POSTED: September 04, 2015

New Drugs For Impotence

Here’s a question a patient suffering from impotence recently asked me. My answer appeared in Prostate Forum Volume 14 Number 9.

Are there any new drugs for impotence now on the market or that may soon enter the market?

Stendra (avanafil) was approved in April 2012. This drug acts by the same mechanism as Viagra, Levitra or Cialis-inhibition of PDE5. Its competitive advantage is that it appears to be the most rapidly acting drug in this family.
There are two drugs not normally used for impotence that have been shown in small, randomized controlled trials to improve the effectiveness of Viagra, Levitra or Cialis.

Losartan is a drug normally used to treat high blood pressure. This drug acts by blocking angiotensin, a hormone in the body that causes blood vessels to contract and thus increase blood pressure. Angiotensin also triggers the formation aldosterone, a hormone that causes salt retention. Angiotensin is the hormone that terminates an erection by causing contraction of the penile artery, shutting down blood flow to the penis. In randomized controlled trials for hypertension, Losartan by itself appears to improve erectile function to a mild degree. Small, randomized controlled trials show addition of Losartan to Viagra is better than either drug alone.

Dopamine is a chemical in your brain that has many functions. One of these is sexual arousal. Cabergoline is synthetic drug that acts like dopamine and is widely used to increase brain dopamine-like activity. One half a milligram two or three times a week increased the effectiveness of Viagra in a small randomized controlled trial. Cabergoline as a single drug has been reported to reverse psychogenic impotence as well.

I have found that the three-way Losartan and Cabergoline added to Levitra or Cialis to be effective when Levitra or Cialis alone were not sufficient.

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