Medicines and Health Conditions That Can Cause Erectile Dysfunction

Short answer: some medicines list erection problems as a side effect in their UK product information (the summary of product characteristics, or SmPC, section 4.8), including some blood pressure medicines (such as ramipril, amlodipine, bisoprolol and bendroflumethiazide), antidepressants such as sertraline and citalopram, gabapentin and finasteride. Conditions that affect blood flow, nerves or hormones can cause it too, such as high blood pressure, high cholesterol, diabetes and heart disease (nhs.uk, British Heart Foundation). Do not stop any prescribed medicine unless your doctor tells you to. Finasteride is different if your mood changes: stop it and seek medical advice (see below). If this is your first time with erection problems, see your GP to check your blood sugar, cholesterol and testosterone, and have a heart health check at least every 5 years. A man taking one of these medicines may still be able to take an erectile dysfunction tablet if a pharmacist or doctor who checks everything he takes finds it suitable, but never with nitrates, including poppers.

This guide gives what each medicine's UK product information says, read on the electronic medicines compendium (emc) and MHRA Products in October 2026, and what the NHS and UK health charities say about the conditions. The general causes, such as stress and lifestyle, are in what is erectile dysfunction.

Which drugs and medications can cause erectile dysfunction?

Medicines whose UK product information lists erection problems include some blood pressure medicines, some antidepressants, gabapentin and finasteride 1mg. The table gives section 4.8 of each, grouped by what the medicine treats.

The bands are the product information's own: very common, more than 1 in 10 people; common, up to 1 in 10; uncommon, up to 1 in 100; rare, up to 1 in 1,000; very rare, up to 1 in 10,000; and not known, where the frequency cannot be estimated from the available data. Each row comes from separate product information, so the rows cannot be compared to show that one medicine is less likely than another to cause erection problems.

Prostate Cancer UK's own list of medicines that can cause erection problems adds medicines for ulcers and an irregular heartbeat, and its advice is the same as ours: do not stop taking any medicines you are on, but ask your doctor or nurse whether they could be affecting your erections.

Can blood pressure tablets cause erectile dysfunction?

Yes, some can: ramipril and amlodipine list erection problems as uncommon, bisoprolol as rare and bendroflumethiazide without a frequency, and high blood pressure is itself a cause (nhs.uk). The British Heart Foundation says beta-blockers and diuretics, the types of medicine bisoprolol and bendroflumethiazide are, can worsen erection problems because they can reduce blood flow to the penis.

Bendroflumethiazide's product information describes the problem as reversible when the medicine is stopped, but whether to stop or change a blood pressure medicine is your prescriber's decision, never one to make yourself: bisoprolol's says treatment should not be stopped suddenly (SmPC 4.2).

Which blood pressure medicine does not cause erectile dysfunction?

Ask the doctor or nurse who prescribes yours. The right medicine depends on your blood pressure, heart, kidneys and other medicines, so no list can rank them, and the NHS says your doctor may switch you to a different medicine if one is causing your erectile dysfunction.

Can antidepressants cause erectile dysfunction?

Yes, some can: sertraline and citalopram, two SSRI antidepressants, list erection problems and a lower sex drive as common, affecting up to 1 in 10 people, and both say there have been reports of sexual problems that continued after an SSRI was stopped (SmPC 4.4 and 4.8). Depression and anxiety can cause erection problems on their own (nhs.uk).

Never stop an antidepressant suddenly or on your own: the product information for both says withdrawal symptoms are common, particularly when treatment is stopped suddenly, and that the dose should be reduced gradually, over at least one to two weeks and for some people over several weeks or months (SmPC 4.2 and 4.4). If erection problems bother you, speak to the doctor who prescribes it before changing anything.

Can statins cause erectile dysfunction?

Possibly, but the evidence is limited: atorvastatin's UK product information does not list erection problems in its table of side effects, though it notes that sexual dysfunction has been reported with some statins, with no frequency given (Lipitor SmPC 4.8), and the British Heart Foundation says there is limited evidence about statins and erections. High cholesterol itself can cause erection problems (nhs.uk), so speak to your prescriber rather than stopping a statin.

Can gabapentin, tamsulosin or finasteride cause erectile dysfunction?

Gabapentin and finasteride list erection problems in their UK product information, gabapentin as common and finasteride 1mg as uncommon, while tamsulosin's lists problems with ejaculation but not with erections (we read its section 4.8 in full).

• Gabapentin, for epilepsy and nerve pain, should not be stopped suddenly (Neurontin SmPC 4.4).
• Tamsulosin, one of the medicines the NHS lists for an enlarged prostate, is an alpha-blocker, which matters if you take an erectile dysfunction tablet (see below).
• Finasteride 1mg, for male pattern hair loss: In some men, sexual side effects have carried on after they stopped taking finasteride. Sexual side effects have also been linked to changes in mood, including thoughts of suicide. If you have any sexual side effects, ask our pharmacist or your GP for advice. If you notice changes in your mood, such as low mood, depression, anxiety or thoughts of suicide, stop taking finasteride and seek medical advice. Call 999 or go to A and E if you feel unsafe, or call the Samaritans free on 116 123 at any time. More in finasteride side effects and on our finasteride page.

Which health conditions cause erectile dysfunction?

Conditions that affect the blood vessels, nerves or hormones can cause erection problems that keep happening: the NHS names high blood pressure, high cholesterol, diabetes, depression or anxiety, and hormone problems.

• Diabetes. Diabetes UK says men with diabetes are three times more likely to have trouble getting or keeping an erection than men without it, because blood sugar that stays high for a long time can damage the blood vessels and nerves that supply the penis.
• Heart disease. The British Heart Foundation says erectile dysfunction can be a warning sign of narrowed arteries and of an increased risk of a heart attack (see the diagram), and that heart failure can worsen it.
• After a heart attack or stroke. We do not supply erectile dysfunction treatment after a stroke or heart attack in the last 6 months. The British Heart Foundation says these tablets can be prescribed from 6 months after a heart attack, providing your condition is stable.
• Conditions of the brain and nerves, such as epilepsy, multiple sclerosis or Parkinson's disease, and prostate problems and their treatments (Prostate Cancer UK).
• Hormone problems, such as low testosterone (see below).

Our consultation asks about risk factors for heart disease, such as:

• Uncontrolled high blood pressure
• High cholesterol
• Diabetes
• Smoking
• Obesity
• Physical inactivity
• Family history of cardiovascular disease

With three or more, we cannot supply treatment until your GP has assessed your heart health; once your GP is happy, treatment may still be an option.

Is erectile dysfunction a sign of prostate cancer?

Not usually on its own: Prostate Cancer UK says most men with early prostate cancer have no signs or symptoms, and lists problems getting or keeping an erection among the symptoms of cancer that has broken out of the prostate or spread, which it says can all be caused by other health problems.

The other symptoms it lists for cancer that has spread are back, hip or pelvis pain, blood in the urine or semen, and unexplained weight loss; tell your GP about any of them. Changes in the way you urinate are more likely to be an enlarged prostate or another health problem, it says, but are still worth getting checked. Treatment for prostate cancer can itself cause erection problems: Prostate Cancer UK says surgery, external beam radiotherapy, brachytherapy, HIFU and cryotherapy can damage the nerves and blood vessels needed for an erection, and that hormone therapy can lower sex drive and cause erection problems. The NHS says the same of surgery to remove the prostate. Prostate Cancer UK's specialist nurses are on 0800 074 8383.

Can low testosterone cause erectile dysfunction?

Sometimes: hormone problems, including low testosterone, are among the causes of erection problems (nhs.uk, Prostate Cancer UK), but the NHS says that in many men in their late 40s and early 50s the symptoms are nothing to do with hormones.

Testosterone falls by about 1% a year from around the age of 30 to 40, which the NHS says is unlikely to cause problems in itself. A deficiency that develops later in life (late-onset hypogonadism) is uncommon, and more likely in men who are obese or have type 2 diabetes. Your GP can check your testosterone with a blood test and refer you to a hormone specialist if it is low (nhs.uk). We do not test or treat testosterone.

Can you take an erectile dysfunction tablet with these medicines?

Often, yes, if the pharmacist finds it suitable: in our consultation, blood pressure medicines and finasteride are cautions a GPhC-registered pharmacist reviews before supply, not reasons on their own to refuse, but some medicines, nitrates above all, rule out every erectile dysfunction tablet.

• Blood pressure medicines. In trials of sildenafil, the medicine in Viagra, men taking the main types of blood pressure medicine had the same pattern of side effects on sildenafil as on a dummy tablet (placebo), though with amlodipine it lowered blood pressure a little further, by about as much as it does on its own (Viagra SmPC 4.5). In studies, tadalafil had no clinically significant interaction with the main types, though its product information says men taking them should be told their blood pressure may fall (Cialis 10mg SmPC 4.5). On daily tadalafil with blood pressure medicines: If you feel dizzy or sick, see your GP to review your blood pressure medicine.
• Alpha-blockers. We ask: "Do you take an alpha-blocker (tamsulosin, alfuzosin, doxazosin, terazosin, prazosin, silodosin or indoramin)?" These are often used for prostate symptoms or blood pressure. With one, a few men get dizzy from low blood pressure, most likely within 4 hours of a sildenafil tablet (Viagra SmPC 4.4), and tadalafil's product information does not recommend it with doxazosin (SmPC 4.5). So we also ask: "Has your alpha-blocker dose stayed the same recently, without dizziness or fainting?" If the answer is no, the consultation says: "We can only supply erectile dysfunction treatment once your alpha-blocker dose has stayed the same, without dizziness or fainting." Treatment starts on the smallest dose, such as sildenafil 25mg, and we do not supply tadalafil taken when needed with any alpha-blocker, tadalafil in either form with doxazosin, or avanafil with tamsulosin or doxazosin.
• Finasteride or dutasteride. In our prescription consultation finasteride is a caution the pharmacist reviews, and dutasteride is checked with your other medicines. Tadalafil's product information advises caution with medicines of this type (5-alpha reductase inhibitors), because no formal interaction study has been done (SmPC 4.5). The pharmacy checklist for Viagra Connect and Cialis Together, which are supplied after a pharmacist consultation with no prescription needed, lists "Taking finasteride or dutasteride, for your prostate or for hair loss" and says: If any of these apply to you, please do not order Viagra Connect or Cialis Together. Speak to your GP, or start our full consultation, where our pharmacist will check whether a prescription treatment is safe for you.
• Antidepressants, gabapentin and statins are not on our list of medicines that rule treatment out, and in sildenafil's product information SSRI and tricyclic antidepressants did not change how the body handles it (SmPC 4.5). The list does include "Rifampicin, phenobarbital, phenytoin, carbamazepine or St John's Wort", so tell us every medicine, herbal remedy and supplement you take: the pharmacist checks each one.

Not suitable if you take:

• Nitrates in any form, including nicorandil or amyl nitrite (poppers)
• Riociguat (Adempas) or vericiguat (Verquvo)
• An HIV protease inhibitor (atazanavir, darunavir, ritonavir, fosamprenavir, lopinavir, saquinavir or tipranavir)
• Ketoconazole, itraconazole, voriconazole or clarithromycin
• Or have severe cardiovascular disease

If your answers rule out every tablet we supply, the consultation says so: "Your answers rule out every erectile dysfunction treatment we can supply. This is a safety limit, not a judgement about you." Please speak to your GP, who has your full records and can assess you safely. Your GP may refer you on to a specialist, for example in cardiology, urology or endocrinology.

How the tablets differ is in sildenafil vs tadalafil, and their side effects in Viagra side effects and tadalafil side effects. Less common side effects are listed in the leaflet in your pack. Please read it before your first dose. The NHS warns that many websites sell fake medicines: see how to check your medicine is genuine. We tell your GP about your treatment if you agree: Will you tell my GP?

What should you do if you think a medicine is causing erectile dysfunction?

Keep taking it and speak to whoever prescribes it: the NHS says your doctor may switch you to a different medicine if one is causing your erectile dysfunction. Finasteride is different if your mood changes: stop it and seek medical advice, as above.

1. Keep taking it. Do not stop any prescribed medicine unless your doctor tells you to. Some, such as bisoprolol, sertraline and gabapentin, need to be reduced slowly, with your prescriber's advice, rather than stopped suddenly, their product information says.

2. Speak to whoever prescribes it. Your GP, nurse or specialist can check whether the medicine could be playing a part, alongside the condition it treats and your other medicines.

3. Ask a pharmacist. A pharmacist can go through your medicines and their leaflets with you, and check whether an erectile dysfunction tablet can be taken alongside them.

4. Get the cause checked. See a GP if erection problems keep happening: the NHS says it might be a sign of a health condition that can be treated.

5. Report the side effect. Tell us or your GP about any side effect. You can also report it to the MHRA Yellow Card scheme.

If a tablet you have tried has not helped, see Viagra not working; for treatments other than tablets, see alternatives to Viagra.