Some doctors are prescribing Apomorphine for erectile dysfunction. But does it really work? Let’s jump into the science and cover what is know about this treatment for ED.
When it comes to treating erectile dysfunction (ED), most people have heard of Viagra or Cialis.
But if you’ve been digging into less mainstream options, you might’ve come across Apomorphine. Apomorphine is a dopamine-acting medication that’s sparked some curiosity in the ED space.
So, does it actually work, and is it worth considering if standard ED meds aren’t your thing?
Let’s unpack what Apomorphine is, how it works, how it compares to FDA-approved treatments like Sildenafil (Viagra) and Tadalafil (Cialis), and whether it’s a smart place to start your ED journey.
If you’re weighing your options and want a clear, side-by-side look at Apomorphine vs the heavy hitters of ED treatment, you’re in the right place.
Let’s break it down.
What Is Apomorphine?
Apomorphine is a dopamine agonist, which means it mimics the effects of dopamine, a chemical messenger tied to everything from pleasure and motivation to sexual arousal.
It’s been around for decades, with initial studies showing Ampomorphine’s success to manage symptoms in Parkinson’s disease, where dopamine levels in the brain are depleted.
More recently, Apomorphine has made its way into conversations around erectile dysfunction. This is especially true in Europe, where it is being prescribed under names like Uprima or Ixense in a sublingual tablet form.
Unlike PDE5 inhibitors like Sildenafil or Tadalafil, which work by increasing blood flow, Apomorphine operates on the central nervous system.
It targets specific dopamine receptors in the brain that play a role in sexual desire and erection initiation.
That makes it a completely different mechanism, one that may be more effective for men whose ED is rooted in psychological or neurogenic causes, rather than just blood flow issues.
Apomorphine is absent from the American Urological Association’s treatment guidelines and hasn’t been approved by the FDA for ED in the U.S.
Its use remains somewhat niche, though a committee of FDA specialists did recommend Ampomorphine’s approval for ED on the condition that strong warnings about serious side effects be included.
It’s generally considered a second-line or off-label option, typically explored when first-line ED treatments haven’t worked well or aren’t well tolerated.
If you’re hearing about it for the first time, you’re not alone. While Ampomorphine certainly is not a household name like Viagra, it’s worthy of a place in the broader ED treatment landscape.
Is Apomorphine Effective for ED?
It can be, but it depends on the root cause of your ED.
In clinical studies, Apomorphine has shown positive results for men with psychogenic ED – the kind that stems more from mental or emotional causes rather than physical ones.
For these men, Apomorphine’s central action on dopamine can help restore sexual motivation and the brain-body connection that leads to arousal.
A large clinical trial of over 5,000 men found that low doses of sublingual apomorphine (2 to 3 mg) improved erections. The effect was most notable in men with mild to moderate ED.
But there’s the trade-off.
A meta analysis published by the NIH showed that Apomorphine may not work as reliably for organic ED caused by diabetes or other vascular issues. Additionally, side effects like nausea and dizziness also appeared more frequently compared to PDE5 inhibitors.
While Apomorphine may be effective for certain ED types or when other treatments haven’t worked, it’s not widely used for most men – and usually not the first option doctors recommend.
Dosages of Apomorphine for ED
Apomorphine is typically prescribed in sublingual tablet form, meaning it dissolves under the tongue for faster absorption.
It should not be swallowed, as doing so significantly reduces its effectiveness.
The usual starting dose is 2mg, taken about 15 to 20 minutes before sexual activity.
If tolerated well, the dose may be increased to 3mg to reach the desired clinical effect.
Unlike daily-use ED medications like low-dose Tadalafil, Apomorphine is taken on demand and should not be used more than once in a 24-hour period.
Side Effects and Safety Considerations
The most commonly reported side effect of apomorphine is nausea, which affects a significant number of users, especially at the beginning.
Other side effects may include:
- Dizziness or lightheadedness
- Fatigue or drowsiness
- Headache
- Sweating
- Dry mouth
More serious but less common side effects include low blood pressure and fainting, particularly when combined with alcohol or other antihypertensive medications.
Apomorphine vs PDE5 Inhibitors
PDE5 inhibitors, including Viagra, Cialis, and Levitra, are typically the first-line treatment for erectile dysfunction.
Apomorphine works differently, acting primarily on the brain rather than directly improving blood flow.
So, how does it stack up? Let’s break it down drug by drug.
Apomorphine vs Viagra
Viagra works by increasing blood flow to the penis via inhibition of the PDE5 enzyme.
Apomorphine, on the other hand, targets dopamine receptors in the brain to stimulate the erection pathway at the neurological level.
Apomorphine kicks in slightly faster, around 15 to 20 minutes, compared to Viagra’s 30 to 60 minutes.
But Viagra has a longer track record and is generally more effective for a wider population.
A 2008 cross-over study found that Viagra was more effective than sublingual apomorphine in achieving erections and overall sexual satisfaction.
Viagra tends to produce firmer erections and is effective in most cases of ED, especially when vascular issues are involved.
Apomorphine may be better suited to men with ED due to stress, anxiety, or emotional factors – where the brain’s arousal response is the key challenge.
Apomorphine vs Cialis
Cialis also works by increasing blood flow to the penis, but it has a much longer half-life (up to 36 hours), earning it the nickname “the weekend pill.”
Apomorphine works within minutes, but only lasts around 1 to 2 hours.
Cialis can be taken once daily or on demand and is often preferred by men who want more spontaneity.
Apomorphine needs to be timed more precisely around sexual activity and doesn’t allow for the same flexibility.
Cialis has higher success rates overall and tends to work better in cases involving physical causes of ED (e.g., poor circulation or diabetes).
Apomorphine may have more limited usefulness, but could appeal to those who can’t tolerate PDE5 inhibitors.
Apomorphine vs. Levitra
Like Viagra and Cialis, Levitra is a PDE5 inhibitor.
It works similarly to Viagra but is considered a bit more selective in its action, which may reduce side effects for some users.
Levitra generally starts working in 30 to 60 minutes and lasts for 4 to 5 hours. That’s longer than apomorphine, but not as long as Cialis.
Some users report that Levitra causes fewer vision-related side effects than Viagra.
However, it still relies on physical arousal and adequate blood flow, whereas apomorphine stimulates desire and arousal from the brain first.
Cost of Apomorphine vs Alternatives
When comparing ED treatments, price often plays a deciding role for long-term users.
Here’s how apomorphine stacks up against popular alternatives like sildenafil and tadalafil.
Apomorphine
Apomorphine isn’t as widely available in the U.S. as PDE5 inhibitors and is typically not covered by insurance for ED.
Prices can vary by compounding pharmacy or provider, but on average, Sublingual tablets (2–3 mg) are around $5 to $10 per dose when sourced online.
Branded versions may be more expensive and harder to find.
Because it’s not FDA-approved for ED in the U.S., availability and pricing may depend on off-label prescribing.
Sildenafil (Generic Viagra)
Sildenafil is FDA-approved, widely available in the U.S., and often covered by insurance or savings programs.
It’s the most commonly prescribed ED medication and typically the most cost-effective at scale.
- Low-dose (25 to 50 mg): $2 to $6 per pill (generic)
- Higher doses (100 mg): $6 to $12 per pill
- Branded Viagra: $70+ per pill without insurance
Tadalafil (Generic Cialis)
Tadalafil tends to be slightly more expensive than sildenafil but offers longer-lasting effects.
Many patients find it more convenient for regular use, which can justify the price
- Daily low-dose (2.5 to 5 mg): $2 to $4 per pill
- On-demand (10 to 20 mg): $6 to $12 per pill
- Branded Cialis: $60 to $70+ per pill without insurance
Who Is Apomorphine Best For?
Apomorphine isn’t a mainstream first-line treatment for ED, and that’s an important context.
But for the right group of patients, it may be a worthwhile option when traditional PDE5 inhibitors like sildenafil or tadalafil aren’t suitable or effective.
Let’s break down the groups for whom apomorphine might offer unique advantages.
People with Psychogenic ED
Psychogenic erectile dysfunction is caused primarily by psychological factors like anxiety, stress, or depression and often occurs without an underlying physical issue.
For men in this category, apomorphine may be a fit because Apomorphine acts on the brain’s reward pathways, potentially restoring the natural signaling needed for arousal.
Studies have shown modest success rates with apomorphine in this group when paired with therapy or lifestyle changes.
People Who Have PDE5 Inhibitor Intolerance
Unlike sildenafil or tadalafil, apomorphine acts on dopamine receptors in the brain rather than affecting nitric oxide production or blood pressure. This makes it potentially useful for men who:
- Have contraindications to vasodilators
- Experience PDE5-related side effects like migraines or visual disturbances
- Prefer a centrally acting medication with a different mechanism
That said, apomorphine is generally less effective than PDE5 inhibitors for moderate to severe organic ED (e.g., vascular or diabetes-related).
It’s also not advised for men on nitrate medications, those with significant cardiovascular conditions, or individuals already using dopamine agonists for Parkinson’s.
Apomorphine isn’t a go-to option, but it may benefit men with mild to moderate ED who can’t tolerate or aren’t suited for traditional blood flow-based treatments.
While not a first-line treatment, sublingual apomorphine may help trigger erections in men with mild to moderate ED, particularly when neurological function is intact and other options aren’t well tolerated.
FAQs: Apomorphine For Erectile Dysfunction
Is apomorphine FDA-approved for erectile dysfunction?
No. Apomorphine is not currently FDA-approved for the treatment of ED in the United States. While it has been approved in certain European countries as a sublingual tablet for ED, its U.S. availability is limited to its use in treating Parkinson’s disease.
How does apomorphine differ from Viagra or Cialis?
Apomorphine works in the brain by stimulating dopamine receptors involved in sexual arousal. Viagra and Cialis, on the other hand, work in the body, by relaxing blood vessels in the penis via PDE5 inhibition.
How fast does apomorphine work for ED?
Sublingual apomorphine typically begins working within 15 to 20 minutes, making it one of the faster-acting ED options, but its window of efficacy is shorter, usually lasting about 60 minutes.
Where can I buy apomorphine for ED?
Since apomorphine isn’t FDA-approved for ED in the U.S., it’s not available over-the-counter or through most telehealth ED providers.
Only purchase apomorphine with a valid prescription from a licensed medical provider.
Is apomorphine better for psychogenic ED?
Yes, early clinical data and user reports suggest apomorphine may be more effective in cases where psychological factors, such as performance anxiety or depression, cause ED.
Final Verdict
Apomorphine might sound intriguing if you’re exploring every available option to treat erectile dysfunction.
But here’s the reality: apomorphine is not FDA-approved for ED in the U.S., it can be relatively hard to access, and it comes with a higher risk of side effects.
If you’re looking for a treatment that’s well-tested, widely prescribed, and more predictable in its effects, Sildenafil and Tadalafil are the gold standards.
Apomorphine may work for some, but Sildenafil and Tadalafil work for millions, and you may be better off starting with what’s proven until further research is published.