Many over-the-counter, prescription and recreational drugs can interfere with normal male sexual response and contribute to impotence. According to the American Urological Association, approximately 1/2 of the adult male population over age 50 in the United States experiences impotence. Evaluating the drugs being taken by a man experiencing impotence can help guide appropriate treatment.
Diuretics
Diuretics, or water pills, are commonly used to treat high blood pressure. According to the University of Maryland Medical Center, erectile dysfunction is a known side effect of these medications, especially the thiazide diuretics such as hydrochlorothiazide, chlorothiazide, bendroflumethiazide and benzyl hydrochlorthiazide.
Beta-Blocker Medicines
Beta-blocker medicines such as atenolol, propranolol, metoprolol and labetolol are frequently prescribed to treat high blood pressure, heart failure and abnormal heart rhythms. The Cleveland Clinic reports these medications may cause impotence in a significant number of men who take them for heart or blood pressure problems.
Calcium-Channel Blocker Medicines
Verapamil, nifedipine and diltiazem are calcium-channel blocker medications. Doctors use these drugs to treat abnormal heart rhythms and high blood pressure. According to Medline Plus, these drugs may contribute to male impotence. The Cleveland Clinic advises that calcium-channel blockers are less likely to cause impotence than beta-blockers, which are also used to treat heart problems.
Tricyclic Antidepressants and Monoamine Oxidase Inhibitors
Tricyclic antidepressants and monoamine oxidase inhibitors, or MAOIs, are antidepressant medications that may also be used to treat other psychiatric and physical disorders. Tricyclics such as amitriptyline and nortriptyline, and MAOIs such as phenelzine and isocarboxazid may cause impotence, according to Medline Plus.
Serotonin-Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors
Serotonin-reuptake inhibitors, or SRIs, and serotonin-norepinephrine reuptake inhibitors, or SNRIs, were developed as antidepressant medications. They are also frequently used to treat anxiety disorders and other psychiatric and medical conditions, including fibromyalgia and diabetic neuropathy. Impotence may be precipitated by SRIs such as paroxetine and fluoxetine, and SNRIs including duloxetine and venlafaxine, advises the University of Maryland Medical Center. The Cleveland Clinic reports erectile dysfunction, decreased sexual interest and difficulties achieving orgasm may occur with these medications.
Anti-psychotic Medicines
The Cleveland Clinic advises that anti-psychotic medications such as prochlorperazine and haloperidol may cause impotence. Other similar medications may also be associated with an increased incidence of impotence.
Histamine-2 Blockers
Cimetidine, famotidine, nizatidine and rantidine are histamine-2 blocker drugs that are commonly used to treat gastroesophageal reflux disease and heartburn. Medline Plus notes these drugs are associated with an increased incidence of impotence.
Hormones and Hormone Inhibitors
Testosterone is an important male hormone that supports normal sexual response. Estrogen-containing drugs, which oppose testosterone, and drugs that block the formation of male sex hormones such as dutasteride and leuprolide can lead to impotence, advises the University of Maryland Medical Center.
Narcotic Pain Relievers
Medline Plus notes that narcotic pain relievers are frequent contributors to male impotence. Drugs included in this class of medications include fentanyl, methadone, oxycodone, morphine, codeine, meperidine and hydromorphone.
Recreational and Illicit Drugs
According to the University of Maryland Medical Center, recreational and illicit drugs commonly contribute to impotence. Examples of these drugs include heroin, cocaine, amphetamines, marijuana, barbiturates, alcohol and nicotine from cigarette smoke.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Erectile Dysfunction
- American Urological Association: Erectile Dysfunction, Causes, Risks and Talking with Your Doctor
- Cleveland Clinic Center for Continuing Education: Erectile Dysfunction
- University of Maryland Medical Center: Impotence (Erectile Dysfunction) Causes
- University of Maryland Medical Center: Drugs That May Cause Impotence
