Q: I am 32 years old. I take Amaryl 1 mg for Sugar, Losar 0.25 during bed time for BP, and Alprax 0.25 during bed time, since I had IBS (it is OK now). Recently, I was advised to take Pantacid DSR once in the morning (empty stomach) for my gastric problem. Will these medicines affect my sex life?

A:For your age, you are consuming far too many medicines just for high blood pressure and diabetes. Naturally, there will be side effects. It is unscientific to go on adding more and more medicines to counter drug-induced side effects. For example, Losar (losartan) causes abdominal bloating (gas) as well as sexual erectile dysfunction. In order to tackle abdominal bloating, Pantocid DSR has been prescribed. It contains two medicines: pantoprazole and domperidone. It is an irrational combination. If in a case like yours, domperidone is not required, but you are forced to consume it since a combination product has been prescribed instead of pantoprazole alone (sold as Pantodac). The side effects of pantoprazole ingredient of Pantocid DSR are: abdominal pain, flatulence (gas), headache, dizziness, sweating, dry mouth, asthenia, rash, pruritus, oedema, blurred vision, fever, depression, worsening of diabetes (hyperglycaemia), atrophic gastritis on long-term use, and gynaecomastia (enlargement of breasts) in males. The side effects of domperidone ingredient of Pantocid DSR are: Enlargement of breasts in males apart from dry mouth, headache and more importantly heart movement abnormalities. When pantoprazole is combined with domperidone, then risk of side effects such as flatulence and gynaecomastia is two times more. Moreover, it should not be given to diabetics, since it can increase blood glucose levels. The side effects of Alprax (alprazolam) are: central nervous system disturbances including impaired alertness, gastric upset, amnesia (loss of memory) and impaired memory, ataxia, joint pains, breathlessness, increased salivation, withdrawal seizures, tremors, decreased libido and sexual dysfunction. From the above account, it is clear that sexual dysfunction could be due to drugs that you are taking. Alprax is supposed to be taken just for short periods (for 5-7 days) for severe anxiety (not normal day-to-day worry). If taken over long durations, it will cause addiction. I think apart from Amaryl your drug treatment should be reviewed. In young sexually active males, the first line therapy for high blood pressure should be Enalapril (sold as Enam) 5-10 mg 1-2 times daily. Apart from least effect on sexual functions, it has an added advantage: it protects the kidney functions in diabetics. You should also undertake mild exercise in the form of brisk walk for 45 minutes daily to cover no less than 4.5 km. This will significantly reduce the need for drugs both for diabetes as well as blood pressure. Serious consideration should be given to use non-drug measures such as Yoga.