Apomorphine erectile dysfunction

The newer drug of same category are alprostadil, vardenafil and tadalafil which are recently introduced for erectile dysfunction in man. Apomorphine is... 

A combination of phentolamine with the nonspecific smooth muscle relaxant papaverine, when injected directly into the penis, may cause erections in men with sexual dysfunction. Long-term administration may result in fibrotic reactions. Systemic absorption may lead to orthostatic hypotension priapism may require direct treatment with an -adrenoceptor agonist such as phenylephrine. Alternative therapies for erectile dysfunction include prostaglandins (see Chapter 18), sildenafil and other cGMP phosphodiesterase inhibitors (see Chapter 12), and apomorphine. 

FIGURE 14-15- Some agents that boost dopamine (perhaps like apomorphine) are promising experimental drugs for enhancing NOS and may be useful to reverse erectile dysfunction. 

Another oral drug, apomorphine, acts by releasing dopamine in the central nervous system and is under investigation for erectile dysfunction. 

Apomorphine is a dopamine agonist with a variegated pattern of usage. Given parenter-ally as an emetic agent to aid elimination of orally ingested poisons, it is not without hazards (hypotension, respiratory depression). In akinetic motor disturbances, it is a back-up drug. Taken orally, it supposedly is beneficial in erectile dysfunction. 

The hypotensive adverse effects of apomorphine may possibly be increased by alcohol. The concurrent use of other drugs used for erectile dysfunction or dopamine agonists or antagonists is not recommended. However, domperidone, and prochlorperazine are said not to interact when apomorphine is used for erectile dysfunction, and domperidone is the recommended antiemetic when apomorphine is used for Parkinson s disease. There is evidence that antidepressants, antiepileptics, and ondansetron do not interact adversely. 

The manufacturers say that interaction studies in subjects given apomorphine (for erectile dysfunction) found that alcohol increased the incidence and extent of hypotension (one of the adverse effects of apomorphine). They also point out that alcohol can diminish sexual performance. ... 

The manufacturers say that no studies about interactions between apomorphine and antidepressants have been undertaken, but clinical experience in erectile dysfunction suggests that no interaction occurs. ... 

The small doses of apomorphine used for erectile dysfunction (2 to 3 mg) do not normally cause vomiting, but nausea does occur in about 7% of patients and the manufacturers say that interaction studies and/or clinical experience show that domperidone, ondansetron or prochlorperazine may safely be given as antiemetics in this patient group. Studies with other antiemetics have not been carried out, so at the moment concurrent use is not recommended. ... 

The manufacturers say that no formal studies have been done with a combination of apomorphine and other drugs used for erectile dysfunction but... 

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