Since the introduction of sildenafil, a phosphodiesterase type 5 (PDE-5) inhibitor, oral therapy is first-line therapy in the management of erectile dysfunction (ED). Two new PDE-5 inhibitors are under clinical development: vardenafil and tadalafil. These new agents appear to have advantages over sildenafil in the areas of time to onset of action, period of responsiveness, side effect profile, effectiveness in difficult to treat patient populations and interaction with food. A centrally active sublingual agent recently released in Europe is effective in the treatment of mild and moderate ED. Apomorphine is a dopaminergic agonist that acts at the paraventricular nucleus in the hypothalamus. In the present article, the benefits of these emerging therapies are reviewed.
