What's New: Drug Therapies for Treatment of Erectile Dysfunction
Effective therapies for erectile dysfunctions were first developed more than 25 years ago with the introduction of penile prostheses. Prior to that time there was virtual nothing available to help patients with a significant erectile dysfunction of organic etiology. It is now anybody can use any supplements or medications such as malebiologicalclock.com/boostultimate-reviews.html
As time progressed less invasive methods, such as intracorporal injections in the mid '80s, and now Sildenafil (ViagraTM by Pfizer) in the late '90s has expanded the horizon of treatment. As less aggressive treatments are developed, large numbers of patients are coming in for successful treatment.
Prior to the introduction of Sildenafil the most commonly prescribed treatment for erectile dysfunction was Yohimbine, a pill with marginal effectiveness.
Following this, intraurethral Prostaglandin E-1 took second place and after this in order of popularity intracorporal injections, vacuum devices, and penile implants. Even though Yohimbine was not that effective in most cases it was tried more commonly than other treatments because of its ease of administration. Today Sildenafil has about 85 percent of the impotence marketplace and medications such as Yohimbine and Intraurethral Prostaglandin E-1 are used more commonly in deference to mechanical treatments such as vacuum devices and implants. The potential for a very effective oral medication in this area of erectile dysfunction which affects about 25 percent of the male population is certainly great.
TAP Pharmaceuticals for the last few years have been studying a centrally acting drug named UprimaTM. This is a sublingually administered compound, Apomorphine, which is a dopamine agonist. This is not related to the opiate, morphine, and the exact mechanism of how the compound stimulates the brain is unknown, Incidentally, brain stimulation very good help chillipear.com/lumonol-reviews.html.
It does require sexual simulation to be effective. More than 2,500 patients were enrolled in clinical trials with multiple etiologies for erectile dysfunction present in these patients. All patients took the IIEF sexual survey and 37 percent were classified as having severe erectile dysfunction, 36 percent moderate dysfunction, and 25 percent were categorized as mild impotence. Three dosages were used 2mg, 4mg, and 6mgs.
A successful result would be considered as able to have intercourse on at least 50 percent of attempts. On the 2mg dosage 46 percent of patients taking UprimaTM satisfied these criteria, while the success rate was 35 percent of the placebo group. For the 4mg dose the UprimaTM success rate was 59 percent while that of placebo 35 percent. Of those taking the 6mg dose 65 percent had successful intercourse half the time and in the placebo group 35 percent were able to complete intercourse in half their attempts. The 6mg dosage was discontinued because of significant nausea which developed. The highest incidence of adverse advents in these series of 2,500 patients with the 2mg and 4mg dosage was nausea which occurred at 17.1 percent of the time. Dizziness was experienced by 9.8 percent of patients, sleepiness by 8.5 percent (it is a pity that did not use supplements to adjust the sleep - http://thekissups.com/alteril-reviews.html, can immediately get more information), sweating, headaches and yawning by 5.9 percent each in this series.
Less commonly noted side effects were weakness in 3.5 percent, vomiting in 3.3 percent and flushing in 3.0 percent. The most significant side effect was vasovagal syncope which occurred on 0.6 percent of those taking the medication. UprimaTM as a sublingual medication has a rapid onset, within 12 to 15 minutes of ingestion.
There is no interaction with food or alcohol and the window of opportunity for sexual activity following ingestion is between two and three hours. The medication can be taken with nitrates and there are no cardiac or blood pressure effects from this drug. (Note: The Food and Drug Administration's panel of scientific advisers voted 9-3 in mid April that UprimaTM should sell as long as men and their doctors get strong warnings. The FDA is not bound by its advisers' decisions but typically follows them.)
Macrochem has been studying a topical cream combining prostaglandin E-1 with SEPA, which helps enhance the absorption of the medicine, which is applied to the glans penis. Prostaglandin E-1 is a powerful smooth muscle relaxant and SEPA is an agent which allows better penetration of the stratum corneum to enhance the delivery of this medication into the corpus spongiosum. The medication will hopefully travel through venous communications into the corpora cavernosa to affect relaxation of the penile smooth muscles.
Sixty patients were enrolled in a recent trial which included applying the medicine to the glans penis accompanied by visual sexual stimulation and a vibrator applied to the penis. An erection judged useful for intercourse occurred in 39 percent of patients (12/31). Seventeen percent of patients using a placebo cream could achieve what was considered a usable erection.
An intriguing compound in development is Melanotan II. This is a melanocortin receptor agonist which acts centrally. The exact mechanism of action is unknown, and it is administered subcutaneously. In a recent trial of 20 patients 85 percent (17 out of 20) noted erections without stimulation.
The onset, however, was somewhat prolonged, between 90 and 120 minutes. In one patient, a duration up to 254 minutes, slightly more than four hours, was noted and documented by Rigiscan, a monitoring device. In 68 percent of patients increase in sexual desire was noted with this medication. Adverse events included nausea in 39 percent, severe nausea in 16 percent, and vomiting in three percent. No pain or priapism was noted in this group of 20 patients.
A number of other compounds are in more preliminary stages of development. Bayer Pharmaceuticals has a type V phosphodiesterase inhibitor, which is now in phase II trials. Bristol Meyer Squibb has filed for development of a type V phosphodiesterase inhibitor and also has a calcium channel opener which is in phase II studies. Sibutramine, a norepinephrine and dopamine reuptake inhibitor, is in preclinical investigation. Pfizer is conducting Phase II clinical trials in Europe on two additional type V - phosphodiesterase inhibitors.
Wide spread trials were recently conducted by Schering Plough on Vasomax, an oral phentolamine preparation, which acts by inhibiting epinephrine at the level of penile musculature. Recently the development of soft tissue tumors on experimental animals has placed further studies with Vasomax on hold. A similar compound Invacorp which combines vasoactive intestine polypeptide with phentolamine injected into the corpus cavernosum is also on hold waiting for the clarification of this toxicity.
Patients are becoming more familiar with discussing and treating erectile dysfunctions. The development of these new medications is certainly a welcome addition to the armamentarium in this field. Some of these medications will be more effective, others less so. With the abundance of available drugs we will be seeing combinations or cocktails of two or more when one treatment alone is not sufficient. This will certainly increase the success rate of acceptable treatments and encourage more patients to visit their physician for help with this problem.