Drugs That Cause Erectile Dysfunction: A Complete Guide

Erectile dysfunction occurs due to vascular, neurogenic, hormonal, psychogenic, or drug-induced causes. Sometimes it is a side effect of the medicines people take. Research shows that a wide range of drugs affect sexual performance by lowering testosterone, interfering with nerve signals, or reducing blood flow to the penis. These include common medications for blood pressure, cholesterol, depression, allergies, pain, prostate disease, cancer, and even over-the-counter or recreational drugs.

Blood pressure drugs like beta-blockers, diuretics, and some calcium channel blockers are frequently linked to ED, although switching to ACE inhibitors or ARBs restores function. Cholesterol-lowering drugs such as statins have mixed evidence, some studies report improved erectile function due to better blood flow, while others note possible impairment. Antidepressants, especially SSRIs and SNRIs, are among the most common culprits, with many users reporting sexual side effects.

Even everyday medicines contribute. Antihistamines like diphenhydramine (Benadryl) and hydroxyzine may impair erections by blocking histamine and acetylcholine pathways, though newer agents like loratadine and cetirizine have a lower risk. Painkillers and steroids suppress hormones, while chemotherapy and neurological drugs often damage nerves linked to arousal. Prostate and hormone treatments such as androgen deprivation therapy almost always cause ED. Finally, recreational drugs and alcohol are strongly tied to long-term erectile problems.

The good news is that medication-related ED is often reversible. Adjusting the dose, switching to an alternative drug, or adding ED treatments like PDE5 inhibitors improve sexual health. Studies confirm that many men regain function once the offending drug is stopped or replaced. Talking openly with a doctor is key to finding a safe balance between managing the primary illness and preserving quality of life.

In the sections below, we explain what drug-induced ED means. We also look at different groups of medications, how they may cause ED, and what research shows about their effects.

What Is Drug-Induced Erectile Dysfunction?

Drug-induced erectile dysfunction (ED) happens when certain medicines cause problems with getting or keeping an erection. These drugs affect blood flow, hormone levels, or the nerves needed for sexual function. The problem is not from the penis itself, but from the way the medicine interferes with the body.

Many common medicines cause this side effect. These include blood pressure drugs, antidepressants, antipsychotics, chemotherapy medicines, and hormone treatments. ED often starts soon after a new medicine is taken or when the dose is increased.

Unlike ED caused by health problems like diabetes or heart disease, drug-induced ED can often be reversed. Stopping, lowering, or switching the medicine under a doctor’s care may improve erections. Talking to a healthcare provider is important so the issue is fixed safely.

What Are the Medications That Can Cause Erectile Dysfunction?

Several commonly prescribed medications list erectile dysfunction (ED) as a possible side effect. These drugs may interfere with blood flow, hormone production, or nerve function, all of which are important for normal sexual performance. Not every man will experience ED from these medicines, but it is important to know which types contribute to the problem.

Here are some categories of medications that cause ED:

1. Blood Pressure Medications
2. Cholesterol & Heart Drugs
3. Antidepressants and Anxiety Medications
4. Antihistamines & Allergy Medications
5. Prostate & Hormone Treatments
6. Painkillers & Sedatives
7. Chemotherapy & Neurological Drugs
8. Psychiatric Medications
9. Gastrointestinal/Other Medications
10. Recreational/Illicit Drugs

Below, we explain each category in more detail and highlight how these medications may contribute to erectile dysfunction.

1) Blood Pressure Medications

Many blood pressure medications are well known to be linked with erectile dysfunction (ED). They work by lowering blood pressure, but in some men, also reduce blood flow to the penis or interfere with nerve and hormone signals needed for erections. Not every man will have side effects, but certain drug types are more often connected to ED.

ACE inhibitors (Lisinopril, Ramipril): These are less likely to cause ED compared to other blood pressure medicines. While direct clinical trials on ACE inhibitors and ED are limited, reviews indicate they likely have a neutral or even positive effect on erectile function due to their beneficial effect on blood flow.

ARBs (Losartan, Valsartan): ARBs are angiotensin II receptor blockers, a type of medication mainly used to treat high blood pressure, heart failure, and kidney disease. These drugs are considered “ED-friendly.” Research suggests that ARBs may do more than just lower blood pressure; they also benefit sexual health. A meta-analysis published in the American Journal of Men’s Health (2019) found that men with hypertension who took ARBs, particularly Valsartan, reported a significant improvement in sexual activity. However, improvements in erectile function scores were less consistent across different ARBs.

Beta-blockers (Metoprolol, Propranolol): These are more often linked to ED and reduced sexual desire. They lower blood flow and dampen the body’s stress response, which is necessary for arousal. A meta-analysis in the Journal of Hypertension (2022), across multiple beta-blockers, showed that nebivolol had the lowest risk of causing ED, whereas bisoprolol, atenolol, and metoprolol had higher risks. Two crossover trials in the Clinical and Experimental Pharmacology and Physiology (2007) compared nebivolol vs. metoprolol. It found that nebivolol preserved erectile function, while metoprolol significantly decreased sexual performance scores (IIEF).

Calcium channel blockers: These drugs relax blood vessels and lower blood pressure. Research shows they are generally neutral for sexual function, meaning they rarely cause ED. Most men do not report sexual side effects while taking them. According to a review in Endocrine (2024), researchers examined the impact of blood pressure medications on erectile dysfunction (ED). They found that older drugs like clonidine and α-methyldopa often make sexual problems worse, while ACE inhibitors, ARBs, and calcium channel blockers are mostly neutral or sometimes even helpful.

However, a study published in Future Science OA (2020) looked at 159 men with high blood pressure over three months to see how their medicine affected sexual function. It found that men on calcium channel blockers had the highest rate of sexual problems, about 20%, with diuretics causing problems in about 17%, and ACE inhibitors in around 13%.

Some studies link calcium channel blockers to sexual dysfunction, while others find no effect. Lab data even suggests they might help. Results are mixed.

Diuretics: These pills are strongly associated with ED. They reduce blood volume and limit blood flow to the penis, making erections harder to achieve. They may also lower zinc levels in the body, which affect testosterone production. According to a study in Archives of Internal Medicine (1991), men taking thiazide diuretics reported more sexual problems than those not on the drug. These included lower sex drive, erection trouble, and ejaculation issues. The problems were not tied to low potassium or blood pressure and showed up more often in private surveys than in face-to-face talks.

Alpha-blockers: These medicines relax the blood vessels in the penis and the prostate. They are less likely to cause ED but lead to ejaculation problems more often than erection issues. A study in Urology (2009) looked at men treated with alpha-blockers for urinary problems. Men over 50 who used these drugs had a lower chance of sexual problems like low libido or erectile issues. The benefit was strongest when their urinary symptoms also improved.

Here’s a table to quickly summarize the findings above:

In short, while some blood pressure drugs raise the risk of ED, others are neutral, or may even help, which leads us to the next group of medications linked to sexual side effects.

2) Cholesterol & Heart Drugs

When it comes to protecting your heart, cholesterol and cardiac medications are often the first line of defense. But many men worry about their possible impact on sexual function.

Statins (Atorvastatin, Rosuvastatin, Simvastatin, Pravastatin): Statins lower cholesterol and improve blood vessel health, which may actually support erections. However, a few men report reduced libido or ED, possibly due to lowered testosterone in rare cases. According to a study in the World Journal of Men’s Health (2019), randomized trials show that statins are linked to a slight improvement in erectile function. The data suggest these drugs may help, rather than harm, male sexual performance. Although the effect is modest, it’s a reassuring sign that statins don’t worsen, and might even improve erectile health. 

But a study in Family Practice (2002) reviewed reports, clinical trials, and drug agency data to check whether cholesterol-lowering drugs cause erectile dysfunction (ED). The findings showed that both fibrates and statins have been linked to cases of ED, though the reasons why remain unclear. This suggests that these drugs may cause ED in some men, but more research is needed to understand the full picture.

Fibrates (Fenofibrate): Fibrates primarily target triglycerides, and their effect on ED is not well established. Some isolated reports link them to sexual dysfunction, but the evidence is weak. As per a study in the Adverse Drug Reactions Journal (2010), researchers tested fenofibrate on male rats and found it lowered both erectile function and testosterone levels. The drop in testosterone may play a key role in reducing sexual performance. These results suggest that fenofibrate could negatively affect male reproductive health.

Other Lipid-Lowering Drugs (Ezetimibe/Zetia, Repatha): Ezetimibe and PCSK9 inhibitors like Repatha generally do not cause ED. They improve cardiovascular risk profiles, which may help maintain erectile health long-term.

Blood Thinners (Eliquis, Plavix, Warfarin): Blood thinners themselves do not directly cause ED. However, they increase the risk of bruising or prolonged erections if combined with ED treatments. Some men report reduced confidence or sexual anxiety due to bleeding risk, but biologically, these drugs don’t impair erectile function.

While heart medicines may interfere with blood flow, drugs that act on the brain also affect sexual function in a very different way.

3) Antidepressants and Anxiety Medications

Antidepressants and anti-anxiety drugs are among the most common causes of medication-related erectile dysfunction (ED). These drugs alter brain chemicals like serotonin, dopamine, and norepinephrine, which regulate both mood and sexual function.

Antidepressants (SSRIs like fluoxetine, sertraline): They are well known to cause sexual side effects, including ED. According to a study in the Journal of Clinical Psychiatry (2001), researchers looked at how often people taking antidepressants experience sexual problems. They found that sexual side effects were common, especially with selective serotonin reuptake inhibitors (SSRIs). The study highlights that doctors should talk to patients about these possible effects when prescribing antidepressants.

In a study in JAMA (2003), researchers tested sildenafil (Viagra) to treat sexual problems caused by antidepressants in men with major depression. They found that sildenafil significantly improved sexual function, including erectile ability and satisfaction, compared to a placebo. Importantly, the men’s depression symptoms remained stable, suggesting that sildenafil managed sexual side effects without affecting mood treatment.

SNRIs, MAOIs, Tricyclics: These may lower libido and cause erection or orgasm problems. A study in Psychiatry Investigation (2010) explored how different antidepressant classes affect sexual function in married adults. Nearly half of the participants, about 47%, reported some form of sexual problem. Venlafaxine, an SNRI, was linked with the highest rates of dysfunction. Amitriptyline, a tricyclic antidepressant, showed problems in about 30% of patients.

Antipsychotics: They raise prolactin and commonly cause sexual dysfunction, including ED. According to a study in the Indian Journal of Psychiatry (2015), researchers compared sexual dysfunction and prolactin levels among men with schizophrenia. They found that sexual problems occurred in 86% of the risperidone group, compared to 48.3% with olanzapine and 31% with clozapine, and elevated prolactin followed the same ranking. This suggests that risperidone is linked to the highest rates of sexual side effects and hormone changes.

Beyond mood drugs, even common allergy medications may unexpectedly play a role in erectile difficulties.

4) Antihistamines & Allergy Medications

Some antihistamines and allergy drugs may interfere with sexual function. These medicines often work by blocking histamine and sometimes acetylcholine, which reduce arousal signals.

Diphenhydramine (Benadryl): It is known to cause drowsiness, sedation, and sometimes ED. According to a review in StatPearls (2025), diphenhydramine causes sexual side effects such as decreased libido and difficulty with erections. These problems are linked to its strong anticholinergic effects. While not everyone experiences them, long-term or high-dose use may increase the risk.

Cetirizine (Zyrtec): It usually has fewer side effects, but some reports link it to decreased libido or ED.

Loratadine (Claritin): It is generally considered safer for sexual function, though rare cases of ED have been reported.

Hydroxyzine & Fexofenadine (Allegra): Hydroxyzine impairs arousal by sedation; Allegra has very limited evidence of ED.

Here’s a short table to summarize the effect of allergy medications on ED.

Some medicines target allergies, but others directly affect hormone levels and prostate health, which are closely tied to erections.

5) Prostate & Hormone Treatments

Medications for prostate issues and hormonal conditions cause erectile dysfunction (ED). These drugs may affect testosterone levels, nerve signals, or the flow of blood. All three are important for normal sexual function.

5-alpha reductase inhibitors (finasteride, dutasteride): They are often used to treat enlarged prostate and, at times, hair loss. These drugs lower dihydrotestosterone (DHT), which may lead to ED, reduced libido, and ejaculation problems. In some men, sexual side effects continue even after stopping the drug (post-finasteride syndrome). A study in the Journal of Sexual Medicine (2011) interviewed men with lasting sexual side effects after stopping finasteride. Erectile dysfunction was reported by 92% of them. On average, the problems continued for 40 months after treatment ended.

Anti-androgens (bicalutamide, flutamide): They are used in the treatment of prostate cancer. They block testosterone activity, often causing ED, loss of libido, and reduced sexual performance.

Besides hormone-related drugs, painkillers and sedatives also interfere with normal sexual response.

6) Painkillers & Sedatives

Certain pain-relief medications and sedatives impact erectile function, though the effects vary by drug type and duration of use. These drugs may affect hormone levels, blood flow, or nerve signaling, all of which are important for normal erections.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) – Ibuprofen, Aspirin, Naproxen, Meloxicam:

NSAIDs are generally safe for sexual function when taken occasionally. However, chronic, high-dose use may interfere with prostaglandin production, potentially reducing blood flow to the penis and causing erectile problems in some men. However, as per a study in the American Journal of Men’s Health (2020), researchers tested aspirin in 214 men with erectile dysfunction caused by blood flow problems. Men who took aspirin had better erections than those who took a placebo. Results are mixed, and more studies are needed to determine efficacy.

Corticosteroids – Prednisone: Long-term corticosteroid therapy reduces testosterone levels and impair sexual desire. High doses may also lead to mood changes, fatigue, and vascular effects, indirectly contributing to erectile dysfunction.

Anabolic Steroids: The use of anabolic-androgenic steroids disrupt the natural hormone balance. The body may decrease its own testosterone production, which lead to ED, testicular shrinkage, and decreased libido. Recovery of erectile function may take months or may be incomplete after prolonged use. According to a study in Frontiers in Toxicology (2024), researchers reviewed the effects of anabolic androgenic steroids (AAS) on male fertility and sexual function. They found that AAS abuse is linked to increased risks of infertility and sexual dysfunction, particularly among young men.

While pain relief medications affect nerves and circulation, certain chemotherapy and neurological drugs may have an even deeper impact.

7) Chemotherapy & Neurological Drugs

Chemotherapy: Some chemo drugs damage blood vessels, nerves, and hormones that support erections. Common culprits include cisplatin, vincristine, and doxorubicin. Animal and clinical reviews link these agents to endothelial injury, cavernosal nerve damage, and peripheral neuropathy, changes that lead to ED during or after treatment. A study published in Frontiers in Endocrinology (2023) found that cisplatin (CDDP), a widely used chemotherapy drug, leads to erectile dysfunction (ED). The drug reduced the amount of smooth muscle and blood vessel cells in the penis and triggered aging in nerve cells, which together impaired nerve function and erection. These findings suggest that clinicians should monitor sexual function in cancer survivors treated with cisplatin.

Another study in Andrology (2022) used the FDA Adverse Event Reporting System. It confirmed that vincristine, doxorubicin, methotrexate, and docetaxel significantly impair erectile function.

Neurological/psychotropic drugs. Many drugs that affect the brain or nervous system also affect erections. They may alter hormone levels, nerve signals, or mood, leading to problems with sexual function.

Antiepileptics (valproate, carbamazepine, lamotrigine): They are tied to lower testosterone and higher ED rates. In a study published in Neurology (2005), men with epilepsy who used lamotrigine had sex drive and hormone levels that matched healthy men. In contrast, those using carbamazepine or phenytoin showed more sexual problems and lower testosterone levels. This suggests that lamotrigine may be less likely to cause sexual side effects than some other epilepsy drugs.

Opioids (chronic use): They suppress the hypothalamic-pituitary-gonadal axis, causing hypogonadism and ED.

Alongside cancer and nerve treatments, psychiatric drugs also stand out as a major cause of sexual side effects.

8) Do Psychiatric Medications Cause Erectile Dysfunction?

Yes, some psychiatric medications cause erectile dysfunction. These drugs often work by changing brain chemicals that control mood and behavior. But those same chemicals also play a role in sexual desire, arousal, and erections. When they are altered, men may notice problems such as reduced interest in sex, trouble getting or keeping an erection, or delayed orgasm.

Beyond brain-acting drugs, even everyday gastrointestinal and metabolic medications sometimes affect erections.

9) Do Gastrointestinal/Other Medications Cause ED?

Yes, some medications for gastrointestinal issues or other conditions may contribute to erectile dysfunction (ED). But, the risk is generally much lower compared to blood pressure, psychiatric, or hormone therapies. These drugs affect sexual function indirectly by altering hormones, reducing blood flow, or causing fatigue and other side effects.

Proton Pump Inhibitors (PPIs) – Omeprazole: Some case reports suggest a potential link between long-term PPI use and ED, possibly due to reduced nitric oxide availability or endothelial dysfunction. Omeprazole is a commonly prescribed drug for treating acid reflux and stomach ulcers. There have been case reports linking omeprazole to ED. For instance, a case study in the Journal of Medical Case Reports (2021) described a healthy 38-year-old man who developed sudden and severe ED within two days of starting over-the-counter omeprazole. His erectile function returned to normal shortly after discontinuing the drug.

Famotidine: Famotidine is commonly used to treat conditions like GERD. Unlike omeprazole, famotidine has not been strongly linked to ED.

Allopurinol, Febuxostat: They are medications used to treat gout by lowering uric acid levels. According to a study in Drugs (2022), men with gout who took febuxostat had a higher risk of developing erectile dysfunction (ED) compared to those taking allopurinol. The increased risk was particularly significant in younger men aged 19-64. The study suggests that healthcare providers should consider this potential side effect when prescribing febuxostat to male gout patients.

Finally, apart from prescription medicines, lifestyle factors and recreational substances like alcohol or drugs also play a big role in erectile health.

10) Recreational/Illicit Drugs

Recreational and illicit drugs have a major impact on sexual function, including erectile dysfunction (ED). These substances may affect blood flow, hormone levels, nerve signaling, and brain chemistry, all essential for normal erections.

Cocaine: This stimulant increases dopamine and causes narrowing of blood vessels. Short-term use may temporarily boost sexual desire, but repeated use damages blood vessels and nerves, often leading to ED. Chronic cocaine use is strongly linked to persistent erectile problems. According to a study in the American Journal of Drug and Alcohol Abuse (1988), researchers examined the impact of cocaine and alcohol abuse on sexual function. They found that both substances were associated with sexual dysfunction, including decreased libido and performance issues.

Cannabis (Weed/Marijuana): Evidence is mixed. Low to moderate use may not significantly affect erections, but heavy or chronic use alter hormone levels, reduce testosterone, and impair blood flow. Some men report difficulty achieving or maintaining erections with regular cannabis use. The relationship between cannabis use and ED is complex. Some studies suggest a link, others do not.

MDMA (Ecstasy): MDMA affects serotonin and dopamine pathways, which impair sexual arousal and erection. Short-term use often delays orgasm or reduces erectile ability. Repeated use leads to longer-lasting ED due to imbalances in neurotransmitters. In a study in European Psychiatry (2001), researchers examined how MDMA, commonly known as ecstasy, affects sexual function in humans. They found that MDMA use leads to both positive and negative changes in sexual behavior and performance. It also increased arousal and altered perception. These findings suggest that MDMA’s impact on sexual function is complex and may vary among individuals.

Alcohol: Although legal, alcohol is relevant because it is widely used recreationally. Moderate alcohol may not cause ED, but heavy or chronic consumption leads to nerve damage, hormonal imbalances, and vascular problems, increasing the risk of long-term erectile dysfunction. According to a study in Urologia Internationalis (2021), researchers reviewed 46 studies with over 216,000 men to see how alcohol affects erectile dysfunction (ED). A J-shaped relationship was found between alcohol consumption and ED risk. It showed that light to moderate drinking was linked to a lower risk of ED. However, heavy drinking did not help and may even increase the risk.

Can You Reverse ED Caused by Medications?

Yes, erectile dysfunction (ED) caused by medications can often be reversed, once the drug is adjusted. Recovery varies based on the type of drug and the individual. Many medications affect erections by reducing blood flow, altering hormone levels, or disrupting nerve signals. In many cases, erections improve when the drug is stopped, the dose is lowered, or a safer alternative is used. A review in the Adverse Drug Reactions Toxicology (1999) found that drug-related ED is mostly readily reversible once the problematic medicine is removed.

Some medicines show this clearly. ED is a common side effect of beta-blockers and diuretics. Many men regain normal function after changing to blood pressure drugs like ACE inhibitors or ARBs. Antidepressants, especially SSRIs, are another common cause. They reduce desire and make erections harder to achieve. In some cases, lowering the dose, changing to a different antidepressant, or adding a drug like bupropion help. Cancer drugs, antipsychotics, and hormone treatments may also trigger ED, but many men recover once treatment is adjusted or finished.

Still, not every case is fully reversible. Some medicines, such as SSRIs and finasteride, have been linked to sexual problems that last even after stopping the drug. Conditions like post-SSRI sexual dysfunction (PSSD) or persistent side effects from finasteride are rare but possible. This shows that drug-induced ED is not always temporary.

Overall, most men improve once the medication is changed, but recovery is not guaranteed for all. Because stopping or switching drugs affect health, it should only be done with a doctor’s guidance. Finding the cause early gives the best chance of restoring sexual function safely.

How Can You Manage Erectile Dysfunction Caused by Drugs?

Managing drug-related sexual problems starts with medical guidance. A doctor can confirm whether a specific medicine is responsible for the issue. Patients should never stop or adjust prescriptions without professional advice, since that can be unsafe. In many cases, doctors may change the treatment plan by switching to another drug, lowering the dose, or suggesting temporary breaks depending on the condition. When these steps are not enough, lifestyle changes such as exercise, a balanced diet, weight loss, and quitting smoking can improve sexual health. Counseling with a psychologist may also help with emotional factors. If symptoms persist, other options may be considered, including erectile dysfunction medication like sildenafil or tadalafil, as well as devices or surgical treatments.

What Are the Pills That Help with ED?

The main oral treatments for erectile dysfunction are designed to improve penile blood flow. Among them, sildenafil pills remain the most recognized option, while others provide different durations and onset times to suit patient needs.

1. Sildenafil Pills (Viagra)
   Sildenafil pills are the most commonly prescribed treatment for erectile dysfunction. They start working within 30 to 60 minutes and last for about 4 to 6 hours, making them suitable for on-demand use.
2. Tadalafil (Cialis)
   Tadalafil is known for its long duration of action. It can last up to 36 hours, which is why it is often called the “weekend pill.” Patients prefer it for greater flexibility.
3. Vardenafil (Levitra, Staxyn)
   Vardenafil works in a similar way to sildenafil but may be slightly more potent. It usually lasts 4 to 6 hours and is effective even in men with certain underlying health conditions.
4. Avanafil (Stendra)
   Avanafil is a newer option with a fast onset of action, often within 15 to 30 minutes. It has fewer side effects and is well tolerated by most patients.

Is There Any Generic for Sildenafil Tablet?

Yes, several generics are available as alternatives to the sildenafil tablet. Popular options include Cenforce, Caverta, Fildena, Kamagra, and Aurogra. These medicines contain the same active ingredient as Viagra and provide similar results at a lower cost.