Medications That May Cause Erectile Dysfunction

Many Drugs Carry This Side Effect

Man putting medication into pill organizer
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Sexual dysfunction, which includes problems getting and maintaining an erection, decreased libido, delayed ejaculation, and lack of orgasm, is a common adverse effect of many prescription and over-the-counter medications. Certain medications can increase your risk of erectile dysfunction by interfering with your nerve impulses or the flow of blood to your penis.

Erectile dysfunction is one of the main reasons why men being treated for conditions such as high blood pressure and depression stop taking their medications.

Between 10 percent and 25 percent of erectile dysfunction that's experienced by American men is caused by medications.

Is Your Erectile Dysfunction Caused by a Medication?

There are a variety of medications that can cause erectile dysfunction. The list of possible drugs is long, and your medication may not be included in this list that follows. If you think that your erectile dysfunction may be due to your medication, check with your physician.

Medications That Often Cause the Problem

  • Cancer chemotherapies such as Myleran (busulfan) and Cytoxan (cyclophosphamide)
  • Many high blood pressure medications, particularly diuretics such as HydroDIURIL (hydrochlorothiazide) and beta-blockers such as Inderal (propranolol)
  • Most medications that are used to treat psychiatric conditions, including anti-anxiety drugs such as Paxil (paroxetine), antidepressants such as Zoloft (sertraline), and anti-schizophrenia drugs such as Seroquel (quetiapine)
  • Tranquilizers such as Valium (diazepam)
  • Hormonal medications that are used to treat prostate cancer, such as Eulexin (flutamide) and Lupron (leuprolide)
  • Propecia (finasteride) that's used to treat an enlarged prostate (BPH) and certain types of male hair loss

Medications That Sometimes Can Be Blamed

  • Histamine H2-receptor antagonists that are used to treat ulcers, such as Tagamet (cimetidine) and Zantac (ranitidine)
  • Antihistamines that are used to treat allergies, such as Benadryl (diphenhydramine) and Vistaril (hydroxyzine)
  • Antibiotics that are used to treat fungal infections of the skin, such as Nizoral (ketoconazole)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) that are used to treat pain, such as Naprosyn (naproxen) when taken frequently

Recreational Drugs That Can Trigger It

  • Alcohol
  • Amphetamines such as Dexedrine (dextroamphetamine)
  • Barbiturates such as Phenobarbital
  • Cocaine
  • Marijuana
  • Methadone
  • Nicotine from smoking and smokeless tobacco
  • Opiates such as heroin and OxyContin

Over time, illegal and recreational drugs can cause serious damage to your blood vessels, and hence result in permanent erectile dysfunction.

What to Do If a Medication Is Causing Erectile Dysfunction

If you develop erectile dysfunction shortly after starting a new drug, the drug is most likely the cause of your problem. In some cases, erectile dysfunction may not occur until you have taken a drug for several months.

If you have erectile dysfunction and think that it may be due to a medication that you are taking, do not stop taking the medication abruptly without first seeking advice from your physician. (This cessation could cause the condition that's being treated to return and could result in serious health problems.) If your physician determines that your erectile dysfunction is related to your medication, he or she may recommend one or more of the following options.

  • Lower the dose of your medication. Erectile dysfunction may be related to the dose of the medication that you are taking. A lower dose may continue to help treat your health condition (such as high blood pressure or depression) but relieve your erectile dysfunction.
  • Switch to a different medication. Changing your medication may also change the sexual adverse effects. You may have to go through a period of trial and error. For example, if you are being treated for depression with Paxil (paroxetine), your physician may switch you to Lexapro (Escitalopram), a similar medication that may have fewer sexual side effects.
  • Stop using tobacco products and recreational or illegal drugs. Avoiding these substances will often resolve your erectile dysfunction. It may take time, however. Your physician can refer you to a smoking cessation program and, if needed, outpatient or inpatient rehabilitation to help you deal with addiction. A 12-step program such as Alcoholics Anonymous can help you manage your alcoholism
  • Take another medication to treat your erectile dysfunction. In some cases, it may not be possible to change medications without interfering with the treatment of a serious chronic illness. If it is safe for you, your physician may recommend that you take an additional medication such as Cialis (tadalafil), Levitra (vardenafil), or Viagra (sildenafil) to improve your sexual function. If you cannot use one of those oral medications, your physician may recommend Caverject (Alprostadil), a hormone that's injected into the penis using a fine needle, or Muse (Alprostadil), a tiny suppository that's inserted into the tip of the penis. Non-drug treatment options include vacuum pump devices, penile prosthesis, and penile implants.

What to Expect Next

After making one or more of the changes above, you can expect normal erections to return within a few weeks. If your problem continues, then your erectile dysfunction may be due to another issue, and your physician may want to do further testing.

Remember: Although you may be embarrassed to talk about sexual problems with your doctor, he or she is trained to provide you with comfort and advice. Erectile dysfunction can be distressing for you and your partner—and it's not something that you have to live with forever. So don't hesitate to discuss it with your physician. 

Source:

Kloner, R. ”Erectile Dysfunction, and Hypertension.” International Journal of Impotence Research. 2007 19:296-302. August 6, 2008.

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