List of medications causes erectile dysfunction, lower libido and premature ejaculation

October 11th, 2007

For years health professionals have concentrated on mental causes of ED or loss of libido. Many practitioners were convinced that women who complained of low sex drive or lack of orgasm were “frigid.” Men who had difficulty achieving an erection were assumed to suffer from “performance anxiety,” guilt, or fear of castration. Blaming the victim was a convenient way to get the doctor off the hook, but it now appears that this approach was misplaced and unproductive.

�Research indicates that three-fourths or more of those experiencing erection difficulties have some under-lying physiological problem or medication complication. Physicians rarely mention that the medicines they prescribe might have sexual side effects. They often worry that patients might be reluctant to swallow pills that could interfere with this basic human drive. But think of the devastation to a relationship when a lack of desire or ability is attributed to old age or disinterest. How much better if the true cause can be uncovered and treated, even if it means finding another medicine less likely to cause sexual difficulties.

Drug companies have generally been unenthusiastic when it comes to studying the sexual side effects of medicine. There have been few really well constructed studies comparing one drug with another regarding negative or positive effects on libido or performance. The Food and Drug Administration (FDA) has rarely required any in depth review of this sensitive subject.

Nevertheless, reports of sexual dysfunction do occasionally end up in the medical literature. This is especially true for men because when the equipment starts to fail it is fairly obvious. Women, on the other hand, have been virtually ignored. There is no obvious corollary to ED. Even if a woman becomes less interested in sexual activity or has difficulty achieving orgasm, she can still participate in lovemaking. Consequently, sexual dysfunction in women rarely gets reported to physicians and it is unusual for such reports to be entered into drug company databases or forwarded on to the FDA. Perhaps women are more reluctant than men to discuss this type of problem, especially if the doctor is a man. It may also be possible, although there is no proof, that women’s sexual difficulties are not taken as seriously as ED. Changes in libido can be subtle and hard to measure. But many drugs, including antidepressants, sedatives and hormones, can dampen desire. The scarcity of literature on drugs affecting female sexuality means that women will have to rely on their own judgment. If a medication seems to be having a negative effect, patient and doctor should consider whether another medicine might be less likely to interfere with sexuality. Trial and error could be the best test, since the doctor may not be able to confirm the reaction by looking it up in a standard reference book. Sex seems simple, but it is actually amazingly complex.

There are a number of ways in which medicines can interfere with the process of sexual satisfaction. First, they can mess with your mind. Lots of drugs can affect libido. They may do this indirectly by causing drowsiness, lethargy, depression, confusion or weight gain. Some drugs also have a direct impact on brain chemistry. There is a growing recognition that “neurotransmitters” the chemical messengers of the brain are critical to sexual interest and performance. They can be easily disrupted by a wide variety of medications, including anti-depressants such as Anafranil (clomipramine), Asendin (amoxapine), Eiavil (amitriptyline), Marpian (isocarboxazid), Nardil (phenelzine), Parnate (tranylcypromine) and Prozac (fluoxetine). Not only do such medications affect sexual desire, they can also interfere with the ability to achieve orgasm. This is a side effect that is rarely mentioned by health professionals. Yet, it can be one of the most frustrating sexual complications of all.

Imagine a woman who has had a satisfying relationship with her partner for years. Then she is put on Prozac for mild depression or perhaps an eating disorder. Gradually, she may find it more difficult to reach climax. In such a situation, sexual-relations can easily become strained. The male partner may feel inadequate or blame her for losing sexual interest. Men are also vulnerable to problems with orgasm. Many medications can delay or prevent ejaculation. Major tranqulizers like Mellaril (thioridazine), Prolixin (fluphenazine), SteIazine (trifluoperazine) and Thorazine (chiorpromazine) are just a few of the drugs that can interfere with normal release of semen. Anti-anxiety drugs such as Valium (diazepam) and Xanax (alprazolam) can alter ejaculation. Even blood pressure pills like Catapres (clonidine), Normodyne and Trandate (labetalol) and AIdornet (methyldopa) may lead to ejaculatory problems.

Erectile Dysfunction and Pills


Teenage males often worry about experiencing arousal at the most inappropriate times. A daydream, a picture or a passing comment can trigger an embarrassing erection. Older men, however, are more likely to be concerned about their ability to achieve or maintain an erection. This process is a lot more complicated than most people would guess. Nerves, blood vessels and hormones must interact in a dynamic harmony for an erection to occur. If there’s a glitch at any step along the way, whether it’s emotional or physiological, frustration may be the result. A number of health conditions can lead to this problem, including diabetes, hypertension, atherosclerosis, spinal cord injury and alcoholism. But medications can also contribute enormously to erection difficulties. Some drugs may affect nerves while others may act on hormones or circulation. Blood pressure pills are notorious for their negative sexual side effects. Diuretics seems to be especially problematic even though physicians think of them as miid drugs. These medications are prescribed routinely with barely a mention of side effects and rarely a word about sexual toxicity. Nevertheless, compounds like hydrochlorothiazide (found in Dyazide, ;Esidrix, Hydrodiuril, Hydropres, Inderide, Maxzide, Moduretic, and many others) can cause ED in some men. So can many other kinds of anti-hypertensive medications, such as Aldomet (methyldopa), Calan (verapamil), Catapres (clonidine), Inderal (propranolol), lsoptin (verapamil), Lopressor (metoprolol), Tenex (guanfacine) and Verelan (verapamil).

People aren’t stupid, so it comes as no surprise that many men simply stop taking their blood pressure medicine once they discover erection difficulties. This is a mistake. Alternatives are available that may not cause such problems. Never stop taking any blood pressure pill without a doctor’s supervision.

List of medications causes erectile dysfunction, lower libido and premature ejaculation:

Brand Name Generic Name Effects Reported
Adalat nifedipine erectile dysfunction
Adapin doxepin lower libido; trouble with ejaculation
Aldactone spironolactone lower libido; erectile dysfunction
Aldomet methyldopa erectile dysfunction (rare)
Altace ramipril change in libido; trouble with orgasm or ejaculation (common); erectile dysfunction (up to 20%)
Anafranil clomipramine erectile dysfunction
Anaprox naproxen erectile dysfunction (uncommon)
Apresoline hydralazine erectile dysfunction
Artane trihexyphenidyl erectile dysfunction
Asendin amoxapine change in libido; erectile dysfunction; painful ejaculation
Ativan Lorazepam lower libido
Aventyl nortriptyline lower libido; erectile dysfunction
Axid nizatadin erectile dysfunction
Bentyl
Dicyclomine		 dicyclorriine erectile dysfunction
Blocadren timolol erectile dysfunction (uncommon); lower libido
Bumex bumetanide premature ejaculation; erectile dysfunction (rare)
BuSpar buspirone change in libido (uncommon); erectile dysfunction (rare); delayed ejaculation (rare)
Calan verapamil erectile dysfunction (uncommon)
Capoten captopril erectile dysfunction (apparently uncommon)
Cardene nicardipine erectile dysfunction (rare)
Cardizem dilfiazem less libido; erectile dysfunction (rare)
Cardura doxazosin sexual difficulties, unspecified (2%)
Cartrol carteolol erectile dysfunction
Catapres clonidine lower libido; erectile dysfunction; slowed ejaculation
Clozaril clozapine erectile dysfunction; prolonged painful erection
Cogentin benztropine -erectile dysfunction
Combipres chlorthalidonelclonidine erectile dysfunction; lower libido; less sexual activity
Compazine prochlorperazine erectile dysfunction; ejaculation problems; prlonged painful erection
Corgard nadolol less libido; erectile dysfunction
Cytotec misoprostol erectile dysfunction; less libido (both infrequent)
Danocrine danazol change in libido
Depo-Provera medroxyprogesterone change in libido; trouble with orgasm
Desyrel trazodone prolonged painful erection; change in lbido trouble with orgasm or ejaculation
Diamox acetazolamide less libido; erectile dysfunction
Dibenzyline phenoxybenzamine trouble with ejaculation
Dilantin phenytoin less libido; erectile dysfunction; prolonged & painful erection
Dipentum olsalazine erectile dysfunction (rare)
Ditropan oxybutynin erectile dysfunction
Diupres chlorothiazide/reserpine lower libido; erectile dysfunction
Diuril chlorothiazide sexual difficulties
Dolophine methadone lower libido; erectile dysfunction; no orgasm; delayed ejaculation
Donnatal phenobarbital/hyoscyamine/ erectile dysfunction
Dopar levodopa increased libido
Doral quazepam less libido; erectile dysfunction
Dyazide hydrochlorothiazide/triamterene sexual difficulties; erectile dysfunction
DynaCirc isradipine lower libido; erectile dysfunction (uncommon)
Elavil amitriptyline less libido; erectile dysfunction; no ejaculation
Eldepryl selegiline sexual difficulties
Endep amitriptyline less libido; erectile dysfunction; no ejaculation
Esidrix hydrochlorothiazide erectile dysfunction
EsimiI guanethidine/hydrochlorothiazide ejaculation problems; erectile dysfunction; prlonged painful erection
Eskalith lithium sexual difficulties; erectile dysfunction
Ethmozine moricizine erectile dysfunction (less than 2%)
Eulexin flutamide loss of libido; erectile dysfunction (up to 33%)
Folex methotrexate loss of libido; erectile dysfunction
Halcion triazolam changes in libido
Haldol haloperidol erectile dysfunction; change in libido; painful ejculation; prolonged painful erection
Hydrodiuril hydrochlorothiazide erectile dysfunction
Hylorel guanadrel less libido; erectile dysfunction; ejaculation prblems
Hytrin terazosin lower libido (rare); erectile dysfunction
Inderal propranolol loss of libido (male and female); erectile dysfunction (rare)
lnderide propranolol hydrochlorochliazide loss of libido (male and female); erectile dysfunction (rare)
Ismelin guanethidine ejaculation problems; erectile dysfunction; prlonged painful erection
Isoptin verapamil erectile dysfunction (uncommon)
Lanoxin digoxin less libido; erectile dysfunction
Larodopa levodopa higher libido; prolonged & painful erection
Librax chlordiazepoxide/clidinium change in libido; erectile dysfunction
Limbitrol chlordiazepoxide/amitriptyline change in libido
Lithobid lithium sexual difficulties; erectile dysfunction
Lopid gemfibrozil less libido; erectile dysfunction
Lopressor metoprolol erectile dysfunction
Lozol indapamide lower libido; erectile dysfunction (less than -5%)
Ludiomil maprotiline less libido; erectile dysfunction (rare)
Lupron leuprolide erectile dysfunction (common); lower libido
Marplan isocarboxazid erectile dysfunction
Maxzide hydrochlorothiazide/triamterene sexual difficulties; erectile dysfunction
Megace megestrol change in libido; trouble with orgasm
Mellaril thioridazine change in libido; erectile dysfunction; prolonged, painful erection; trouble with orgasm
Minipress prazosin erectile dysfunction; prolonged painful erection (rare)
Moduretic amiloride/hydrochlorothiazide less libido; erectile dysfunction
Monopril fosinopril sexual difficulties
Mysoline primidone change in libido; erectile dysfunction (uncommon)
Naprosyn naproxen erectile dysfunction
Nardil phenelzine erectile dysfunction; lack of orgasm; ejaculation problems; prolonged and painful erections
Navane thiothixene erectile dysfunction; trouble with ejaculation; pro longed and painful erections
Nizoral ketoconazole erectile dysfunction; less libido
Normodyne labetalol erectile dysfunction; ejaculation problems; less libido; painful & prolonged erection
Normozide labetalol/hydrochlorothiazide erectile dysfunction; ejaculation problems; less libido; painful & prolonged erection
Norpace disopyramide erectile dysfunction
Norpramin desipramine erectile dysfunction; less libido; trouble with orgasm
Oretic hydrochlorothiazide erectile dysfunction
Pamelor nortriptyline erectile dysfunction; less libido
Parnate tranylcypromine erectile dysfunction; problems with ejaculation
Pepcid famotidine erectile dysfunction (rare)
Pertofrane desipramine erectile dysfunction; less libido; trouble with orgasm
Plendil felodipine less libido; erectile dysfunction
Prinivil lisinopril erectile dysfunction (quite rare)
Pro-Banthine propantheline erectile dysfunction
Procardia nifedipine erectile dysfunction
Propecia finasteride erectile dysfunction
Prolixin fluphenazine lower libido; erectile dysfunction; trouble with ejaculation; prolonged painful erection
Provera medroxyprogesterone change in libido; trouble with orgasm
Prozac fluoxetine lower libido; problems with orgasm ejaculation (male); erectile dysfunction (rare);
Reglan metoclopramide lower libido; erectile dysfunction
Rheumatrex methotrexate loss of libido; erectile dysfunction
Robinul glycopyrrolate erectile dysfunction
Rocaltrol calcitriol lower libido
Serax oxazepam change in libido
Serentil mesoridazine erectile dysfunction; ejaculation problems; prolonged painful erection
Sinemet carbidopaIIevodopa increased libido; prolonged painful erection
Sinequan doxepin less libido; trouble with ejaculation
Stelazine trifluoperazine erectile dysfunction; problems with ejaculafion
Tagamet cimetidine less libido (male and female); erectile dysfunction
Tegretol carbamazepine erectile dysfunction
Tenex guanfacine erectile dysfunction; lower libido
Tenormin atenolol erectile dysfunction (uncommon)
Thorazine chlorpromazine less libido; erectile dysfunction; prolonged painful erection; no ejaculation
Timoptic timolol less libido (male and female); erectile dysfunction
Tofranil imipramine less libido; erectile dysfunction; trouble with orgasm
Trandate Iabetalol erectile dysfunction; ejaculation problems; less libido; painful & prolonged erection
Valium diazepam less libido; erectile dysfunction; trouble with orgasm (female) or ejaculation (male)
Vasotec enalapril erectile dysfunction (rare)
Verelan verapamil erectile dysfunction (uncommon)
Visken pindolol erectile dysfunction (uncommon)
Voltaren diclofenac erectile dysfunction (rare)
Wellbutrin bupropion sexual difficulties; erectile dysfunction
Xanax alprazolam less libido; trouble with ejaculation (male) & orgasm (female)
Zantac ranitidine less libido; erectile dysfunction (occasional)
Zestril lisinopril erectile dysfunction (quite rare)
Zoloft sertraline sexual difficulties