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New Erection Drugs on the Way

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Feb. 8, 2002 -- Move over, Viagra -- here comes the competition. New drugs -- and new interest in older methods -- mean more erections for more men.

Viagra's release in 1998 helped many of the 30 million U.S. men who have problems getting erections. Problem solved? Not yet. Viagra can't help everyone. Some men can't safely use it because they are on other medications, have other illnesses, or experience side effects. And for other men, Viagra just doesn't work. For these men and their sex partners, claims that Viagra has cured erectile dysfunction have been misleading and frustrating.

But the huge research effort that Viagra spurred has already provided new insights into male sexual function -- and new treatments, some of which will be available soon.

The Challengers

What's wrong with Viagra? Nothing, for men in whom it safely works. But that hasn't stopped two major drug companies from getting ready to release their own Viagra-like drugs. Eli Lilly and Company's much-anticipated drug, Cialis, may be ready to come to market later in 2002. Bayer's offering, vardenafil, should be ready some time in 2003. They work much the same way as Viagra, but they should have fewer side effects. Whether they will prove safer or more effective remains to be seen.

Cialis works faster than Viagra -- in about 15 minutes instead of half an hour. It lasts a lot longer, helping men get erections for 24 hours vs. the four-hour window Viagra provides.

Vardenafil -- yet to get a catchy brand name -- seems to work for men with many different types of erectile dysfunction. It seems to work especially well for men whose erectile dysfunction is related to diabetes. In one clinical trial, it worked even better for diabetic men with severe erectile dysfunction than for those with milder problems.

Other Oral Alternatives

Uprima was to have been the next treatment advance: By stimulating the brain rather than the muscles and nerves of the penis, Uprima placed under the tongue produced strong erections in most of the men on whom it was tested. It had preliminary approval from an FDA committee before it was withdrawn by the manufacturer: A small number of people passed out after taking it. It's available overseas, but plans for a U.S. release are on hold.

That hasn't stopped Nastech Pharmaceutical Co. Inc. from developing a nasal version of the drug. In a preliminary study, it helped men with several different kinds of erectile dysfunction -- and none of them passed out. Large-scale clinical trials are planned this year.

Yohimbine is another popular nerve-blocking agent used to treat this problem. It's been available in the U.S. for many years, but carefully designed studies convincingly show that it isn't very effective in promoting normal erection and sexual performance.

The amino acid arginine has been touted as a natural alternative to other erectile dysfunction drugs. When studied under rigorous conditions, though, results have been disappointing.

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