Can Amlodipine Cause Erectile Dysfunction?

Some medications can affect blood flow to the penis, which can contribute to erectile dysfunction (ED). If you’re wondering whether amlodipine is one of them, keep reading.

In this article, we’ll cover if amlodipine can cause erectile dysfunction and look at alternative drugs that are less likely to cause erectile dysfunction. 

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What is amlodipine?

Amlodipine¹ (Norvasc) is a type of prescription medication consumed orally in either a tablet or liquid form. It is prescribed to adults and children over the age of six to treat various conditions. 

Amlodipine acts as a calcium channel blocker in the smooth muscle of our blood vessels. This drug reduces the influx of calcium into vascular smooth muscle cells, causing them to relax. 

This relaxation of smooth muscle cells causes the arterial wall to relax, which allows blood to flow more easily through a larger passageway. For this reason, amlodipine is effective in reducing blood pressure. 

Uses

Amlodipine is a highly useful drug that is prescribed for many conditions, including: 

  • Chest pain (angina)

  • Coronary artery disease

  • High blood pressure (antihypertensive)

It is also often used for Raynaud’s. However, it is not FDA approved for this condition.

When amlodipine is used to treat angina, it works to increase oxygen delivery to the heart, which can help manage chest pain. This blood flow modulation means the heart is getting the oxygen it needs. 

Amlodipine is also helpful in cases of coronary artery disease. This condition causes a narrowing of the blood vessels in the heart, which can cause cardiac issues if the body's demand for oxygen increases. 

Amlodipine can relax coronary and peripheral blood vessels and allow them to widen further. This means there is less resistance from the blood, and the heart does not have to work as hard to push it around the body.

Amlodipine's efficacy in lowering blood pressure is very useful in preventing the diseases and detriments associated with high blood pressure. If left untreated, high blood pressure can cause damage to the brain, heart, arteries, and kidneys. 

This can have many flow-on effects, such as an increased likelihood of heart attack, stroke, blindness, and kidney failure.

An additional benefit of amlodipine is its long half-life (30-50 hours). This means, unlike most other calcium channel blockers, it only has to be taken once a day.

Can amlodipine cause erectile dysfunction?

Erectile dysfunction² is a relatively common issue in biological males. It occurs when the male is unable to gain or keep an erection long enough for sexual intercourse to take place. 

Individuals often feel embarrassed about this issue, and it can have a detrimental effect on the individual's mental health and their relationships. ED can be caused due to a variety of reasons, including lifestyle factors, certain disorders, and medications. 

A common family of drugs considered to influence erectile dysfunction is antihypertensives. Diuretics and beta-blockers are some of the antihypertensives that may cause erectile dysfunction with their blood pressure lowering effects. 

Others point toward a different antihypertensive, amlodipine. Some researchers³ have suggested that calcium channel blockers can cause erectile dysfunction. However, most research specific to amlodipine fails to show an association with erectile dysfunction.

A 2007 study⁴ demonstrated that calcium channel inhibitors such as amlodipine can increase the risk of erectile dysfunction in hypertensive males. 

Although amlodipine, similar to other CCBs, was originally thought to have no effect on erectile function, a recent study⁵ also showed that long-term administration of amlodipine inhibited sexual activity in hypertensive rats. These rats had reduced erection and sexual behavior after three months of treatment. 

Another study⁶ interestingly demonstrated that calcium channel blockers had the highest rate of sexual dysfunction among other blood pressure medications. Thus further showing that higher quality studies are needed to settle whether amlodipine has an effect on erectile function.

Finally, a higher-quality study⁷ showed that erectile dysfunction occurred in relatively low numbers in hypertensive men treated with amlodipine. Even those erectile issues that appeared were usually tolerable and ceased without withdrawal from the medication.

Can amlodipine help improve ED?

Erectile dysfunction is often considered a primarily vascular issue (up to 40% of cases).⁸ In many cases,⁹ individuals with high blood pressure have comorbid erectile dysfunction. 

In general, those with treated hypertension (high blood pressure) tend to have a lower prevalence of erectile dysfunction than those untreated. This prevalence also increases with age. 

So it makes sense to consider certain antihypertensives like amlodipine to treat erectile dysfunction. Lowering blood pressure through calcium channel antagonism is not expected to cause erectile dysfunction. 

Some studies¹⁰ have even found that although there is an interaction between tadalafil and amlodipine, this is unlikely to be clinically relevant. Another study demonstrated no synergistic effects. 

Many studies¹¹ suggest that the effect of calcium channel blockers on erectile dysfunction is neutral. They have shown that combination therapy, however, has minimal negative effects on cardiovascular health and can actually improve the outcome of erectile dysfunction in hypertensive patients.

If you are worried about developing erectile dysfunction while on antihypertensives, it may be helpful to talk to a healthcare professional about which option is best for you.

What are the effects of amlodipine on men?

When amlodipine is administered in females, it seems to have little to no effect on their sex drive. 

Amlodipine may also affect males by altering the cellular forms of their testicles. It has been demonstrated that amlodipine can change the morphology of testes in adult rats. This, however, only occurred with extremely high doses that were given over at least 8 weeks, and all indications of alterations in the testes are currently in rat models, with no clinical evidence.

Amlodipine can also affect the motility of sperm ejaculated by males, especially when used in conjunction with other common medications such as statins. This may be because calcium influx can be detrimental to sperm motility, and amlodipine can change this concentration and thus stimulate motility.

In all genders, amlodipine is known to have some side effects. These include dizziness, headache, rash, nausea, and drowsiness. 

Some more severe side effects include heart failure, pulmonary edema, abdominal pain, and peripheral edema. In extremely rare cases,¹² amlodipine use can promote drug-induced liver disease. 

Does amlodipine lower testosterone?

Amlodipine may reduce testosterone levels in men. A 2010 study¹³ of male rats indicated that the long-term use of amlodipine tended to lower their testosterone levels. This reduction was higher with higher amlodipine doses. 

This may have flow-on effects, such as reduced enjoyment of sex and the inability to gain and sustain an erection. Though clinical studies in humans have failed to demonstrate such effects.

Can you take viagra while taking amlodipine?

The combination of Viagra (sildenafil) and amlodipine medications is generally considered safe, with only moderate interactions occurring between the two drugs. While there can be an additional effect of lowering blood pressure, this is not generally dangerous. 

One particular study¹⁴ demonstrated that adverse effects were similar in individuals taking just amlodipine and those taking Viagra in combination with amlodipine. They suggested that the additional antihypertensive effects of these drugs were safe and did not increase the adverse effect profile. 

However, taking amlodipine with some other drugs can be rather risky. Using amlodipine and clarithromycin or erythromycin, two antibiotic drugs can significantly increase the risk of hypotension. This co-administration can also heighten the risk of kidney damage.

If you experience dizziness, frequent fainting, headache, changes in heart rate/pulse, flushing, and lightheadedness with these medications, it is important to promptly consult a medical professional. 

These side effects are unlikely but can occur with dose changes or the beginning of new treatments.

Alternative drugs that are less likely to cause erectile dysfunction

While it is uncommon for amlodipine to cause erectile dysfunction, you may wish to seek other treatments for high blood pressure. These include:

ACE inhibitors

 Angiotensin-converting enzyme inhibitors¹⁵ are a group of drugs, including captopril, lisinopril, and benazepril, which, like amlodipine, act to widen the blood vessels. They also decrease blood volume, allowing for a lowering of blood pressure and a lessening demand on the heart. 

Erectile dysfunction would not be expected to be seen with ACE-I.¹⁶ 

Alpha-blockers

These drugs work differently from amlodipine as they act on alpha receptors instead of the calcium channels. Alpha-blockers reduce the tightening effect that norepinephrine (hormone) has on the arteries and veins. 

This means blood vessels are relaxed. Individuals using these drugs rarely experience ED, with some studies actually suggesting that alpha-blockers can improve erectile dysfunction.

ARBs

Angiotensin II receptor blockers, such as azilsartan, irbesartan, and losartan, are other antihypertensives that may help with erectile dysfunction rather than cause it. 

In hypertensive individuals, sexual activity and erectile function can be improved with ARBs. This is suggested to be because of their blocking effect on angiotensin II, which has a possible effect on erectile dysfunction.

It is crucial to consult your doctor or another healthcare professional before you switch your medications. This will ensure the treatment you receive is best suited for you. 

The lowdown

More research is required to pin down amlodipine’s effect on erectile dysfunction. Some studies indicate it as a causative factor in ED, and others point to its effectiveness as an adjunctive therapy. 

With either outcome, you must consult a doctor before changing your medication and inform them as soon as possible if you encounter erectile issues.

  1. Amlodipine | NHS

  2. Erectile dysfunction (ED) | NIH: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

  3. Cardiovascular drug use and the incidence of erectile dysfunction (2006)

  4. Cardiovascular drug use and the incidence of erectile dysfunction (2007)

  5. Long-term treatment of clonidine, atenolol, amlodipine and dihydrochlorothiazide, but not enalapril, impairs the sexual function in male spontaneously hypertensive rats (2015)

  6. A prospective study of the effect of antihypertensive medications on the sexual functions of hypertensive adult male patients (2020)

  7. Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women (1997)

  8. Male sexual circuitry (2020)

  9. Erectile dysfunction (2000)

  10. Pharmacokinetic drug interaction between amlodipine and tadalafil: An open-label, randomized, multiple-dose crossover study in healthy male volunteers (2021)

  11. Sexual function in patients with chronic angina pectoris (2013)

  12. Short-term amlodipine induced liver injury : An extremely rare acute complication (2013)

  13. Effect of amlodipine, a calcium channel antagonist, on gonadal steroid of male Wistar albino rats (2010)

  14. Effect of sildenafil in patients with erectile dysfunction taking antihypertensive therapy (2021)

  15. New insights into hypertension-associated erectile dysfunction (2014)

  16. Effect of first-line antihypertensive agents on sexual function and sex hormones (1988)

Other Sources:

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