Does amlodipine cause erectile dysfunction

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Does 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 there is ongoing research to understand the potential impact of antihypertensive medications, including amlodipine, on sexual health.

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 increase the long-term risk of erectile dysfunction compared to other common antihypertensive drugs.

Comparative Studies with Other Antihypertensive Drugs

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 does not directly imply that amlodipine causes ED but rather that losartan may offer additional protective benefits for penile health.

Interaction with Erectile Dysfunction Treatments

Combined Use with Sildenafil

Studies have shown that the combined use of amlodipine and sildenafil, a phosphodiesterase-5 inhibitor used to treat ED, is well-tolerated and does not significantly affect the pharmacokinetics of either drug 35. This indicates that amlodipine does not interfere with the effectiveness of sildenafil, and the combination can be a viable option for hypertensive patients experiencing ED.

Mechanistic Insights

Amlodipine has been observed to improve impaired relaxation in the penile corpus cavernosum in hypertensive rats, suggesting a potential beneficial effect on erectile function through the enhancement of nitric oxide (NO)-dependent relaxation pathways . This mechanistic insight supports the notion that amlodipine may not adversely affect erectile function and could even have a positive impact in certain contexts.

Conclusion

Current research indicates that amlodipine does not significantly increase the risk of erectile dysfunction compared to other antihypertensive medications. Additionally, it can be safely combined with ED treatments like sildenafil without adverse interactions. While some studies suggest that other antihypertensive drugs may offer additional protective benefits for penile health, amlodipine itself does not appear to be a direct cause of erectile dysfunction.

Sources and full results

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·

325citations

·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.

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

Long-term treatment with amlodipine significantly reduces testosterone levels in male albino rats, potentially impacting sexual function and enjoyment in men.

2010·

3citations

·F. Onwuka et al.

The safety of amlodipine.

Amlodipine has a good safety profile, with once-daily dosage, smooth onset, and long duration of action, making it a suitable antihypertensive and antiischemic agent.

Meta-AnalysisHighly Cited

1989·

72citations

·Ian H Osterloh

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