Future treatments for erectile dysfunction focus on providing medications that are more effective, work rapidly, and have fewer, if any, side effects than currently available treatments. Currently there are five oral drugs available to treat ED — Cialis, Levitra, Stendra, Staxyn, and Viagra. A number of pharmaceutical companies are researching new treatments for ED, and many new options may be just around the corner. These include:
Uprima: Uprima (apomorphine) comes in a tablet form that dissolves under the tongue. Uprima works by stimulating the brain chemical dopamine, which heightens sexual interest and sensations. Its major side effects are nausea and vomiting. Additionally, a small number of people passed out after taking Uprima. Therefore, its release in the U.S. is on hold. It is currently available in Europe. Clinical trials are also currently being conducted on a nasal spray form of this drug, which may cause less nausea.
Topiglan: Still under investigation, a cream applied to the penis called topiglan uses the same drug (alprostadil) that is injected and also used in suppositories to treat ED. If topiglan proves to be safe and effective, it is still not entirely clear which patients would benefit from its application and whether patients on injection and suppository therapy would no longer have to use these techniques.
Melanocortin activators: These are drugs that appear to act through the central nervous system (for example, the brain). They have been shown in animal studies to produce an erection. Initial studies in humans suggest that the drug (PT-141) can be effective if given intranasally (through the nose) in men with nonmedical (psychological/emotional) rather than physical causes of ED and mild to moderate ED. Larger studies will be necessary to demonstrate the safety and overall effectiveness of these drugs.
Gene therapy: This novel therapy would deliver genes that produce products or proteins that may not be functioning properly in the penile tissue of men with ED. Replacement of these proteins may result in improvement in erectile function. Experimental animal models have demonstrated improvement in erectile function with gene therapy. Human studies may also demonstrate success with this therapy. Gene therapy may take a long time for regulatory approval and public acceptance.