Managing Hypertension Medications and Erectile Dysfunction: Key Insights

Blood pressure medications and erectile dysfunction?

Hello Doctor, I have been taking medication for primary hypertension for the past six years.
For the first two years, I was on Epaned 5/80mg, which caused erectile dysfunction, and even with the use of Viagra or Cialis, the effects were unstable.
Recently, I switched to Norvasc 5mg starting last summer, and the erectile dysfunction has significantly improved.
However, with the recent drop in temperature, my blood pressure at home has been reaching 140/90 while only taking Norvasc 5mg.
During my follow-up visit, my doctor prescribed an additional dose of Diltiazem 80mg, stating it has kidney protective functions.

(1) I would like to know if adding Diltiazem will cause erectile dysfunction similar to Epaned?
(2) Additionally, can you tell me if the medication Caduet, as mentioned in the link below, can also avoid the side effect of erectile dysfunction? https://news.tvbs.com.tw/other/400735
(3) Is it possible for the doctor to prescribe both Norvasc and Caduet to lower blood pressure?
(4) Should antihypertensive medications and Viagra be taken a few hours apart for safety?

Liang Ba, 30~39 year old female. Ask Date: 2018/12/18

Dr. He Dongjin reply Cardiology

Hello, Koyue.
You and De'an should belong to the same family of medications (ARBs), and their side effects are expected to be similar.
Whether or not side effects occur can vary from person to person.
In theory, antihypertensive medications and Viagra should not conflict with each other, but if you are concerned, you can take them a few hours apart.
Changhua Hospital cares about you.

Reply Date: 2018/12/18

More Info

Managing hypertension, particularly in the context of erectile dysfunction (ED), is a complex issue that requires careful consideration of medication interactions and side effects. Your experience with various antihypertensive medications highlights the challenges many patients face when trying to manage both blood pressure and sexual health.

1. Impact of Adding Amlodipine (Norvasc): You mentioned that your doctor prescribed Amlodipine (Norvasc) in addition to your current medication, Nebivolol (Nebilet). Amlodipine is a calcium channel blocker that is often used to treat high blood pressure and can have a different side effect profile compared to beta-blockers like Nebivolol. While some beta-blockers can contribute to erectile dysfunction, Amlodipine is generally considered to have a lower incidence of this side effect. However, individual responses can vary. It is essential to monitor how you feel after starting Amlodipine, as it may not necessarily lead to the same issues you experienced with other medications.

2. Combination Therapy and ED: The link you provided discusses a combination of medications that may help mitigate erectile dysfunction while managing hypertension. Certain medications, such as angiotensin receptor blockers (ARBs) like Losartan or Valsartan, are known to have a more favorable side effect profile regarding sexual function. If you are considering adding a medication like "可悅您" (likely referring to a specific ARB or another antihypertensive), it is crucial to discuss this with your healthcare provider. They can help determine the best combination of medications that will effectively manage your blood pressure without exacerbating erectile dysfunction.

3. Medication Safety and Timing: Regarding the timing of taking antihypertensive medications and erectile dysfunction medications like Viagra (Sildenafil) or Cialis (Tadalafil), it is generally recommended to space them out to avoid potential interactions. For instance, taking a PDE5 inhibitor (like Viagra) too close to your antihypertensive medication can lead to a significant drop in blood pressure, which may cause dizziness or fainting. A common recommendation is to wait at least 4-6 hours after taking your blood pressure medication before taking a PDE5 inhibitor. However, this can vary based on individual health conditions and specific medications, so it’s best to follow your doctor’s advice.

4. Lifestyle Modifications: In addition to medication management, lifestyle changes can significantly impact both hypertension and erectile dysfunction. Regular exercise, a balanced diet low in sodium, maintaining a healthy weight, and avoiding smoking and excessive alcohol can improve overall cardiovascular health and may help alleviate some symptoms of erectile dysfunction.

5. Follow-Up and Monitoring: Regular follow-up appointments with your healthcare provider are essential to monitor your blood pressure and assess any side effects from your medications. If you notice any changes in your sexual health or experience side effects, it is crucial to communicate these with your doctor, who may adjust your treatment plan accordingly.

In conclusion, managing hypertension while addressing erectile dysfunction requires a comprehensive approach that includes medication management, lifestyle changes, and regular communication with your healthcare provider. By working closely with your doctor, you can find a treatment plan that effectively controls your blood pressure while minimizing the impact on your sexual health.

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