6. H2 blockers
Why they’re prescribed: H2 blockers, also called H2-receptor antagonists, are used to treat gastrointestinal disorders, including gastroesophageal reflux disease (GERD), gastric ulcers, peptic ulcers and erosive esophagitis.
How they can cause sexual dysfunction: H2 blockers can cause impotence (as well as breast enlargement in men) when taken at high doses for a long period of time.
Cimetidine (Tagamet) is associated with a wider range of sex-related side effects than other H2 blockers, including ranitidine (Zantac), famotidine (Pepcid) and nizatidine (Axid). Cimetidine’s side effects include decreased libido, reduced sperm count and ED.
Options: If you are taking an H2 blocker for GERD or other reflux problems — and H2 blockers, with the exception of cimetidine, are the treatment of choice for older people — changes in your diet and sleep habits may be helpful. Some of my patients have reported success with the home remedy of apple cider vinegar and honey (one tablespoon of each in a glass of water), taken throughout the day, along with melatonin at bedtime.
Why they’re prescribed: Anticonvulsant drugs are typically used to control seizures in people who have epilepsy. They are also used to treat some types of chronic pain, including neuropathic pain and migraines, even though they weren’t designed for that purpose. Anticonvulsants are also increasingly being used “off label” in the treatment of bipolar disorder.
How they can cause sexual dysfunction: Studies have shown that these drugs can lower testosterone levels, which can depress desire and interfere with arousal (erection problems for men, lubrication problems for women). They also can impair the ability to have orgasms.
Options: Some newer anticonvulsants like gabapentin (Neurontin) and topiramate (Topamax) may have fewer side effects than older drugs like carbamazepine (Tegretol) and phenytoin (Dilantin), so ask your doctor or other health care provider if switching medications makes sense for you — and your sex life.
"Ask the Pharmacist" is written by Armon B. Neel Jr., PharmD, CGP, in collaboration with journalist Bill Hogan. They are coauthors of Are Your Prescriptions Killing You?, to be published in July by Atria Books.
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