Medication-induced ED is estimated to occur in 25% of men seen in general medical outpatient clinics. Among the antihypertensive agents, the thiazide diuretics and beta blockers have been implicated most frequently. Calcium channel blockers and angiotensin-converting enzyme inhibitors are less frequently cited. These drugs may act directly at the corporal level (e.g., calcium channel blockers) or indirectly by reducing pelvic blood pressure, which is important in the development of penile rigidity. α Adrenergic blockers are less likely to cause ED. Estrogens, GnRH agonists, H₂ antagonists, and spironolactone cause ED by suppressing gonadotropin production or by blocking androgen action. Antidepressant and antipsychotic agents—particularly neuroleptics, tricyclics, and SSRIs—are associated with erectile, ejaculatory, orgasmic, and sexual desire difficulties

 

 

 

Drugs Associated with Erectile Dysfunction

Classification Drugs Diuretics Thiazides Spironolactone Antihypertensives Calcium channel blockers Methyldopa Clonidine Reserpine β-Blockers Guanethidine Cardiac/anti-hyperlipidemics Digoxin Gemfibrozil Clofibrate Antidepressants Selective serotonin reuptake inhibitors Tricyclic antidepressants Lithium Monoamine oxidase inhibitors Tranquilizers Butyrophenones Phenothiazines H2 antagonists Ranitidine Cimetidine Hormones Progesterone Estrogens Corticosteroids GnRH agonists 5α-Reductase inhibitors Cyproterone acetate Cytotoxic agents Cyclophosphamide Methotrexate Roferon-A Anticholinergics Disopyramide Anticonvulsants Recreational Ethanol Cocaine Marijuana