Sublingual apomorphine for the treatment of erectile dysfunction

Abstract

Erectile dysfunction (ED) is a prevalent problem in the world and wreaks havoc on the psychosocial well-being of sufferers as well as partners. First-line treatment for ED is oral therapy, however, the currently available oral erectogenic agent is not uniformly successful and requires approximately 1 h to exert its effect. Apomorphine is a novel, oral erectogenic agent taken sublingually. It exerts its effect on hypothalamic centres involved in the triggering of the erection cascade. It dissolves rapidly and results in an erection in responders in approximately 20 min. By avoiding first pass metabolism through its sublingual administration, apomorphine avoids any significant interaction with food or other drugs. In trials in over 4000 subjects representative of the general ED population, beneficial effects were seen in a significant percentage of men. Its exact position in the market remains to be seen, however, its ability to permit spontaneous sexual relations will prove to be of significant benefit to many men.

Placebo Responses Among Men With Erectile Dysfunction Enrolled in Phosphodiesterase 5 Inhibitor Trials

“…80 The dopaminergic hypothesis is supported by dopamine agonists having been used in the treatment of ED. [81][82][83] There was a significant association of the active drug with erectile function scores in patients with ED. Given that the site of action of PDE5Is is the smooth muscle cells that influence the blood flow necessary to achieve erection, it seems plausible that the effect of the active drug would vary depending on the cause of the ED.…”

Apomorphine for Parkinson’s Disease: Efficacy and Safety of Current and New Formulations

“…The sedative effects of the drug were employed in a variety of psychiatric conditions, such as mania, hysteria, schizophrenic excitement, anxiety, dementia and, most importantly, alcohol-related disorders [19]. In these studies, spontaneous erection was noted as an unexpected effect, which would much later lead to the commercialization of apomorphine as an agent to treat erectile dysfunction [20].…”

Dopamine receptor agonists: standard and non-standard applications in medicine

“…Гиперсексуальность, которую описывают в рамках развития ИКР при приеме АДР и считаю щуюся негативным проявлением действия препарата, можно считать положительным эффектом терапии при наличии у больного эректильной дисфункции. К сожалению, сегодня из всех препаратов группы АДР влияние на эректильную дисфункцию изучено только у апоморфина, на данный момент еще не зарегистрированного на территории РФ, однако предполагается, что и другие препараты этой группы могут оказывать положительный эффект и использоваться для лечения данного состояния [24,25]. Чаще всего необходимость назначения нестандартных препаратов для пациентов с эректильной дисфункцией возникает тогда, когда они не могут принимать ингибиторы фосфодиэстеразы 5-го типа (например, нитраты).…”