Based on PubMed | Can amlodipine cause erectile dysfunction, and how common is this side effect?

Amlodipine and erectile dysfunction: what we know Amlodipine can be associated with erectile dysfunction (ED), but it appears to be an uncommon side effect and, in many studies, calcium channel blockers like amlodipine show little to no negative impact on sexual function compared with other blood pressure medicines. ^{[1] [2]}

Key takeaway

• Amlodipine’s official product labeling lists “sexual dysfunction” (including in males) as a possible adverse reaction. ^[1]
• Large reviews suggest calcium channel blockers overall have no meaningful adverse effect on erectile function, especially compared with thiazide diuretics and many beta‑blockers. ^[2]
• Real‑world reports and some observational analyses show ED can occur with various antihypertensives, but causation is often difficult to prove due to confounding factors like age, diabetes, and vascular disease. ^[3]

What the official labeling says

• Multiple FDA‑listed amlodipine labels include “sexual dysfunction (male and female)” among post‑marketing or infrequent adverse events. ^[1]
• This means ED is recognized as a potential side effect, though the labels do not provide a precise frequency from controlled trials. ^[1]

How common is it?

• The exact rate attributable to amlodipine alone is not clearly quantified in the labeling, indicating it is likely infrequent or uncommon. ^[1]
• Systematic analyses of cardiovascular drugs report that calcium channel blockers, as a class, generally have “no relevant” adverse effect on erectile function, in contrast to thiazide diuretics and many beta‑blockers, which are more consistently linked to ED. ^[2]
• Observational pharmacovigilance data suggest ED can be reported across most antihypertensive classes; however, reporting rates do not equal true incidence and are influenced by many biases. ^[3]

How amlodipine might affect erections (theory)

• Amlodipine is a dihydropyridine calcium channel blocker that relaxes vascular smooth muscle and lowers blood pressure, and it does not typically impair mechanisms required for erection; in fact, calcium channel blockers are largely considered neutral regarding erectile function. ^{[4] [2]}
• Experimental work suggests vasodilatory therapies and nitric‑oxide–cGMP pathways interact favorably with penile hemodynamics, which supports the view that calcium channel blockers are unlikely to directly worsen erectile physiology. ^{[5] [4]}

Distinguishing drug effect from other causes

• ED frequently coexists with cardiovascular risk factors like aging, diabetes, high blood pressure itself, and atherosclerosis, which can be stronger drivers of ED than the blood pressure medicine. ^[2]
• In spontaneous report series, ED often improved after stopping or switching the suspected drug (“positive dechallenge”), but confounding still limits certainty. ^[3]

Practical guidance if you notice ED on amlodipine

• Consider other contributors first: vascular risk factors, stress, depression, low testosterone, alcohol, and other medications (for example, thiazide diuretics and several beta‑blockers are more strongly linked to ED). ^[2]
• If timing suggests a connection to amlodipine and symptoms persist, a supervised switch within guideline‑appropriate antihypertensives (e.g., to an ACE inhibitor or ARB) can be considered while monitoring blood pressure control. ^[2]
• Approved ED treatments (phosphodiesterase‑5 inhibitors such as sildenafil) can be used safely with amlodipine for many people, though blood pressure may drop a bit more; clinicians typically adjust dosing and counsel on dizziness or lightheadedness. ^[5]

Bottom line

• ED can occur with amlodipine, as acknowledged in official labeling, but it seems to be uncommon and calcium channel blockers overall are generally viewed as neutral for sexual function compared with some other antihypertensives. ^{[1] [2]}