MS-0494

A 57-year-old man comes to see his doctor with concerns about his sexual relationship with his new wife. Upon further inquiry, he discloses that he is experiencing difficulty in achieving physical arousal and is experiencing delayed orgasms. He did not report any such issues during his medication review six weeks ago and believes that the recent change in medication may be responsible for this.

The patient’s medical history includes asthma, hypertension, migraine, bilateral hip replacement, and gout.

Which medication is the most likely cause of his recent prescription change?