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    The Next Viagra?

    Uprima was supposed to be the next hot drug for erectile dysfunction. What happened?

    Tantalizing Possibilities, Alarming Problems continued...

    It didn't work.

    Invasive treatments like surgery, penile injections, or suppositories were out of the question, so Doe and his wife of 37 years were left to ponder the unpleasant prospect that they would never again enjoy sex the way they used to.

    "I started telling myself that gardening was more fun than sex, as a way not to feel bad," he says.

    But then Doe's doctor invited him to take part in a trial of Uprima. (Uprima's active ingredient, apomorphine, bears only a distant relationship to its precursor, morphine.) That was eight months ago, and it was the last time he and his wife worried about their sex life. He's been taking the experimental drug two times a week, he says, "and it's worked every time."

    Doe liked Uprima so much that in April he testified in favor of the drug's approval before an FDA advisory committee; his expenses to come to Washington were paid for by drugmaker TAP.

    Robert Carelli, a 69-year-old retired teacher from Thousand Oaks, Calif., also participated in a Uprima trial for the better part of a year. He, too, was pleased with how the drug helped him sexually -- at first.

    "I was happy with it for a while," says Carelli, who also received an honorarium from TAP to speak on behalf of Uprima. "It worked; it certainly corrected the problem." But the drug also made him nauseated -- mildly so about 10% of the time and extremely so on a couple of occasions.

    "That hardly made me feel amorous," Carelli says. Eventually, the nausea bothered him so much that he gave up on the drug and switched to Viagra.

    Some men who took Uprima in clinical trials suffered more serious side effects. According to FDA medical reviewers, one in 30 men who took Uprima in its optimal 4 milligram dose either fainted or experienced dangerously low blood pressure. One 33-year-old man blacked out while driving about 30 minutes after taking a 4-milligram dose and crashed into a fence. Another man, 56, had his blood pressure plunge, lost consciousness for 15 minutes, then woke up and vomited before fainting again in the emergency room. Other patients fainted and struck their heads, suffering lacerations and fractures.

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