HIV meds and erectile dysfunction

[smallcocksissyboi]

I’ve read a few articles suggesting that some hiv medication can cause erectile dysfunction. Anyone experienced this?

[BootmanLA]

On 1/29/2024 at 6:14 AM, smallcocksissyboi said:

I’ve read a few articles suggesting that some hiv medication can cause erectile dysfunction. Anyone experienced this?

From the limited research I did on this today (which I'm certain is not comprehensive), there is a higher incidence of erectile dysfunction among HIV-positive men than among men in the general population. That said, it's not clear to what extend that HIV medications are the cause. The studies are limited.

In one such study, for instance, the average age of the participants was 42, meaning half were already at an age where ED starts to become more common. The studies I saw didn't control for things like alcohol consumption or other "party favor" usage, which may well be higher among gay men and which can also contribute to ED.

An ideal study, in my view, would have three age-matched groups of men who have sex with men (that is, bi or gay or whatever), who are also matched in terms of levels of sexual activity and substance usage - one group HIV-negative, one group HIV-positive on treatment, and one group HIV-positive not on treatment (which presents some ethical problems, but we're presumably talking guys who choose not to go on meds). That would give a much clearer view as to (a) whether the groups experience ED at different rates, and (b)  if so, is it HIV or HIV treatment that is the likely culprit.

[ellentonboy]

Has anyone been told by their pharmacist that the medication "Flomax" or it's generic version "tamsulosin" may cause their HIV med  PREZCOBIX to be less effective?  When I was first written a script for Flomax, and fortunately I do not have prostate cancer, the pharmacist called me and said "Oh by the way, there is research that indicates Flomax may reduce the effectiveness of Prezcobix".  I do have a viral load now.  I was wondering if anyone knows of a particular article or where I could find this information.

I posted on this subject earlier, but I see my HIV specialist in about two weeks.  His snotty nurse called to tell me I had to get new labs run because I now had a viral load and they wanted to make sure that I was taking the medication, or I could be dropped as a patient for being non-compliant.  My previous doctor never made such threats, back in those days I had a viral load of over 2 million and he just dealt with my reluctance to take my meds.

I would just like to go to the doctor's visit with some information in hand,  I appreciated the pharmacist giving me that information, but the printed paperwork I received regarding Flomax did not specifically mention a possible negative impact on Prezcobix...

Any information, or where to find it, would be greatly appreciated.  I just want to have some documentation so I can defend myself when I see the doctor and that nurse of his.

[rpup]

I know that your Norvir or Cobicistat boosting your Protease Inhibitor (or in your Genvoya) will also provide a major boost to Viagra too.

[SomewhereonNeptune]

On 1/31/2024 at 9:19 AM, ellentonboy said:

Has anyone been told by their pharmacist that the medication "Flomax" or it's generic version "tamsulosin" may cause their HIV med  PREZCOBIX to be less effective?  When I was first written a script for Flomax, and fortunately I do not have prostate cancer, the pharmacist called me and said "Oh by the way, there is research that indicates Flomax may reduce the effectiveness of Prezcobix".  I do have a viral load now.  I was wondering if anyone knows of a particular article or where I could find this information.

Drugs.com gave me the following contraindications for just those two drugs together:

Major: tamsulosin  cobicistat
Applies to: tamsulosin, Prezcobix (cobicistat / darunavir)

Using tamsulosin together with cobicistat is not recommended. Combining these medications may significantly increase the blood levels and effects of tamsulosin. This may cause blood pressure to fall excessively and heart rate to increase, especially when you rise from a sitting or lying position. The risk of other side effects such as dizziness, lightheadedness, fainting, headache, flushing, nasal congestion, heart palpitation, and priapism (prolonged and painful erection unrelated to sexual activity) may also increase. Let your doctor know if you develop these symptoms while using tamsulosin and they do not go away on their own or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When you use the generic for Prezcobix (darunavir), the interaction is almost word for word the same contraindication, but the interaction is considered Moderate. Unclear why. When you mentioned Flomax, you got me curious since I've used that for a while now and would be concerned if I needed to use those two drugs. Fortunately, Truvada doesn't pop-up with the same warning, good to know if you need to use that for PrEP. Another note is that tadalafil (Cialis) enhances the efficacy of tamsulosin and is considered as an off-label indication when Tamsulosin alone isn't quite enough, so that's a bonus if you use Cialis for (ahem) other purposes. 😉

[ellentonboy]

3 hours ago, SomewhereonNeptune said:

Drugs.com gave me the following contraindications for just those two drugs together:

Major: tamsulosin  cobicistat
Applies to: tamsulosin, Prezcobix (cobicistat / darunavir)

Using tamsulosin together with cobicistat is not recommended. Combining these medications may significantly increase the blood levels and effects of tamsulosin. This may cause blood pressure to fall excessively and heart rate to increase, especially when you rise from a sitting or lying position. The risk of other side effects such as dizziness, lightheadedness, fainting, headache, flushing, nasal congestion, heart palpitation, and priapism (prolonged and painful erection unrelated to sexual activity) may also increase. Let your doctor know if you develop these symptoms while using tamsulosin and they do not go away on their own or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When you use the generic for Prezcobix (darunavir), the interaction is almost word for word the same contraindication, but the interaction is considered Moderate. Unclear why. When you mentioned Flomax, you got me curious since I've used that for a while now and would be concerned if I needed to use those two drugs. Fortunately, Truvada doesn't pop-up with the same warning, good to know if you need to use that for PrEP. Another note is that tadalafil (Cialis) enhances the efficacy of tamsulosin and is considered as an off-label indication when Tamsulosin alone isn't quite enough, so that's a bonus if you use Cialis for (ahem) other purposes. 😉

I am well aware. I used both those drugs and my viral load has gone up. The pharmacy called me, to advise me, prior to filling the tamsulosin, that my viral load would go up since I used Prezcobix.  I did not care, nor did my doctor.

i have had a viral load of over 2 million and lived to tell the tale. I don’t give a damn I am too evil to die.

With that being said, we found out the cause of my urinary incontinence. I take 3 mg of Xanax and two mg of lorazepam every day. I had added a third medication, an over the counter sleep aid that basically knocked me out within a few minutes. That caused my urinary issues. Once I stopped taking the third part of my “cocktail” I never once had an incontinence issue. From  now on, I will be patient and wait for the other two drugs to knock me out. Thanks for your input.

[Leatherman667]

14 hours ago, ellentonboy said:

I am well aware. I used both those drugs and my viral load has gone up. The pharmacy called me, to advise me, prior to filling the tamsulosin, that my viral load would go up since I used Prezcobix.  I did not care, nor did my doctor.

i have had a viral load of over 2 million and lived to tell the tale. I don’t give a damn I am too evil to die.

With that being said, we found out the cause of my urinary incontinence. I take 3 mg of Xanax and two mg of lorazepam every day. I had added a third medication, an over the counter sleep aid that basically knocked me out within a few minutes. That caused my urinary issues. Once I stopped taking the third part of my “cocktail” I never once had an incontinence issue. From  now on, I will be patient and wait for the other two drugs to knock me out. Thanks for your input.

What was the ‘sleep aid’?

[BootmanLA]

20 hours ago, SomewhereonNeptune said:

Drugs.com gave me the following contraindications for just those two drugs together:

Major: tamsulosin  cobicistat
Applies to: tamsulosin, Prezcobix (cobicistat / darunavir)

Using tamsulosin together with cobicistat is not recommended.  .....

When you use the generic for Prezcobix (darunavir), the interaction is almost word for word the same contraindication, but the interaction is considered Moderate. Unclear why. 

What this is saying is that tamsulosin combined with cobicistat has a major interaction. So when you combine tamulosin with ANYTHING that contains cobicistat (including Prezcobix), the interaction is still major.

But the generic for Prezcobix is not "darunavir". Prezcobix is a two-drug combination of both cobicistat AND darunavir. And apparently the interaction between tamsulosin and darunavir is less problematic than the interaction between tamsulosin and cobicistat.

Put another way, combining A and B is not recommended. So combining A and BC is not recommended, either. But combining A and C is not as big of a problem, because B is not involved.

[ellentonboy]

2 hours ago, Leatherman667 said:

What was the ‘sleep aid’?

The third item I added was CVS’s acetaminophenPM 500 mg. I get a $25 dollar a month benefit from my secondary insurance, so it doesn’t cost me anything. I know it is not great on my liver, but my  gosh, I go to sleep almost immediately. There is a problem with being almost unconscious, so I have decided just to stick with the Xanax and lorezapam.  I tried last night with just the two and it worked fine.  There have just been some nights I felt I needed something “extra” but I realize I should not be doing it every night.

A great nights sleep is a wonderful thing, but with all the medication running through my system I thought removing one from that 24 hour cycle might be a good thing…

[PozBearWI]

I guess I am bless that at least at this point in my history my viral load is reasonably well controlled without meds.  When I went to pick up Biktarvy the first time the pharmacist told me I should not take it as long as I am taking pill for diclofenac.  Stopping that would significantly interfere with my mobility.  

[Bimarried001]

On 1/29/2024 at 7:14 AM, smallcocksissyboi said:

I’ve read a few articles suggesting that some hiv medication can cause erectile dysfunction. Anyone experienced this?

That could’ve been my problem. Something to look into.