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What Causes Erectile Dysfunction While On Atenolol?
Question: I have been on Atenolol (25 mg per day for almost a year), for tachycardia and hypertension. You advised me to take it. It was working fine for most of the year.
However, I (lately) noticed that 25 mg is not enough as my tacchcardia can sometimes be obvious (HR from 80 to 100), and BP reaches 150/90.
As far as ED is concerned, I noticed that most of the time, Atenolol improved blood flow to the penis and there was no signs of ED.
However, I lately (again) became impotent (only about 3 to 4 weeks ago and all of a sudden). Penis is not hard enough to do penetration at all. My sex drive is almost gone also. No matter what my wife does to excite me, it does not work. I also lost morning erection (is it because beta blockers lower blood levels of testosterone?).
Although my sex life is in jeopardy, I did not try to take any ED drugs because of their possible side effects that might include blindness.
Few months ago, I got an advice from you to use atenolol 50 daily (and on the day I use Viagra 50, I should reduce Atenolol to 25). I am still on Atenolol 25 daily and never took Viagra till now. Can this regimen work with Cialis also as it may be more safe?
Or I should switch to an alternative antihypertensive drug that has lower risk of causing ED and/or use a safe ED drug?
Please advice me about a suitable antihypertensive drug / ED drug combination.
However, I (lately) noticed that 25 mg is not enough as my tacchcardia can sometimes be obvious (HR from 80 to 100), and BP reaches 150/90.
As far as ED is concerned, I noticed that most of the time, Atenolol improved blood flow to the penis and there was no signs of ED.
However, I lately (again) became impotent (only about 3 to 4 weeks ago and all of a sudden). Penis is not hard enough to do penetration at all. My sex drive is almost gone also. No matter what my wife does to excite me, it does not work. I also lost morning erection (is it because beta blockers lower blood levels of testosterone?).
Although my sex life is in jeopardy, I did not try to take any ED drugs because of their possible side effects that might include blindness.
Few months ago, I got an advice from you to use atenolol 50 daily (and on the day I use Viagra 50, I should reduce Atenolol to 25). I am still on Atenolol 25 daily and never took Viagra till now. Can this regimen work with Cialis also as it may be more safe?
Or I should switch to an alternative antihypertensive drug that has lower risk of causing ED and/or use a safe ED drug?
Please advice me about a suitable antihypertensive drug / ED drug combination.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on asking on HCM!
I passed carefully through your question and would explain that erectile dysfunction is a known adverse effect of atenolol. This adverse effect is not dose dependent, which means that even low doses of atenolol can cause this adverse effect.
In many studies, beta-blockers (except for nebivolol) have shown to cause erectile dysfunction.
From the other hand beta-blockers are not very effective in lowering blood pressure. Their main action is on the heart rate (by lowering it). Another known adverse effect of these drugs is the decrease in physical performance.
But, If you would like to continue on a beta-blocker, I would recommend switching to nebivolol, which is the only beta-blocker that does not cause erectile dysfunction. You can start from a dose of 5mg daily and increase the dose slowly (by 5 mg every two weeks) depending on your heart rate and blood pressure values.
Other anti-hypertensive drugs to consider would be ARB (losartan, valsartan) or ACEI (lisinopril, ramipril, etc.). These drugs are more preferred compared to beta-blockers, because they have less adverse effects in this regard.
So, you can start ramipril with a dose of 2.5mg daily and increase the dose with 2.5mg every week up to the maximal daily dose of 20mg daily (based on your blood pressure values).
The same is for valsartan: you can start with the dose of 40mg daily and increase every week with 40mg (based on your blood pressure values).
Regarding interaction between betablockers and viagra or cialis it is similar. All the betablockers (including atenolol or bisoprolol) can cause low blood pressure when combined with viagra or cialis. So, they should be used with caution (reduce the dose of bisoprolol) the day that you are going to take viagra or cialis.
The same is for all other anti-hypertensive drugs (including valsartan and ramipril).
You should discuss with your doctor on the above issues.
Feel free to ask me again whenever you need!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on asking on HCM!
I passed carefully through your question and would explain that erectile dysfunction is a known adverse effect of atenolol. This adverse effect is not dose dependent, which means that even low doses of atenolol can cause this adverse effect.
In many studies, beta-blockers (except for nebivolol) have shown to cause erectile dysfunction.
From the other hand beta-blockers are not very effective in lowering blood pressure. Their main action is on the heart rate (by lowering it). Another known adverse effect of these drugs is the decrease in physical performance.
But, If you would like to continue on a beta-blocker, I would recommend switching to nebivolol, which is the only beta-blocker that does not cause erectile dysfunction. You can start from a dose of 5mg daily and increase the dose slowly (by 5 mg every two weeks) depending on your heart rate and blood pressure values.
Other anti-hypertensive drugs to consider would be ARB (losartan, valsartan) or ACEI (lisinopril, ramipril, etc.). These drugs are more preferred compared to beta-blockers, because they have less adverse effects in this regard.
So, you can start ramipril with a dose of 2.5mg daily and increase the dose with 2.5mg every week up to the maximal daily dose of 20mg daily (based on your blood pressure values).
The same is for valsartan: you can start with the dose of 40mg daily and increase every week with 40mg (based on your blood pressure values).
Regarding interaction between betablockers and viagra or cialis it is similar. All the betablockers (including atenolol or bisoprolol) can cause low blood pressure when combined with viagra or cialis. So, they should be used with caution (reduce the dose of bisoprolol) the day that you are going to take viagra or cialis.
The same is for all other anti-hypertensive drugs (including valsartan and ramipril).
You should discuss with your doctor on the above issues.
Feel free to ask me again whenever you need!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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