Common Medications That Cause ED

Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

Medications

One reason erectile dysfunction becomes more common with age is that older men are more likely to be on medication. Indeed, it's been estimated that 25% of all erectile dysfunction is a side effect of medication.

Many drugs can produce erectile difficulties, especially antihypertensives, antidepressants, and tranquilizers, as well as the prostate drug finasteride. Propecia, a low-dose preparation of finasteride used to counteract baldness, is reported to cause erectile dysfunction in 1.3% of men. According to a 2006 study of Finnish men ages 50 to 70, even familiar painkillers like aspirin, naproxen, and ibuprofen (part of a group of medications known as nonsteroidal anti-inflammatory drugs) or acetaminophen may make it harder for some men to have and maintain erections sufficient for intercourse. The researchers found that men who regularly took these drugs to ease pain from joint disorders were more likely than nonusers to have ED. However, these findings are controversial, and many men are able to take these medications with no such side effects.

Not all drugs are equally problematic. Among the blood pressure medications, for example, erectile dysfunction is an occasional side effect of thiazide diuretics, loop diuretics, and beta blockers, but rarely results from use of alpha blockers, ACE inhibitors, and angiotensin-receptor blockers (see Table 1).

When you see a doctor about erectile dysfunction, it's important that you report all prescription and over-the-counter medications that you take on a regular basis. If your doctor suspects that a medication is to blame, he or she may be able to substitute another one. It can take anywhere from several days to several weeks after stopping a medication for erections to return.

Table 1: Medications that can cause erectile dysfunction

Type of medication

Some examples

Medications more likely to cause ED:

Antidepressants

sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), fluoxetine (Prozac), amitriptyline (Elavil), and many others

Antifungals

ketoconazole (Nizoral), itraconazole (Sporanox), amphotericin B lipid complex injection (Abelcet)

Anti-ulcer drugs

cimetidine (Tagamet), famotidine (Pepcid), ranitidine hydrochloride (Zantac)

Beta blockers

propranolol (Inderal), timolol (Blocadren), penbutolol (Levatol)

Diuretics

chlorothiazide (Diuril), spironolactone (Aldactone), chlorthalidone (Thalitone)

Tranquilizers

diazepam (Valium), thioridazine (Mellaril), chlordiazepoxide (Librium)

Miscellaneous

finasteride (Proscar, Propecia), estrogens, anti-androgens, antihistamines, anticholinergics, some anticancer drugs

Medications less likely to cause ED:

ACE inhibitors

captopril (Capoten), enalapril (Vasotec), ramipril (Altace)

Calcium-channel blockers

diltiazem (Cardizem), nifedipine (Procardia), verapamil (Verelan)

Cholesterol-lowering drugs

niacin, lovastatin (Mevacor), simvastatin (Zocor)

Nitrates

isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo)

Copyright: Harvard Health Publications

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Erectile dysfunction is a normal part of aging.