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Drugs that may cause erection problems

Impotence caused by medicines; Drug-induced erectile dysfunction; Prescription medicines and impotence

Information

Many medicines and recreational drugs can affect a man's sexual arousal and sexual performance. What causes erection problems in one man may not affect another man.

Talk to your health care provider if you think that a drug is having a negative effect on your sexual performance. Never stop taking any medicine without first talking to your provider. Some medicines may lead to life-threatening reactions if you do not take care when stopping or changing them.

The following is a list of some medicines and drugs that may cause erectile dysfunction (ED) in men. There may be additional drugs other than those on this list that can cause erection difficulties.

Antidepressants and other medicines for mental health conditions:

• Amitriptyline (Elavil)
• Amoxapine (Asendin)
• Buspirone (Buspar)
• Chlordiazepoxide (Librium)
• Chlorpromazine (Thorazine)
• Clomipramine (Anafranil)
• Clorazepate (Tranxene)
• Desipramine (Norpramin)
• Diazepam (Valium)
• Doxepin (Sinequan)
• Fluoxetine (Prozac)
• Fluphenazine (Prolixin)
• Imipramine (Tofranil)
• Isocarboxazid (Marplan)
• Lorazepam (Ativan)
• Meprobamate (Equanil)
• Mesoridazine (Serentil)
• Nortriptyline (Pamelor)
• Oxazepam (Serax)
• Phenelzine (Nardil)
• Phenytoin (Dilantin)
• Sertraline (Zoloft)
• Thioridazine (Mellaril)
• Thiothixene (Navane)
• Tranylcypromine (Parnate)
• Trifluoperazine (Stelazine)

Antihistamine medicines (certain classes of antihistamines are also used to treat heartburn):

• Cimetidine (Tagamet)
• Dimenhydrinate (Dramamine)
• Diphenhydramine (Benadryl)
• Hydroxyzine (Vistaril)
• Meclizine (Antivert)
• Nizatidine (Axid)
• Promethazine (Phenergan)
• Ranitidine (Zantac)

High blood pressure medicines and diuretics (water pills):

• Atenolol (Tenormin)
• Bethanidine
• Bumetanide (Bumex)
• Captopril (Capoten)
• Chlorothiazide (Diuril)
• Chlorthalidone (Hygroton)
• Clonidine (Catapres)
• Enalapril (Vasotec)
• Furosemide (Lasix)
• Guanabenz (Wytensin)
• Guanethidine (Ismelin)
• Guanfacine (Tenex)
• Haloperidol (Haldol)
• Hydralazine (Apresoline)
• Hydrochlorothiazide (Esidrix)
• Labetalol (Normodyne)
• Methyldopa (Aldomet)
• Metoprolol (Lopressor)
• Nifedipine (Adalat, Procardia)
• Phenoxybenzamine (Dibenzyline)
• Phentolamine (Regitine)
• Prazosin (Minipress)
• Propranolol (Inderal)
• Reserpine (Serpasil)
• Spironolactone (Aldactone)
• Triamterene (Maxzide)
• Verapamil (Calan)

Thiazides are the most common cause of erectile dysfunction among the high blood pressure medicines. The next most common cause is beta blockers. Alpha blockers tend to be less likely to cause this problem.

Parkinson disease medicines:

• Benztropine (Cogentin)
• Biperiden (Akineton)
• Bromocriptine (Parlodel)
• Levodopa (Sinemet)
• Procyclidine (Kemadrin)
• Trihexyphenidyl (Artane)

Chemotherapy and hormonal medicines:

• Antiandrogens (Casodex, Flutamide, Nilutamide)
• Busulfan (Myleran)
• Cyclophosphamide (Cytoxan)
• Ketoconazole
• LHRH agonists (Lupron, Zoladex)
• LHRH antagonist (Firmagon)

Other medicines:

• Aminocaproic acid (Amicar)
• Atropine
• Clofibrate (Atromid-S)
• Cyclobenzaprine (Flexeril)
• Cyproterone
• Digoxin (Lanoxin)
• Disopyramide (Norpace)
• Dutasteride (Avodart)
• Estrogen
• Finasteride (Propecia, Proscar)
• Furazolidone (Furoxone)
• H2 blockers (Tagamet, Zantac, Pepcid)
• Indomethacin (Indocin)
• Lipid-lowering agents
• Licorice
• Metoclopramide (Reglan)
• Nonsteroidal anti-inflammatory drugs (NSAIDs, ibuprofen, etc.)
• Orphenadrine (Norflex)
• Prochlorperazine (Compazine)
• Pseudoephedrine (Sudafed)
• Sumatriptan (Imitrex)

Opiate analgesics (painkillers):

• Codeine
• Fentanyl (Innovar)
• Hydromorphone (Dilaudid)
• Meperidine (Demerol)
• Methadone
• Morphine
• Oxycodone (Oxycontin, Percodan)

Recreational drugs:

• Alcohol
• Amphetamines
• Barbiturates
• Cocaine
• Marijuana
• Heroin and other opioids
• Nicotine

References

Burnett AL, Ramasamy R. Evaluation and management of erectile dysfunction. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 69.

Liu JL, Bivalacqua TJ. Erectile dysfunction. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 191.

Waller DG. Erectile dysfunction. In: Waller DG, ed. Medical Pharmacology and Therapeutics. 6th ed.  Philadelphia, PA: Elsevier Limited; 2022:chap 16.

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Review Date: 1/1/2023  

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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