Can amlodipine cause erectile dysfunction

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Can Amlodipine Cause Erectile Dysfunction?

Introduction to Amlodipine and Erectile Dysfunction

Amlodipine is a widely used calcium channel blocker prescribed for the treatment of hypertension and angina. Erectile dysfunction (ED) is a common concern among patients with cardiovascular diseases, and the potential impact of antihypertensive medications on sexual function is a critical consideration for both patients and healthcare providers.

Amlodipine and Erectile Dysfunction Risk

Long-Term Risk Assessment

A comprehensive study examining the 18-year risk of various conditions, including erectile dysfunction, among users of different antihypertensive drugs found no statistically significant difference in the risk of ED between patients taking amlodipine and those taking other antihypertensive medications such as chlorthalidone and lisinopril . This suggests that amlodipine does not significantly increase the long-term risk of developing erectile dysfunction compared to other common antihypertensive drugs.

Comparative Studies with Other Antihypertensives

Research comparing the effects of losartan (an angiotensin II receptor blocker) and amlodipine on penile structures in hypertensive rats indicated that while both drugs effectively reduced blood pressure, losartan provided more significant protection against structural changes in the erectile tissue . However, this study did not directly link amlodipine to an increased risk of erectile dysfunction but highlighted the superior protective effects of losartan on penile health.

Interaction with Erectile Dysfunction Medications

Combined Use with Sildenafil

Several studies have explored the interaction between amlodipine and sildenafil, a common treatment for erectile dysfunction. One study demonstrated that sildenafil enhances the beneficial hemodynamic effects of amlodipine in hypertensive rats, suggesting a potential therapeutic synergy without adverse effects on erectile function . Another study confirmed that the combined administration of tadalafil (another PDE5 inhibitor) and amlodipine was well tolerated in healthy male subjects, with no significant increase in adverse events compared to monotherapy .

Blood Pressure and Erectile Function

A study investigating the effects of sildenafil in men with hypertension taking amlodipine found that sildenafil produced additive reductions in blood pressure without significant adverse effects, indicating that the combination is safe and does not exacerbate erectile dysfunction . Additionally, treatment with amlodipine improved neurogenic relaxation in the penile corpus cavernosum of hypertensive rats, suggesting a potential benefit for erectile function in hypertensive patients .

Conclusion

Current research indicates that amlodipine does not significantly increase the risk of erectile dysfunction compared to other antihypertensive medications. Moreover, when combined with erectile dysfunction treatments like sildenafil or tadalafil, amlodipine is well tolerated and may even enhance therapeutic outcomes. Therefore, patients concerned about erectile dysfunction while on amlodipine therapy should discuss their options with their healthcare provider, but the evidence suggests that amlodipine is unlikely to be a major contributing factor to ED.

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Most relevant research papers on this topic

Sildenafil augments the beneficial hemodynamic and histopathological effects of amlodipine in nitric oxide-deficient hypertensive rats: role of nitric oxide-cyclic GMP pathway.

Sildenafil enhances the beneficial hemodynamic and histopathological effects of amlodipine in nitric oxide-deficient hypertensive rats, with a key role played by the NO-cGMP pathway.

RCTAnimal Study

2008·

11citations

·M. Aboutabl et al.

The 18-year risk of cancer, angioedema, insomnia, depression, and erectile dysfunction in association with antihypertensive drugs: post-trial analyses from ALLHAT–Medicare linked data

Lisinopril has a higher risk of angioedema over 18 years, while amlodipine and chlorthalidone have similar risks, while erectile dysfunction risk remains unchanged.

Observational Study

2023·

0citations

·Xianglin L. Du et al.

Pharmacokinetic Drug Interaction Between Amlodipine and Tadalafil: An Open-Label, Randomized, Multiple-Dose Crossover Study in Healthy Male Volunteers

The combined administration of tadalafil and amlodipine shows a substantial pharmacokinetic drug interaction, but is well tolerated in healthy male subjects.

RCTRigorous Journal

2022·

1citation

·Hyungsu Kim et al.

Different Effect of Losartan and Amlodipine on Penile Structures in Male Spontaneously Hypertensive Rats

Losartan, but not amlodipine, effectively protects penile structures from structural changes caused by arterial hypertension.

2004·

33citations

·J. Toblli et al.

Sildenafil citrate and blood-pressure-lowering drugs: results of drug interaction studies with an organic nitrate and a calcium antagonist.

Sildenafil citrate can potentiate the hypotensive effects of glyceryl trinitrate, an organic nitrate, without significantly affecting heart rate or heart rate variability.

RCTHighly Cited

1999·

323citations

·David J. Webb et al.

Treatment with Hypotensive Agents Affects the Impaired Relaxation of the Penile Corpus Cavernosum in Hypertensive Rats

Amlodipine and imidapril improve impaired relaxation in the corpus cavernosum of hypertensive rats by increasing neuronal NO synthesis and release, potentially improving erectile dysfunction.

Non-RCTAnimal Study

2006·

11citations

·M. Ushiyama et al.

In vivo and in vitro effects of nebivolol on penile structures in hypertensive rats.

Nebivolol effectively reduces blood pressure and protects against structural changes in erectile tissue in hypertensive rats, while amlodipine shows similar blood pressure control.

Non-RCTAnimal Study

2006·

30citations

·J. Toblli et al.

Formulation of Double-layer Tadalafil and Amlodipine Complex Tablets to Treat Erectile Dysfunction and Hypertension

The double-layer complex tablet effectively treats erectile dysfunction and hypertension, offering a potential pharmaceutical therapeutic agent.

In Vitro Study

2019·

1citation

·Eun Yeong Shin et al.

Interactions between drugs for erectile dysfunction and drugs for cardiovascular disease

Erectile dysfunction drugs can interact with cardiovascular disease drugs, potentially leading to severe hypotension, increased bleeding risk, and poor documentation on drug interactions.

2002·

32citations

·U. Simonsen

EFFECT OF ANTIHYPERTENSIVE THERAPY ON METABOLIC PROFILE AND ERECTILE FUNCTION IN HYPERTENSIVE MEN WITH HIGH CARDIOVASCULAR RISK: FOCUS ON THE COMBINATION OF LISINOPRIL AND AMLODIPINE

The combination of lisinopril and amlodipine significantly reduced blood pressure in hypertensive men with high cardiovascular risk without affecting plasma lipid profile, glucose, and uric acid levels or erectile function.

Non-RCT

2010·

0citations

·Mamedov Mn et al.

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