Can amlodipine cause erectile dysfunction? It is possible but uncommon, and the tablet may not be the cause. The Australian leaflet for amlodipine (Nordip) lists "sexual problems" among side effects that "may or may not be due to" the medicine, and its prescribing information puts male sexual dysfunction at under 1% of patients in the placebo-controlled trials. In a trial that followed men for up to four years, those taking amlodipine had erection problems about as often as those taking a placebo.
What does the amlodipine leaflet say about erections?
It lists "sexual problems", with indigestion, under the line "These may or may not be due to NORDIP, but you should tell your doctor"; the more common side effects are headache, dizziness, flushing, tiredness, drowsiness, and stomach pain or nausea (Nordip CMI, October 2024). The product information for prescribers is more precise. Male "sexual dysfunction" is among the events seen in 1% of patients or fewer, listed "where a causal relationship is uncertain", and the label adds that it occurred in under 1% of patients in the placebo-controlled trials and in 1% to 2% across all its multiple-dose studies (Nordip product information, revised October 2024). Amlodipine is a calcium channel blocker, and it works "by widening your blood vessels" (Nordip CMI).
Is amlodipine worse for erections than other blood-pressure tablets?
Not in the trial that compared them. The Treatment of Mild Hypertension Study followed 557 men for up to four years on a placebo or one of five medicines: amlodipine, chlorthalidone, acebutolol, enalapril or doxazosin. Only chlorthalidone, a diuretic, raised the rate of erection problems — 17.1% against 8.1% on placebo at two years, a gap that was no longer significant by four years. For amlodipine, acebutolol and enalapril the rate was "similar to that in the placebo group", and it was lowest with doxazosin (Grimm et al., Hypertension 1997). Australian Prescriber names diuretics and alpha- and beta-blockers among the medicines linked with erectile dysfunction (Australian Prescriber). The Australian leaflets differ from tablet to tablet. Losartan's lists "inability to get or maintain an erection" (Cozavan CMI). Telmisartan, which relaxes blood vessels by a different route — it blocks the hormone angiotensin II — does not list erection problems at all (Micardis CMI). Each has its own page: can telmisartan cause erectile dysfunction?, does losartan cause erectile dysfunction? and do beta-blockers cause erectile dysfunction?
Could high blood pressure be the cause rather than the tablet?
It may be. healthdirect counts high blood pressure among the conditions that contribute to erection problems, names reduced blood flow to the penis from clogged arteries as a cause, and notes that erection problems are often the first sign of high blood pressure or heart disease (healthdirect). In the trial above, 12.2% of the men already had erection problems before treatment began — more often the older they were, the higher their systolic blood pressure, and if they had taken blood-pressure medicine before — and the authors warned against "routine attribution of erection problems to antihypertensive medication" (Grimm et al.). More in can high blood pressure cause erectile dysfunction?
Should you stop amlodipine if your erections change?
No — talk to your doctor first. The leaflet says "to keep taking your medicine even if you feel well", and to speak to your doctor or pharmacist before you decide to stop any medicine (Nordip CMI). In the trial, erection problems on treatment in many cases "did not require withdrawal of medication" (Grimm et al.). What a GP looks at is the timeline between starting a medicine and the start of the problem (Australian Prescriber). The same question for blood-pressure tablets in general: can high blood pressure medication cause erectile dysfunction?
Can you take Viagra with amlodipine?
That is a separate question from whether amlodipine causes erection problems. In a study in 16 men with high blood pressure, amlodipine and sildenafil each lowered blood pressure on its own account when taken together (Nordip product information), and blood-pressure medicines are on healthdirect's list of medicines that interact with sildenafil (healthdirect — sildenafil). The full answer is in can Viagra be taken with amlodipine and other blood-pressure medicines?
The short answer
Sexual problems are a listed but uncommon side effect of amlodipine — under 1% of patients in its placebo-controlled trials, with the cause uncertain — and in a long trial men on it had erection problems no more often than men on a placebo. High blood pressure is itself a cause. Tell your doctor, and do not stop the tablet on your own. More medicines, one by one, are in our guide to which medicines and conditions can cause erectile dysfunction.
