From the FDA Drug Label
Urogenital/Reproductive: dysuria, kidney calculus, nocturia, breast engorgement, polyuria, urogenital disorder, erectile dysfunction (ED)
- Erectile dysfunction (ED) is listed as a potential adverse event in the urogenital/reproductive category.
- The FDA drug label for nifedipine extended-release tablets reports erectile dysfunction (ED) with an incidence of less than 3% in daily doses up to 90 mg 1.
- Nifedipine may cause erectile dysfunction in some patients.
From the Research
Nifedipine is unlikely to cause significant erectile dysfunction, and its impact on sexual function may be minimal or even slightly positive in some cases, as suggested by a study from 1993 2. As a calcium channel blocker used to treat high blood pressure and angina, nifedipine works by relaxing blood vessels, which can sometimes affect blood flow patterns necessary for achieving and maintaining erections. However, the evidence from the provided studies does not strongly support a significant link between nifedipine and erectile dysfunction. In fact, a study from 1993 2 found that nifedipine showed a trend toward improved sexual function, although this was not statistically significant. Another study from 1988 3 found that nifedipine caused sexual dysfunction, mainly problems in ejaculation, in the short term, but this effect was not observed in the long term. It's essential to note that the incidence of erectile dysfunction with nifedipine is estimated to be around 1-5% of male patients taking the medication, but this is not supported by the most recent and highest quality studies. If you experience erectile dysfunction while taking nifedipine, you should not stop the medication on your own but instead consult your healthcare provider, who may consider adjusting your dose or switching to a different medication. The mechanism behind any potential side effect likely involves the medication's impact on vascular smooth muscle relaxation, which can disrupt the precise balance of blood flow required for normal erectile function. Some patients may develop this side effect shortly after starting the medication, while others might experience it after longer-term use. It's crucial to weigh the benefits and risks of nifedipine and consider alternative treatments if necessary, prioritizing morbidity, mortality, and quality of life as the primary outcomes. In the context of real-life clinical medicine, a firm decision on the side of caution is essential, and healthcare providers should carefully evaluate the potential effects of nifedipine on sexual function and overall health. The most recent and highest quality study 2 provides the best evidence for guiding clinical decisions, and its findings should be prioritized when assessing the potential link between nifedipine and erectile dysfunction. Ultimately, the decision to prescribe or continue nifedipine should be based on a thorough evaluation of the patient's individual needs and health status, with a focus on minimizing potential harms and maximizing benefits.