Is there a relationship between losartan (angiotensin II receptor antagonist) and erectile dysfunction (ED)?

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From the Guidelines

Losartan may potentially help with erectile dysfunction (ED) in some patients, though it is not FDA-approved for this purpose. Losartan is an angiotensin II receptor blocker (ARB) primarily used to treat high blood pressure and protect kidney function in diabetes. Some studies suggest that losartan might improve erectile function, particularly in men whose ED is related to high blood pressure or who have experienced ED as a side effect from other blood pressure medications like beta-blockers or thiazide diuretics. The typical dosage for losartan ranges from 25-100 mg daily, but any use for ED would be considered off-label. The potential benefit for erectile function may be related to losartan's ability to improve blood vessel function and blood flow by blocking the vasoconstrictive effects of angiotensin II. Unlike some other blood pressure medications that can worsen ED, ARBs like losartan generally have neutral or potentially positive effects on sexual function. However, patients should not take losartan specifically for ED without consulting their doctor, as other medications like PDE5 inhibitors (sildenafil, tadalafil) are the first-line treatments specifically approved for erectile dysfunction.

Key Points

  • Losartan is not FDA-approved for treating ED, but it may have potential benefits in some patients.
  • The typical dosage for losartan ranges from 25-100 mg daily.
  • ARBs like losartan generally have neutral or potentially positive effects on sexual function.
  • PDE5 inhibitors (sildenafil, tadalafil) are the first-line treatments specifically approved for erectile dysfunction.

Evidence

The evidence for losartan's effect on ED is limited, but some studies suggest that it may improve erectile function in men with high blood pressure or those who have experienced ED as a side effect from other blood pressure medications 1. The American College of Physicians recommends that clinicians initiate therapy with a PDE-5 inhibitor in men who seek treatment for erectile dysfunction and who do not have a contraindication to PDE-5 inhibitor use 1. However, the use of losartan for ED would be considered off-label, and patients should consult their doctor before taking it for this purpose.

From the Research

Losartan and Erectile Dysfunction (ED)

  • Losartan, an angiotensin II receptor blocker, has been studied for its potential effects on erectile dysfunction (ED) in patients with hypertension 2, 3, 4, 5.
  • Research suggests that losartan may have a positive effect on erectile function, potentially decreasing the incidence of ED in patients with hypertension 2.
  • A study found that long-term combined therapy with losartan and a phosphodiesterase type 5 inhibitor improved erectile tissue in hypertensive rats 3.
  • Clinical trials have shown that losartan can improve erectile function in diabetic patients with ED, particularly when used in combination with other treatments such as tadalafil 4.
  • A meta-analysis of randomized controlled trials found that angiotensin receptor blockers, including losartan, may improve sexual activity in hypertensive men, but the evidence for their effect on erectile function is limited and inconsistent 5.
  • The relationship between hypertension and ED is complex, and endothelial dysfunction is thought to be a common link between the two conditions 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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