Which medications can cause erection problems?
| Therapy area | Drug class or drug | Impact on ED |
|---|---|---|
| Cardiovascular | ||
| Cardiovascular | Diuretics | Not determined, but believed to interfere with smooth muscle relaxation |
| ACE and ARB inhibitors | Interferes with smooth muscle relaxation | |
| Aldosterone antagonists | An anti-adrenergic action | |
| Beta-blockers | Affects sex hormones, impairs vasodilation of the corpora cavernosa | |
| Clonidine | Depresses adrenergic output | |
| Psychotropic | ||
| Psychotropic | Anti-depressants, e.g. selective seretonin reuptake inhibitors, tricyclics, monoamine oxidase inhibitors, lithium | Decreases arousal and desire |
| Anti-psychotics, e.g. phenothiazines, butyrophenones | Increases prolactin levels | |
| Anti-epileptics | ||
| Anti-epileptics | Carbamazepine Phenytoin Barbiturates |
Affects sex hormone levels |
| Endocrine drugs | ||
| Endocrine drugs | Testosterone antagonists/ oestrogen agonists Anabolic steroids Luteinising hormone-releasing hormone analogues |
Affects androgen receptors, reducing sexual desire |
| Recreational drugs | ||
| Recreational drugs | Alcohol, heroin, cocaine, marijuana, methadone | |
| Other | ||
| Other | H2 antagonists, ranitidine and cimetidine | Increases prolactin levels, reducing sexual desires |
| Cytotoxics, e.g. cyclophosphamide | The effect of nausea and general malaise associated with such drugs often diminish libido | |
The link between EPs and cardio-metabolic disease
The onset of EPs in men can be an early warning sign of underlying cardiovascular and metabolic conditions, including coronary artery disease and diabetes. EPs in men can be associated with a significantly increased risk of future cardiac events.
Studies have shown that EPs can be an early marker of undiagnosed diabetes, especially in middle-aged men.2
With increasing rates of obesity and diabetes in younger men, [reference to be added] pharmacists can play an essential role in the early detection of cardio-metabolic risk factors among those presenting to the pharmacy with concerns about EPs.
It is important that all men with EPs are advised to consult their doctor within six months of receiving Viagra Connect, for a clinical review of potential underlying conditions and risk factors associated with EPs.