If your erections changed around the time you started a new medicine, the medicine may be part of the reason. Many common prescription and over-the-counter medicines can affect erections or sex drive1. The good news is that there is usually something your doctor can do, but the first rule is simple: do not stop a medicine on your own.
How medicines can affect erections
An erection needs good blood flow, working nerves, the right hormone levels and sexual desire. Medicines can interfere with any of these, and some also delay orgasm or change ejaculation. The condition being treated can itself cause ED too, so it is not always easy to tell whether the medicine or the illness is to blame.
Medicines most often linked to ED
| Type of medicine | Examples |
|---|---|
| Antidepressants | SSRIs (such as sertraline, fluoxetine) and tricyclics2 |
| Some blood pressure medicines | Thiazide diuretics (“water tablets”) and beta-blockers2 |
| Antipsychotics | Medicines for psychosis and some mood conditions2 |
| Hormone treatments | Hormone therapy for prostate cancer; finasteride and dutasteride (5-alpha-reductase inhibitors)2 |
| Some painkillers | Codeine and oxycodone; non-steroidal anti-inflammatories1 |
| Others | Antihistamines (including some for heartburn), ulcer medicines, sedatives, appetite suppressants and chemotherapy1 |
| Recreational drugs | Cannabis, cocaine, heroin, methadone, anabolic steroids and heavy drinking2 |
Not everyone who takes these medicines gets ED. The list tells you what to ask about, not what will definitely happen.
Antidepressants
The NHS lists sexual problems among the side effects of antidepressants, including low sex drive, difficulty reaching orgasm and difficulty getting or keeping an erection. For some people, these problems may carry on after stopping3.
Depression itself can also cause ED1, so treating it properly matters. If sexual side effects are a problem, talk to your doctor. They may suggest a different dose or a different medicine4. The NHS advises never stopping an antidepressant suddenly, because it can cause withdrawal symptoms; any change should be planned with your doctor3.
Blood pressure medicines
European guidelines list thiazide diuretics and beta-blockers among the blood pressure medicines linked to ED2. However, they also note that a large analysis found heart and blood pressure medicines did not strongly affect the risk of later being prescribed an ED treatment2. High blood pressure damages blood vessels and is itself a common cause of ED1.
So never stop a blood pressure tablet because of ED. Your doctor may be able to change the medicine, and ED tablets can usually be taken with blood pressure medicines; see our guide to ED pills and blood pressure. For the main blood pressure medicine groups, see ACE inhibitors vs ARBs.
Prostate and hair-loss medicines
- Finasteride and dutasteride are used for an enlarged prostate, and finasteride also for hair loss. The NHS lists problems getting an erection and less interest in sex as common side effects of finasteride, along with ejaculation problems. They usually improve, but can sometimes carry on after stopping5.
- Tamsulosin mainly affects ejaculation rather than erections: less semen, no ejaculation, or semen going backwards into the bladder. This was dose-related in trials6. Tamsulosin also needs care when combined with ED tablets because both lower blood pressure6.
Our guide to tamsulosin vs finasteride explains how these medicines work.
Hormone therapy for prostate cancer
Medicines that lower or block testosterone, used to treat prostate cancer, are also linked to ED and lower sex drive2. Our guide to ED after prostate cancer treatment covers this in detail.
What about HIV medicines?
People often ask whether dolutegravir (in Tivicay, Dovato and Triumeq) or Biktarvy cause ED. Erectile dysfunction is not listed as a side effect on the US labels for these medicines78. That does not rule out an effect in an individual person, and HIV itself, low mood and other medicines can all play a part. If you notice a change, talk to your HIV team rather than stopping treatment. Our guide to HIV medication side effects covers the side effects that are listed.
What to do if you think a medicine is the cause
- Do not stop it on your own. Talk to the doctor who prescribed it first4.
- Note the timing. When did the problem start, and did you start or change a medicine around then?
- Ask about options. Your doctor may suggest a different dose or switch you to another medicine4.
- Ask about ED treatment. If the medicine is essential, an ED tablet may still help, as long as it is safe with your other medicines. ED tablets have been shown to work in men taking antidepressants and blood pressure medicines9.
Our ED medicines page lists the treatments we supply. If you are young and wondering about the cause, see erectile dysfunction in young men.
ED tablets we supply include Viagra 100 mg, Cialis 20 mg and Levitra 20 mg. All need a prescription, and your prescriber should check them against your other medicines.
Frequently asked questions
Do antidepressants cause ED?
They can. Sexual problems, including difficulty getting or keeping an erection, are a known side effect of antidepressants, and for some people they carry on after stopping. Talk to your doctor before making any change.
Which blood pressure medicine does not cause ED?
Guidelines link thiazide diuretics and beta-blockers to ED, but the overall effect of blood pressure medicines on ED appears small, and high blood pressure itself causes ED. Ask your doctor whether a different medicine would suit you. Do not stop your tablets on your own.
Does finasteride cause permanent ED?
Erection problems and lower sex drive are common side effects of finasteride. They usually improve, but the NHS says they can sometimes carry on after stopping. If you notice them, speak to your doctor.
Does dolutegravir cause erectile dysfunction?
ED is not listed as a side effect on the US labels for dolutegravir, Dovato, Triumeq or Biktarvy. If you notice a change, speak to your HIV team, because other causes are possible and treatment should not be stopped.
Can I take an ED tablet with my other medicines?
Often yes, but not with nitrates or riociguat, and some medicines need a lower ED tablet dose. Give your prescriber a full list of everything you take.
Sources & references
- National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and Causes of Erectile Dysfunction. Last reviewed October 2024.
- European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Management of erectile dysfunction.
- NHS. Antidepressants. Page last reviewed 12 June 2025.
- National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for Erectile Dysfunction. Last reviewed October 2024.
- NHS. Side effects of finasteride. Page last reviewed 2 August 2023.
- US National Library of Medicine, DailyMed. Tamsulosin hydrochloride capsules prescribing information.
- US National Library of Medicine, DailyMed. Tivicay (dolutegravir) prescribing information.
- US National Library of Medicine, DailyMed. Biktarvy prescribing information.
- US National Library of Medicine, DailyMed. Viagra (sildenafil) prescribing information.
Related reading
- Can women take Viagra?
- ED in young men
- What is erectile dysfunction?
- Diabetes and erectile dysfunction
- Tamsulosin medicines
- Dutasteride medicines
- Sildenafil medicines
This content is for informational purposes only and is not medical advice. Never stop or change a prescribed medicine without talking to your doctor. Used as prescribed by a licensed medical professional.
Hari Ramalingam is a licensed clinical pharmacist with 14 years of experience. He holds a B.Pharm from Dr. M.G.R. Medical University. At OnlineMeds, he reviews medicine and health content to help ensure it is accurate, evidence-based, and easy to understand.