Drug interactions
Sildenafil + Verapamil
Severity: Moderate
Sildenafil and Verapamil: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Verapamil moderately inhibits CYP3A4 and also lowers blood pressure, so it may raise sildenafil levels and add to hypotension. Dizziness or symptomatic hypotension may occur.
What this interaction means in plain words
Sildenafil and Verapamil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Sildenafil belongs to Genitourinary; Verapamil belongs to Cardiovascular.
Why it happens
CYP3A4 inhibition reduces sildenafil clearance, combined with additive vasodilation.
What to do
Consider starting sildenafil at 25 mg and monitor blood pressure. Counsel the patient about orthostatic symptoms.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Sildenafil
- Amyl nitrite + Sildenafil Contraindicated
- Atazanavir + Sildenafil Contraindicated
- Cobicistat + Sildenafil Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Sildenafil Contraindicated
- Glyceryl trinitrate pr + Sildenafil Contraindicated
- Isosorbide dinitrate + Sildenafil Contraindicated
Other interactions of Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Sildenafil with Verapamil?
MediHelp rates the interaction as moderate. Sildenafil and Verapamil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Verapamil moderately inhibits CYP3A4 and also lowers blood pressure, so it may raise sildenafil levels and add to hypotension. Dizziness or symptomatic hypotension may occur.
How serious is the interaction between Sildenafil and Verapamil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider starting sildenafil at 25 mg and monitor blood pressure. Counsel the patient about orthostatic symptoms.
What other medicines interact with Sildenafil?
MediHelp also lists interactions of Sildenafil with, for example, Amyl nitrite, Atazanavir, Cobicistat. The full list is on the Sildenafil page.
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