Product Information: Ixense (previously
|Ixense - Sublingual Testosterone
2 x 3mg
Apomorphine: The Development Of Ixense (previously Uprima®)
Our Uprima product has recently changed it's name to Ixense.
Ixense is a potent agonist of dopamine, specifically it acts upon D1
receptor sites, and this makes it different to the majority of ergot derived
drugs for dopamine improvement, such as, bromocriptine, which normally
target D2 receptors. Accordingly, Ixense doesn’t act directly upon
the penis like Viagra® or Befar®, but instead exerts its influence
in the brain for arousal, pleasure and climax. Ixense is known to act
upon receptors in the hypothalamus, and that this can enhance erection
by increasing the signals from the brain to begin the process. Specifically,
it induces selective activation in the nucleus paraventricularis, leading
to erectogenic signals.
It is this brain action that makes Uprima® a unique new approach
to the treatment of ED. As Dr. Dula stated after being involved with a
trial of 1472 patients using Ixense; “From a urologist’s perspective,
it is important to understand that this is an entirely novel agent and
works totally differently to Sildenafil (Ed.- Viagra®). It is a centrally-acting
agent. What’s more, apomorphine works fairly quickly, in 15-25 minutes.
The main side effect is nausea, but over time and repeated dosages it
rapidly dissipates. We think that it is a safe and efficacious treatment
for erectile dysfunction.”
In a multi-center, double blind study, 520 patients (of an average median
age of 54) took either 2mg, 4mg, 5mg, 6mg of apomorphine or a placebo.
The number of attempts resulting in an erection firm enough for intercourse
was recorded, along with the actual attempts resulting in intercourse.
The most significant improvements over placebo are at dosages of 4mg
to 6mg. However it was clear in this same trial and others, that increased
dosages also increase the likelihood of the most common side effect of
nausea. These side effects are reported to diminish with continued dosing.
In fact, the most favorable risk/ benefit ratio is seen with a dose optimization
regimen of 3mg, with the 3mg dose providing efficacy comparable to that
of 4mg, but with fewer side effects.
Other side effects with Ixense include headache, dizziness, and flushing.
Contraindications with apomorphine include heart medications, (particularly
those for hypertension) and because of potential synergy any other dopamine
agonists such as bromocriptine, hydergine, deprenyl and L-dopa etc. Should
you be taking such drugs, then always consult with your physician before
embarking upon a concurrent use of apomorphine.
As stated earlier, the average dosages of Ixense are 2mg or 3mg taken
sublingual (dissolved under the tongue) about 15 minutes before sex. (Note
that the advent of the sublingual tablet is the only way that apomorphine
should be used to treat ED). The drug insert clearly states, that (like
most ED drugs), a 3mg dose should not be repeated again within any 8-hour
Ixense represents a radical new departure in the treatment of ED. Rather
than just stimulation to the penis for enhanced blood flow etc., for the
first time brain receptor sites are being targeted for enhanced sexual
We are confident that we are going to see other drugs being developed
along similar lines in the coming months and years. I am also confident
that similar (and even some of the same drugs), are eventually also going
to be approved for sexual enhancement in females too.
What Uprima is and what it is used for?
Uprima tablets are sub-lingual tablets each containing 3mg of apomorphine
(as hydrochloride). The 3mg tablet is available is packs of 2 and 4 sublingual
tablets. Uprima 3mg tablets are brick red in colour and are triangle shaped
embossed with 3 on one side and the Abbott logo on the other side. Uprima
is a medicine known as a dopaminergic agonist which helps men achieve
an erection by stimulating the region of the brain, called the hypothalamus,
thereby helping to produce the natural signals which start the erection
process in the penis. Sexual stimulation is necessary for Uprima to work.
Uprima is different to morphine and has no morphine-like properties. Uprima
is a therapy for the treatment of men with erectile dysfunction (sometimes
called ED or impotence). This is a condition in which a man cannot get,
or keep, a hard penis (erection) sufficient for satisfactory sexual performance.
Before you take Uprima:
Do not take Uprima if:
You have ever had allergic reaction to apomorphine or any of the ingredients
in Uprima. Possible signs of an allergic reaction include rash, itching,
swollen face or lips and shortness of breath. Tell your doctor if you
get any of these.
You have severe unstable angina, recent myocardial infarction, severe
heart failure or hypotension, and other medical conditions, which could
make sexual activity dangerous. Always consult your Doctor about your
Your partner is pregnant or breastfeeding.
You should tell your doctor if:
You have a deformity of disease of the penis as these may require special
care when using medicines such as Uprima.
You experience severe dizziness/light headedness or feel faint after taking
Uprima, especially if you also have severe nausea or vomiting, sweating,
become pale or become unusually hot. In these cases you should not attempt
to stand up. If you experience these symptoms or feel faint for any reason
you should like down and raise your legs. The feeling of faintness should
You are taking nitrates (often used for relief of angina or chest pains)
or any medicines for hypertension (high blood pressure).
You have liver or kidney problems. Your suitability for Uprima and/or
the appropriate dose may need to be considered by your doctor.
You have abnormally high or low blood pressure or are prone to dizzy spells
You are taking any other treatment for erectile dysfunction. Uprima should
not be used with any other treatment for erectile dysfunction.
Uprima should not be given to children under the age of 18. No dose adjustment
is required for the elderly. Taking alcohol with Uprima can increase undesirable
effects, in particular low blood pressure. In addition, Taking alcohol
can make it more difficult to obtain an erection. Not for use in women.
Driving and using machinery:
Because some patients can experience dizziness, light headedness and,
uncommonly fainting, it is recommended that you do not drive or operate
machinery for at least 2 hours after taking Uprima or until any such symptoms
are fully resolved.
Taking other medicines:
Please inform your doctor if:
You are taking nitrates (often used for the relief of angina or chest
pains) or any medicines for hypertension (high blood pressure).
You are taking drugs that affect the dopamine systems (often used to treat
Parkinson’s disease, disturbance of the mind or to prevent vomiting.
You should also inform your doctor or pharmacist if you are taking or
have recently taken any other medicines, even those not prescribed.
How to take Uprima
Your doctor will decide the dose of Uprima which is suitable for you.
Do not take more tablets than your doctor has prescribed. All patients
should begin with the 2mg tablet. If your erection is not sufficient for
satisfactory sexual activity at this dose and you have not experienced
side effects, you may increase the dose to the 3mg tablet following consultation
with your doctor. You should not take more than 3mg in any 8-hour period.
When taking Uprima:
Swallow a small amount of water to help moisten your mouth.
Place one tablet of Uprima under your tongue. The tablet will not work
if you swallow it.
Let the tablet dissolve under your tongue – this usually takes about
10 minutes (if any tablet residue is left after 20 minutes it may be swallowed).
Sexual activity may begin as soon as the Uprima is placed under the tongue
and you may proceed with intercourse when you and your partner are ready.
Typically erections may be achieved in less than 20 minutes, although
this varies from person to person.
You should not take more than 3mg Uprima in any 8-hour period.
If Uprima does not help you get a satisfactory erection
tell your doctor, as your dose may need adjustment.
You should only take Uprima as directed. If you
take too many tablets or the wrong dose, contact your doctor.
Possible side effects
Like all medicines, Uprima can have side effects. These are generally
mild and transient in nature. Common undesirable effects are nausea, headache,
dizziness, yawning, sleepiness, infection, sore throat, pain, increased
cough, rhinitis, flushing, taste disorder and sweating. Uncommonly, fainting
has occurred. If you feel faint, follow the instructions given under 'Do
not take Uprima'.
If you have chest pains during intercourse, you
should stop immediately and contact your doctor. If you have any undesirable
effect, which is severe or prolonged, you should tell your doctor. If
you notice any side effects not mentioned in this leaflet, please inform
your doctor or pharmacist.
Keep out of the reach and sight of children.
Store your Uprima in the original package. Do not use this medicine after
the expiry date shown on the pack or if the pack has been damaged or tampered