vardenafil HCl oral disintegrating tablets. GlaxoSmithKline (per FDA), Research Triangle Park, NC, 2023. DailyMed
- Product Information: amitriptyline HCl oral tablet, amitriptyline HCl oral tablet. RemedyRepack Inc. (per DailyMed), Indiana, PA, 2010. DailyMed
Keep reading about Amitriptyline
Keep reading about Vardenafil
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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