title: The management of erectile dysfunction: innovations and future perspectives.
abstract: Phosphodiesterase 5 (PDE5) inhibitors are recommended as first line therapy for the treatment of erectile dysfunction (ED). To date, three PDE5 inhibitors are on the market: sildenafil, vardenafil and tadalafil. These compounds are available as oral tablets; they are rapidly absorbed in the gastrointestinal tract and are excreted mainly in the fces and to a lexer extent in the urine. Recently, an orodisnersible formulation of feces and, to a lesser extent, in the urine. Recently, an orodispersible formulation of vardenafil (vardenafil ODT) has been developed, which is able to dissolve in the mouth within seconds, releasing a minty flavor, without the need of being swallowed with water. The clinical studies so far performed showed that vardenafil ODT has a bioavailability superior to the traditional film-coated tablet. Among the other PDE5 inhibitors under development we report mirodenafil, lodenafil carbonate, avalafil and SLx-2101 It is likely that in the future molecules that act on pathways other than the one of NO/cGMP will be available. Such as Rho-kinase inhibitors, which inhibit the mechanism that leads to smooth muscle contraction thus allowing erection and hydrogen sulphide (H2S), an endogenous molecule synthesized from cysteine that can be both a vasodilator and a vasoconstrictor according to its concentration.
authors.affiliation: CURA - Centro Uro-Andrologico Acireale, Italy. leonardi.r@tiscali.it
authors.forename: Rosario
authors.initials: R
authors.lastname: Leonardi
authors.forename: Matteo
authors.initials: M
authors.lastname: Alemanni
mesh_terms: D007172:Erectile Dysfunction / Q000188:drug therapy*; D005544:Forecasting; D006801:Humans; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*
chemical_list: D058986:Phosphodiesterase 5 Inhibitors