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Lisinopril is a prescription drug commonly used to treat high blood pressure. Like most drugs, lisinopril may cause side effects—but erectile dysfunction (ED) isn’t usually one of them.
ED is the inability to get or keep an erection long enough for sex. It can feel embarrassing to discuss ED with a healthcare provider, but they can help. They can determine and treat any underlying causes or prescribe effective medication for ED, such as Viagra or Cialis.
What is lisinopril?
Healthcare providers commonly prescribe lisinopril to treat hypertension (high blood pressure). It belongs to a class of blood pressure medications known as ACE inhibitors. ACE (angiotensin-converting enzyme) is an enzyme in the body with many functions, but it can lead the blood vessels to constrict, increasing the pressure needed to move blood through the body (aka high blood pressure). Lisinopril works by blocking ACE, thus limiting blood vessel constriction and lowering blood pressure (Unger, 2020; DailyMed, 2018).
ACE inhibitors are typically a first-line treatment for high blood pressure. Besides lisinopril (brand names: Zestril, Prinivil), other examples of ACE inhibitors are benazepril (Lotensin), enalapril (Vasotec), and quinapril (Accupril).
Can Lisinopril cause erectile dysfunction?
ED is a common type of sexual dysfunction that involves the consistent or recurrent inability to attain or maintain an erection (Burnett, 2018). While ED has many potential causes, including physical, social, or psychological issues, blood flow problems are the most common culprit. So it’s not surprising that many people with ED are also on blood pressure medications (Yafi, 2016).
While some blood pressure medications commonly cause erectile dysfunction as a side effect, lisinopril isn’t one of them. In fact, lisinopril can help improve sexual function in men with ED and high blood pressure. This is because a major cause of ED is high blood pressure, and about 40% of men with ED also have hypertension. So, getting your blood pressure under control with the help of a medication, such as lisinopril, can help. Being an ACE inhibitor, lisinopril is less likely to cause ED than other classes of antihypertensive drugs (Sooriyamoorthy, 2022).
If you are taking lisinopril but have trouble getting or keeping an erection, talk to your healthcare provider. They may need to adjust your dosing to get your blood pressure under control. They may also want to check you for the root cause of ED and for underlying conditions that can make it worse. Your provider may also make adjustments to other medications. Examples of factors and conditions commonly associated with ED include (Yafi, 2016; Sooriyamoorthy, 2022):
- High cholesterol or atherosclerosis (narrowed or hardened blood vessels)
- Heart disease
- Low testosterone
- Sleep apnea
Your healthcare provider may also talk to you about lifestyle changes you can make to help improve erectile function, such as quitting smoking, losing weight, and limiting alcohol use.
What are the side effects of Lisinopril?
Side effects of lisinopril are more likely to occur at higher doses. The dosing of lisinopril ranges from 2.5 mg to 40 mg per day.
Common side effects are (DailyMed, 2018):
- Dry cough
- Hypotension (low blood pressure)
- Increased potassium levels
Rarely, lisinopril may cause serious side effects, such as problems with your vision or immune system, and severe allergic reactions like rash or angioedema (a severe type of swelling that can affect your lips, mouth, and breathing).
Lisinopril’s side effects may be more common in people with preexisting kidney problems, autoimmune disorders, electrolyte imbalances, and those taking specific medications that could interact. Your healthcare provider can offer personal medical advice regarding how to manage side effects from blood pressure meds.
High blood pressure and erectile dysfunction
Biologically speaking, getting an erection is a complex process. It requires your brain, nerves, and blood vessels to work together. An erection happens when your brain signals the blood vessels in your penis to open up. This allows blood to flow into the penis, making it swell and stiffen. If there’s a “glitch” in any part of the system, it becomes more difficult to get or keep an erection. With high blood pressure, a glitch may occur when your blood vessels can’t open enough after receiving the signal from your brain. This is because high blood pressure damages the lining of blood vessels, which limits blood flow throughout the body, including to the penis.
Not only can high blood pressure cause ED, but left unchecked, it can also raise your risk of serious complications, such as heart attack and stroke. Maintaining a healthy blood pressure range can prevent or slow blood vessel damage, so treatment is essential. However, certain medication used to treat high blood pressure, such as diuretics and beta-blockers (like atenolol), may cause or worsen erectile dysfunction (Sooriyamoorthy, 2022).
If you have ED and high blood pressure, you should not stop or skip your high blood pressure medication. Intead, talk with a healthcare provider. They can work with you to find the right medications and dosages.
Erectile dysfunction treatment
Experts recommend a variety of lifestyle changes and treatment options for managing ED, depending on the underlying causes of erectile dysfunction. Medical treatment of ED generally involves taking medications from the PDE-5 inhibitor drug class. All of the medications in this class have similar effectiveness, but may not be safe for everyone (Sooriyamoorthy, 2022).
Some of the most commonly used PDE-5 inhibitors include:
- Viagra (sildenafil; see Important Safety Information)—This medication is taken only as needed before sexual activity and takes about 30 minutes to an hour to take effect.
- Cialis (tadalafil; see Important Safety Information)—This medication can be either taken as needed or once a day (with a different dosing protocol). As needed use allows for flexibility, while once-daily use allows for more spontaneity. Tadalafil is also beneficial in improving the symptoms of BPH (enlarged prostate), a common condition in men with ED.
In some cases, ED may be caused by underlying mental health problems, such as depression, anxiety, or stress. A mental health professional may suggest therapy to talk through the root causes and learn ways to cope with triggers and symptoms (Burnett, 2018).
Other non-drug treatment options for ED include natural remedies and ED vacuum devices. These devices use suction to assist in getting an erection, and may be a good choice for men unable or unwilling to take ED medications or for those not seeing improvement with PDE-5 inhibitors. Surgical options are also a possibility but generally only used as a last resort when other available options haven’t helped.
If you have ED, don’t give up on your sex life. Help is available. Talk with a healthcare provider who can help you find the best treatment option for you.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
- Burnett, A.L., Nehra, A., Breau, R.H. et al. (2018). Erectile dysfunction: AUA guidelines. Journal of Urology, 200, 633-41. Retrieved from https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline
- DailyMed. (2018). Lisinopril tablets, for oral use. Retrieved from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=d45181e7-0eb8-48e3-bbfe-a922b4204e49&type=display
- Sooriyamoorthy, T. & Leslie, S. W. (2022). Erectile dysfunction. StatPearls. Retrieved on Jan. 12, 2023 from https://www.ncbi.nlm.nih.gov/books/NBK562253/
- Unger, T., Borghi, C., Charchar, F., et al. (2020). 2020 International society of hypertension global hypertension practice guidelines. Hypertension, 75(6), 1334-57. Retrieved from https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.15026
- Yafi, F. A., Jenkins, L., Albersen, M., et al. (2016). Erectile dysfunction. Nature Review Disorder Primers, 2, 16003. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.