Does amlodipine cause erectile dysfunction?

In this article:

• Does amlodipine cause ED?
• Hypertension, amlodipine, and ED
• Other causes of ED
• What to do if you experience ED
• The bottom line

In this article

• Does amlodipine cause ED?
• Hypertension, amlodipine, and ED
• Other causes of ED
• What to do if you experience ED
• The bottom line

Amlodipine is FDA approved to treat high blood pressure and chest pain (angina) that’s caused by coronary artery disease (a type of heart disease). It is in the family of medicines known as a calcium channel blocker and is sold under the brand names Norvasc, Amvaz, Katerzia, and Norliqva.

If you are taking amlodipine and are experiencing sexual side effects, you might be wondering: Does amlodipine cause erectile dysfunction (ED)? After all, adequate penile blood flow is important for intimacy. While amlodipine does lower blood pressure, it doesn’t typically cause ED. 

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Can amlodipine cause ED?

“Amlodipine has minimal to no effect on erectile dysfunction, especially as compared to other medications people take for high blood pressure,” says Boback Berookhim, MD, urologist at Northwell’s Lenox Hill Hospital. “Yes, patients complain about ED, but usually it is due to their high blood pressure or other medical problems.”

The research supports this as well. For example, one narrative review noted that calcium channel blockers like amlodipine have neutral or possibly even positive effects on erectile function. An older clinical trial, which looked at the impacts of different blood pressure medications on sexual function, found that amlodipine had a similar impact on sexual function as a placebo. 

Sexual dysfunction occurs in less than 1% of people taking amlodipine. On the other hand, side effects like swelling, flushing, dizziness, heart palpitations, fatigue, nausea, and stomach pain are more common side effects than sexual dysfunction. 

The interplay of hypertension, amlodipine, and ED

It’s a common concern: You start taking amlodipine, then notice erectile dysfunction (ED), and assume the medication is to blame. But timing doesn’t equal causation.

ED and amlodipine often overlap because they share a common link: high blood pressure. In many cases, it’s not the medication causing symptoms, but the underlying condition it’s prescribed to treat.

Long-standing or poorly controlled hypertension can damage blood vessels and reduce blood flow throughout the body, including to the penis. “Hypertension, if prolonged and poorly treated, can result in changes in blood vessels that might impair blood flow, which could then lead to ED,” explains James Udelson, MD, chief of cardiology at Tufts Medical Center.

That vascular connection is key. “The penis is a vascular organ, and impaired blood flow will affect erectile function,” says Dr. Berookhim. Over time, high blood pressure contributes to vascular disease, making it more difficult to achieve or maintain an effective erection.

This overlap makes it tricky to pinpoint the exact cause. Many people taking amlodipine already have hypertension, which itself raises the risk of ED. As a result, symptoms may appear after starting treatment, even if the medication isn’t the driver. “People with high blood pressure can develop ED, and people with high blood pressure may be taking amlodipine, so people on amlodipine may develop ED, particularly if their blood pressure is not well controlled,” Dr. Udelson explains.

In other words, when ED occurs or worsens, it’s worth looking beyond the prescription bottle and evaluating overall cardiovascular health.

Other potential causes of ED in amlodipine users

Besides hypertension, there may be other causes of ED while you are taking amlodipine. “Amlodipine by itself is unlikely to cause ED symptoms,” says Mohamed Dahodwala, MD,  cardiologist at Saint Anthony Hospital in Chicago.

According to Dr. Dahodwala, ED symptoms in patients who take amlodipine are often from:

• Other blood pressure medications: Often, people who are on amlodipine are taking other medications, and these medications may impact their erectile function, according to Dr. Berookhim. Medication side effects, coupled with hypertension itself, are often the reasons behind ED while using amlodipine.
• Other health conditions: “ED is a multifactorial issue, with causes including sexual performance anxiety, cardiovascular disease (such as high blood pressure), medication side effects, and neurologic causes,” Dr. Berookhim says. It can also be caused by poor circulation from high cholesterol or diabetes.

“The best advice is to discuss this with one’s doctor to see what has caused the issue,” says Dr. Berookhim.

What to do if you are experiencing ED while on amlodipine

First, you’ll want to discuss with your healthcare provider what may be causing your ED, keeping in mind that it’s unlikely to be amlodipine. “Have your doctor relook at other meds you may be taking and look for any circulation problems in the lower abdomen,” Dr. Dahodwala recommends. Your healthcare provider may also ask you questions about your health history, lifestyle, sexual health, cardiovascular health, and any other underlying health conditions.

In rare instances, it might make sense to stop taking amlodipine and try an alternative blood pressure drug. “If a patient and their provider think that the amlodipine might be causing ED, strategies can be discussed, such as temporarily stopping the drug, to see if the problem resolves,” Dr. Udelson says. “This might be safe if blood pressure is only modestly elevated for 1-2 weeks.”

It’s also important to consider what not to do if you’re experiencing ED while using amlodipine. “Do not simply stop the medication,” warns Dr. Berookhim. “Speak to your provider and see if there are alternatives or if there are other treatments for the ED.”

If you end up stopping amlodipine, it’s best to switch to a different category of blood pressure medication. For example, angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin II receptor blockers (ARBs) are usually good alternatives to calcium channel blockers like amlodipine, Dr. Udelson says. 

There are certain blood pressure medications to stay away from, because these can make ED symptoms worse. “Other hypertension medicines like beta blockers or diuretics are more commonly associated with ED symptoms,” Dr. Dahodwala explains. 

The bottom line

There is no research showing that amlodipine causes ED. While some patients have sexual problems while taking the medication, it’s unlikely that the medication itself is causing the ED. More common causes of ED in amlodipine users include hypertension, other medication side effects, circulation issues, performance anxiety, or neurological causes.

ED can seriously impact mental health and quality of life. If you are experiencing ED symptoms and are taking amlodipine, reach out to your healthcare provider to discuss the possible causes, how to manage them, and if a medication change or addition might be the best path forward for you.