Drug induced erectile dysfunction (ED) is an important problem that we need to assess with our patients.  Here’s the case! A 48 year old male presents with a past medical history of hypertension, glaucoma, and erectile dysfunction.  His blood pressure has been a problem in the past.  He has incorporated a better lifestyle including more exercise and adoption of the DASH diet.  His current blood pressure is fairly good at 138/68.

His primary concern with you is that he recently started taking sildenafil for his erectile dysfunction and it doesn’t seem to be working despite the dose being maximized.  He did notice that when he doesn’t take his blood pressure medication, he is able to have an erection.

Other medications include:

• Amlodipine
• Atenolol
• Travatan

Beta blockers and diuretics tend to be the worst antihypertensives as far as contributing to erectile dysfunction issues and we should try to do an alternative if we have that option. Reference

In this case, our patient was able to successfully be transitioned to lisinopril which is usually a much better blood pressure option to avoid sexual dysfunction.

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