Table of ContentsView AllTable of ContentsPrescription DrugsOTC DrugsRecreational DrugsOther DrugsED ManagementOther CausesFAQ
Table of ContentsView All
View All
Table of Contents
Prescription Drugs
OTC Drugs
Recreational Drugs
Other Drugs
ED Management
Other Causes
FAQ
Erectile dysfunction (ED)is often related to underlying health issues, but there are also prescription and non-prescription drugs that affect your ability to achieve and sustain anerection.
ED, previously known as impotence, affects 52% of males between the ages of 40 and 70.Among the medications that can contribute to ED are over-the-counter (OTC) decongestants and antihistamines as well as prescription medications used to treat high blood pressure, pain, depression, and more. Recreational drugs are also associated with ED.
This article offers a long list of prescription, OTC, and recreational drugs that can cause or contribute to erectile dysfunction. It also describes how to manage drug-induced ED and other causes of ED that you may or may not be aware of.
Verywell / Daniel Fishel
Causes and Risk Factors of Erectile Dysfunction
Prescription Drugs That Cause Erectile Dysfunction
There are five categories of prescription drugs that have an increased potential to cause ED, either on their own or in combination with other risk factors such as aging or diabetes.
Antidepressants and Other Psychiatric Drugs
The sexual side effects ofantidepressantsand other psychiatric drugs are well known. By altering levels of the “feel-good” hormoneserotonin, antidepressants can cause an imbalance of other hormones that regulate sexual function. These includetestosteronewhich influences sexual arousal and the ability to achieve an erection, anddopamine, which plays a role inorgasms.
Other types of psychiatric drugs can cause erection problems, includinganxiolytics(anti-anxiety drugs) andantipsychotics.
Psychiatric drugs that have the potential to cause ED include:
High Blood Pressure Medications
There are several classes of drugs used to treat hypertension, includingACE inhibitors,angiotensin receptor blockers (ARBs),beta-blockers,calcium channel blockers, anddiuretics(“water pills”).
The high blood pressure drugs most commonly linked to ED include:
How Hypertension and Erectile Dysfunction Are Linked
Chemotherapy and Anti-Cancer Drugs
There arechemotherapy drugsand other anti-cancer agents that can cause ED.
These include hormonal drugs used to slow the progression ofprostate cancer. These medications have anti-androgenic effects, meaning that they block the action of testosterone or lower testosterone. While this can slow the growth of a cancerous tumor, it can also lead to the loss of erectile function and fertility.
Among the drugs commonly linked to this are:
Opioid Drugs
Opioidsare powerful narcotic drugs used to treat pain. One of the common side effects of opioid drugs is ED. This is caused when the drug impairs signals between thetestes(testicles),pituitary gland, andhypothalamusof the brain. The blockage of communication can lead to a steep drop in testosterone and an increased risk of ED.
The opioids most commonly linked to ED include:
Parkinson’s Disease Drugs
By altering the action of theseneurotransmitters, the excitatory nerves in the penis may be impaired. At the same time, a lack of acetylcholine can prevent the dilation (widening) of blood vessels, making it difficult to achieve an erection.
The medications that can cause ED in people with Parkinson’s include:
Over-the-Counter Drugs That Cause Erectile Dysfunction
Several over-the-counter drugs can cause or contribute to erectile dysfunction. Chief among these areantihistamines.
These not only include antihistamines used specifically to treat allergies but also those classified asH2 blockersthat function asantacids. Antihistamines block the action ofhistamine, a chemical in the body that is involved both in allergic reactions and the regulation of stomach acid.
What many people do not realize is that histamine also helps relax smooth muscles, allowing the blood vessels in the penis to engorge. The overuse of antihistamines may lead to erection problems, particularly in those with other risk factors for ED.
OTC antihistamines and H2 blockers closely associated with ED include:
In addition to OTC antihistamines, prescription antihistamines like Phenergan (promethazine) and Vistaril (hydroxyzine) are also linked to ED.
Sudafed and Erectile Dysfunction
How to Cope With Erectile Dysfunction
Recreational Drugs That Cause Erectile Dysfunction
Recreational drugs, both legal and illegal, can cause erectile dysfunction in different ways. Some impair signals to and from the brain that facilitate erections. Others affect blood pressure or cause the narrowing of blood vessels, both of which restrict the flow of blood to the penis.
Recreational drugs that increase the risk of ED include:
Can Quitting Cigarettes Reverse Erectile Dysfunction?
Other Drugs That Cause Erectile Dysfunction
The National Institutes of Health lists other common and uncommon drugs linked to ED. These include prescription medications and certain supplements that can reduce testosterone levels when overused.
In addition to the above-listed drugs, there are other medications that can potentially cause erection problems, including:
What Causes Sudden Erectile Dysfunction?
There are times when medications (or medication doses) can be changed because of ED and others when they can’t. If medications are the cause of your ED, you need to speak with your healthcare provider to weigh the benefits and risks of changing treatment.
For instance, it may be reasonable to switch from a drug likePepcid (famotidine), used to treat acid reflux and GERD, to another class of drugs, likeNexium (esomeprazole), if you are struggling with ED. Changing may be less reasonable if you are managing cancer or a serious heart condition.
Depending on the medication you take—and when you started treatment—your healthcare provider may recommend:
However much ED may be worrying you,do notstop treatment or reduce the dose without first speaking with a healthcare provider. Doing so may undermine the goals of therapy (such as lowering your blood pressure) or cause severe withdrawal symptoms (such as can occur with opioids and antidepressants).
If you are drinking heavily or taking recreational drugs and cannot stop, ask your healthcare provider for a referral to a treatment center that can help.
Other Causes of Erectile Dysfunction
Erectile dysfunction is often multifactorial, meaning that many different things can contribute to your inability to achieve or sustain an erection. It is not uncommon, for instance, to have both a physiological andpsychological causeof ED—such as high blood pressure and anxiety—with one making the other worse.
Similarly, medications like antidepressants may be a major factor for your ED, but stopping them doesn’t necessarily mean that the ED will go away. Other factors may be at play.
Because of this, it is important to understand the risk factors for ED before deciding that a medication you are taking is the one-and-only cause.
Among the possible risk factors for ED are:
Summary
A wide variety of drugs can increase the risk of erectile dysfunction. Among prescription drugs, antidepressants, anxiolytics, antipsychotics, opioids, blood pressure medications, Parkinson’s disease medications, chemotherapy agents and hormonal medications may lead to ED.
OTC medications linked to ED include antihistamines, H2 blockers, and Sudafed. Recreational drugs that may increase the risk of ED include alcohol, amphetamines, barbiturates, cocaine, heroin, marijuana, and nicotine.
If you believe that medications are causing your ED, speak with a healthcare provider. Do not stop taking any prescribed medications without first speaking with your provider.
What Is Erectile Dysfunction?
Frequently Asked QuestionsThere is no evidence of this. Some antibiotics like erythromycin can slow the breakdown of the erectile dysfunction (ED) drugViagra (sildenafil), allowing the drug to accumulate and increasing the risk of side effects.The prolonged use of antibiotics can lead todelayed ejaculationin some people but not ED.PDE5 inhibitorsare a class of drugs used in the first-line treatment of erectile dysfunction. A 2013 review of studies inEuropean Urologyreported that the drug Cialis (tadalafil) appeared slightly more effective in treating ED but was no more or less safe than any of the other ED medications.
Frequently Asked Questions
There is no evidence of this. Some antibiotics like erythromycin can slow the breakdown of the erectile dysfunction (ED) drugViagra (sildenafil), allowing the drug to accumulate and increasing the risk of side effects.The prolonged use of antibiotics can lead todelayed ejaculationin some people but not ED.
PDE5 inhibitorsare a class of drugs used in the first-line treatment of erectile dysfunction. A 2013 review of studies inEuropean Urologyreported that the drug Cialis (tadalafil) appeared slightly more effective in treating ED but was no more or less safe than any of the other ED medications.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of erectile dysfunction.Jing E, Straw-Wilson K.Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: a narrative literature review.Ment Health Clin. 2016;6(4):191–196. doi:10.9740/mhc.2016.07.191MedlinePlus.Drugs that may cause erection problems.Hernandez-Cerda J, Berotomeu-Gonzalez V, Zuazola P, Cordero A.Understanding erectile dysfunction in hypertensive patients: the need for good patient management.Vasc Health Risk Manag. 2020;16:231–239. doi:10.2147/VHRM.S223331Donovan KA, Gonzalez BD, Nelson AM, Fishman MN, Zachariah B, Jacobsen PB.Effect of androgen deprivation therapy on sexual function and bother in men with prostate cancer: a controlled comparison.Psycho-Oncology. 2018;27(1):316–324. doi:10.1002/pon.4463Ajo R, Segura A, Inda MDM, et al.Erectile dysfunction in patients with chronic pain treated with opioids. Med Clin (Barc). 2017;149(2):49-54. doi:10.1016/j.medcli.2016.12.038Pahwa R, Isaacson SH.Pharmacology and evidence-based strategies for current and emerging treatments for off periods in Parkinson disease.J Clin Psychiatry. 2020;82(1):SU19004BR2C. doi:10.4088/JCP.SU19004BR2CJung J, Woo H, Kwon H, Jeong NY.Clinical neuroanatomy and neurotransmitter-mediated regulation of penile erection.Int Neurourol J.2014;18(2):58–62. doi:10.5213/inj.2014.18.2.58Alvarez CA, Mortensen EM, Makris UE, et al.Association of skeletal muscle relaxers and antihistamines on mortality, hospitalizations, and emergency department visits in elderly patients: a nationwide retrospective cohort study.BMC Geriatr.2015;15:2. doi:10.1186/1471-2318-15-2Levey HR, Segal RL, Bivalacqua TJ.Management of priapism: an update for clinicians.Ther Adv Urol.2014;6(6):230–244. doi:10.1177/1756287214542096Javier Del Rio F, Cabello F, Fernandez I.Influence of substance use on the erectile response in a sample of drug users.Int J Clin Health Psychol.2015;15(1):37–43. doi:10.1016/j.ijchp.2014.10.002Kaplan-Marans E, Sandozi a, Martinez M, Lee J, Schulman A, Khurgin J.Medications most commonly associated with erectile dysfunction: evaluation of the Food and Drug Administration national pharmacovigilance database.Sex Med.2022 Oct;10(5):100543. doi:10.1016/j.esxm.2022.100543Huri HZ, Sanusia NDM, Razack AHA, Mark R.Association of psychological factors, patients’ knowledge, and management among patients with erectile dysfunction.Patient Prefer Adherence.2016;10:807–823. doi:10.2147/PPA.S99544Huang SA, Lie JD.Phosphodiesterase-5 (PDE5) inhibitors In the management of erectile dysfunction.P T.2013;38(7):407, 414-419.Kalejaiye O, Almekaty K, Blecher G, Minhas S.Premature ejaculation: challenging new and the old concepts.F1000Res. 2017;6:2084. doi:10.12688/f1000research.12150.1Yuan JQ, Zhang RJ, Yang ZY, et al.Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis.Eur Urol. 2013;63(5):902-912. doi:10.1016/j.eururo.2013.01.012
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of erectile dysfunction.Jing E, Straw-Wilson K.Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: a narrative literature review.Ment Health Clin. 2016;6(4):191–196. doi:10.9740/mhc.2016.07.191MedlinePlus.Drugs that may cause erection problems.Hernandez-Cerda J, Berotomeu-Gonzalez V, Zuazola P, Cordero A.Understanding erectile dysfunction in hypertensive patients: the need for good patient management.Vasc Health Risk Manag. 2020;16:231–239. doi:10.2147/VHRM.S223331Donovan KA, Gonzalez BD, Nelson AM, Fishman MN, Zachariah B, Jacobsen PB.Effect of androgen deprivation therapy on sexual function and bother in men with prostate cancer: a controlled comparison.Psycho-Oncology. 2018;27(1):316–324. doi:10.1002/pon.4463Ajo R, Segura A, Inda MDM, et al.Erectile dysfunction in patients with chronic pain treated with opioids. Med Clin (Barc). 2017;149(2):49-54. doi:10.1016/j.medcli.2016.12.038Pahwa R, Isaacson SH.Pharmacology and evidence-based strategies for current and emerging treatments for off periods in Parkinson disease.J Clin Psychiatry. 2020;82(1):SU19004BR2C. doi:10.4088/JCP.SU19004BR2CJung J, Woo H, Kwon H, Jeong NY.Clinical neuroanatomy and neurotransmitter-mediated regulation of penile erection.Int Neurourol J.2014;18(2):58–62. doi:10.5213/inj.2014.18.2.58Alvarez CA, Mortensen EM, Makris UE, et al.Association of skeletal muscle relaxers and antihistamines on mortality, hospitalizations, and emergency department visits in elderly patients: a nationwide retrospective cohort study.BMC Geriatr.2015;15:2. doi:10.1186/1471-2318-15-2Levey HR, Segal RL, Bivalacqua TJ.Management of priapism: an update for clinicians.Ther Adv Urol.2014;6(6):230–244. doi:10.1177/1756287214542096Javier Del Rio F, Cabello F, Fernandez I.Influence of substance use on the erectile response in a sample of drug users.Int J Clin Health Psychol.2015;15(1):37–43. doi:10.1016/j.ijchp.2014.10.002Kaplan-Marans E, Sandozi a, Martinez M, Lee J, Schulman A, Khurgin J.Medications most commonly associated with erectile dysfunction: evaluation of the Food and Drug Administration national pharmacovigilance database.Sex Med.2022 Oct;10(5):100543. doi:10.1016/j.esxm.2022.100543Huri HZ, Sanusia NDM, Razack AHA, Mark R.Association of psychological factors, patients’ knowledge, and management among patients with erectile dysfunction.Patient Prefer Adherence.2016;10:807–823. doi:10.2147/PPA.S99544Huang SA, Lie JD.Phosphodiesterase-5 (PDE5) inhibitors In the management of erectile dysfunction.P T.2013;38(7):407, 414-419.Kalejaiye O, Almekaty K, Blecher G, Minhas S.Premature ejaculation: challenging new and the old concepts.F1000Res. 2017;6:2084. doi:10.12688/f1000research.12150.1Yuan JQ, Zhang RJ, Yang ZY, et al.Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis.Eur Urol. 2013;63(5):902-912. doi:10.1016/j.eururo.2013.01.012
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of erectile dysfunction.Jing E, Straw-Wilson K.Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: a narrative literature review.Ment Health Clin. 2016;6(4):191–196. doi:10.9740/mhc.2016.07.191MedlinePlus.Drugs that may cause erection problems.Hernandez-Cerda J, Berotomeu-Gonzalez V, Zuazola P, Cordero A.Understanding erectile dysfunction in hypertensive patients: the need for good patient management.Vasc Health Risk Manag. 2020;16:231–239. doi:10.2147/VHRM.S223331Donovan KA, Gonzalez BD, Nelson AM, Fishman MN, Zachariah B, Jacobsen PB.Effect of androgen deprivation therapy on sexual function and bother in men with prostate cancer: a controlled comparison.Psycho-Oncology. 2018;27(1):316–324. doi:10.1002/pon.4463Ajo R, Segura A, Inda MDM, et al.Erectile dysfunction in patients with chronic pain treated with opioids. Med Clin (Barc). 2017;149(2):49-54. doi:10.1016/j.medcli.2016.12.038Pahwa R, Isaacson SH.Pharmacology and evidence-based strategies for current and emerging treatments for off periods in Parkinson disease.J Clin Psychiatry. 2020;82(1):SU19004BR2C. doi:10.4088/JCP.SU19004BR2CJung J, Woo H, Kwon H, Jeong NY.Clinical neuroanatomy and neurotransmitter-mediated regulation of penile erection.Int Neurourol J.2014;18(2):58–62. doi:10.5213/inj.2014.18.2.58Alvarez CA, Mortensen EM, Makris UE, et al.Association of skeletal muscle relaxers and antihistamines on mortality, hospitalizations, and emergency department visits in elderly patients: a nationwide retrospective cohort study.BMC Geriatr.2015;15:2. doi:10.1186/1471-2318-15-2Levey HR, Segal RL, Bivalacqua TJ.Management of priapism: an update for clinicians.Ther Adv Urol.2014;6(6):230–244. doi:10.1177/1756287214542096Javier Del Rio F, Cabello F, Fernandez I.Influence of substance use on the erectile response in a sample of drug users.Int J Clin Health Psychol.2015;15(1):37–43. doi:10.1016/j.ijchp.2014.10.002Kaplan-Marans E, Sandozi a, Martinez M, Lee J, Schulman A, Khurgin J.Medications most commonly associated with erectile dysfunction: evaluation of the Food and Drug Administration national pharmacovigilance database.Sex Med.2022 Oct;10(5):100543. doi:10.1016/j.esxm.2022.100543Huri HZ, Sanusia NDM, Razack AHA, Mark R.Association of psychological factors, patients’ knowledge, and management among patients with erectile dysfunction.Patient Prefer Adherence.2016;10:807–823. doi:10.2147/PPA.S99544Huang SA, Lie JD.Phosphodiesterase-5 (PDE5) inhibitors In the management of erectile dysfunction.P T.2013;38(7):407, 414-419.Kalejaiye O, Almekaty K, Blecher G, Minhas S.Premature ejaculation: challenging new and the old concepts.F1000Res. 2017;6:2084. doi:10.12688/f1000research.12150.1Yuan JQ, Zhang RJ, Yang ZY, et al.Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis.Eur Urol. 2013;63(5):902-912. doi:10.1016/j.eururo.2013.01.012
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of erectile dysfunction.
Jing E, Straw-Wilson K.Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: a narrative literature review.Ment Health Clin. 2016;6(4):191–196. doi:10.9740/mhc.2016.07.191
MedlinePlus.Drugs that may cause erection problems.
Hernandez-Cerda J, Berotomeu-Gonzalez V, Zuazola P, Cordero A.Understanding erectile dysfunction in hypertensive patients: the need for good patient management.Vasc Health Risk Manag. 2020;16:231–239. doi:10.2147/VHRM.S223331
Donovan KA, Gonzalez BD, Nelson AM, Fishman MN, Zachariah B, Jacobsen PB.Effect of androgen deprivation therapy on sexual function and bother in men with prostate cancer: a controlled comparison.Psycho-Oncology. 2018;27(1):316–324. doi:10.1002/pon.4463
Ajo R, Segura A, Inda MDM, et al.Erectile dysfunction in patients with chronic pain treated with opioids. Med Clin (Barc). 2017;149(2):49-54. doi:10.1016/j.medcli.2016.12.038
Pahwa R, Isaacson SH.Pharmacology and evidence-based strategies for current and emerging treatments for off periods in Parkinson disease.J Clin Psychiatry. 2020;82(1):SU19004BR2C. doi:10.4088/JCP.SU19004BR2C
Jung J, Woo H, Kwon H, Jeong NY.Clinical neuroanatomy and neurotransmitter-mediated regulation of penile erection.Int Neurourol J.2014;18(2):58–62. doi:10.5213/inj.2014.18.2.58
Alvarez CA, Mortensen EM, Makris UE, et al.Association of skeletal muscle relaxers and antihistamines on mortality, hospitalizations, and emergency department visits in elderly patients: a nationwide retrospective cohort study.BMC Geriatr.2015;15:2. doi:10.1186/1471-2318-15-2
Levey HR, Segal RL, Bivalacqua TJ.Management of priapism: an update for clinicians.Ther Adv Urol.2014;6(6):230–244. doi:10.1177/1756287214542096
Javier Del Rio F, Cabello F, Fernandez I.Influence of substance use on the erectile response in a sample of drug users.Int J Clin Health Psychol.2015;15(1):37–43. doi:10.1016/j.ijchp.2014.10.002
Kaplan-Marans E, Sandozi a, Martinez M, Lee J, Schulman A, Khurgin J.Medications most commonly associated with erectile dysfunction: evaluation of the Food and Drug Administration national pharmacovigilance database.Sex Med.2022 Oct;10(5):100543. doi:10.1016/j.esxm.2022.100543
Huri HZ, Sanusia NDM, Razack AHA, Mark R.Association of psychological factors, patients’ knowledge, and management among patients with erectile dysfunction.Patient Prefer Adherence.2016;10:807–823. doi:10.2147/PPA.S99544
Huang SA, Lie JD.Phosphodiesterase-5 (PDE5) inhibitors In the management of erectile dysfunction.P T.2013;38(7):407, 414-419.
Kalejaiye O, Almekaty K, Blecher G, Minhas S.Premature ejaculation: challenging new and the old concepts.F1000Res. 2017;6:2084. doi:10.12688/f1000research.12150.1
Yuan JQ, Zhang RJ, Yang ZY, et al.Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis.Eur Urol. 2013;63(5):902-912. doi:10.1016/j.eururo.2013.01.012
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