Can perindopril (Angiotensin-Converting Enzyme Inhibitor) cause decreased libido (hyposexuality)?

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From the Guidelines

Perindopril is likely to have a lower risk of causing decreased libido compared to other medications, as it is an angiotensin converting enzyme inhibitor, which is listed as an alternative drug with lower risk of erectile dysfunction. According to the UK management guidelines for erectile dysfunction published in the BMJ in 2000 1, angiotensin converting enzyme inhibitors, such as perindopril, are considered to have a lower risk of erectile dysfunction. While the exact incidence of decreased libido as a side effect of perindopril is not specified, the fact that it is classified as a lower-risk medication suggests that it may be a better option for patients who are concerned about sexual side effects. Some key points to consider when evaluating the risk of decreased libido with perindopril include:

  • The medication's mechanism of action, which affects blood vessel function and hormone levels that influence sexual desire
  • The availability of alternative treatments, such as calcium channel blockers or ARBs, which may have fewer sexual side effects for certain individuals
  • The importance of discussing any concerns about sexual side effects with a healthcare provider, rather than stopping the medication on one's own. It's also worth noting that the study published in the BMJ in 2000 1 provides guidance on the management of erectile dysfunction, and suggests that specialist opinion may be required before changing treatment, depending on the diagnosis and options available.

From the FDA Drug Label

Among 1,012 patients in placebo-controlled U. S. trials, the overall frequency of reported adverse events was similar in patients treated with perindopril erbumine tablets and in those treated with placebo (approximately 75% in each group) ... male sexual dysfunction (each 1.4%),

Perindopril can cause decreased libido, as male sexual dysfunction is reported in 1.4% of patients treated with perindopril erbumine tablets 2.

From the Research

Perindopril and Decreased Libido

  • There is no direct evidence in the provided studies that perindopril causes decreased libido 3, 4, 5.
  • The studies primarily focus on the pharmacological properties, therapeutic use, and adverse effect profile of perindopril in relation to cardiovascular disorders, particularly hypertension 3, 4, 5.
  • However, it is worth noting that decreased libido is a common side effect of certain medications, particularly those that affect the central nervous system or have hormonal effects 6, 7.
  • The provided studies on psychotropic drugs suggest that antidepressants and antipsychotics can cause sexual dysfunction, including decreased libido 6, 7, but perindopril is an angiotensin-converting enzyme (ACE) inhibitor and not a psychotropic drug.
  • Therefore, based on the available evidence, it cannot be concluded that perindopril causes decreased libido 3, 4, 5.

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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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