Current and future trends in the oral pharmacotherapy of male erectile dysfunction.
The promising clinical data on the use of the first orally active phosphodiesterase inhibitor sildenafil citrate (Viagra) for treatment of male erectile dysfunction have been accompanied by an increase in research activities on the physiology of the male erectile mechanism. This included both peripheral intracellular signal transduction in the corpus cavernosum as well as central brain and spinal cord pathways that control penile erection. This work provided the basis for the development and introduction of several new therapeutic modalities into the management of erectile dysfunction that is now offered to the patients. Since the concept of 'taking a pill' as a cure for an illness or the relief of symptoms of a disease has become widely accepted by consumers, the pharmacological treatment of erectile dysfunction has primarily focused on selective, orally available drugs that act via influencing intracellular or central regulatory mechanisms, combining a high response rate and the advantage of an 'on-demand' intake. These agents are regarded as more efficacious, have a faster onset of drug action in the target tissue and an improved effect-to-side effect ratio than sildenafil. The purpose of this review is to describe the major novel and evolving pharmacological advances in the field of oral pharmacotherapy for the treatment of male erectile dysfunction.
Uckert
Stefan
S
Hannover Medical School, Department of Urology, 30625 Hannover, Germany. sue_de_99@yahoo.de
Stief
Christian G
CG
Jonas
Udo
U
D000284:Administration, Oral; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D015259:Dopamine Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D015195:Drug Design; D020536:Enzyme Activators / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D044101:Receptors, Melanocortin / Q000819:agonists; D012702:Serotonin Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use
D000317:Adrenergic alpha-Antagonists; D015259:Dopamine Agents; D020536:Enzyme Activators; D010726:Phosphodiesterase Inhibitors; D044101:Receptors, Melanocortin; D012702:Serotonin Antagonists; D019382:Human Growth Hormone