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When it comes to treating erectile dysfunction, few medications have raised more eyebrows—or been more misunderstood— than apomorphine (APO).
Apomorphine is a dopamine agonist that is most commonly used to treat Parkinson's disease, but has a history of being prescribed for many other reasons, including sexual dysfunction, gastric emptying, respiratory disorders, and more (Auffret, 2018).
Truthfully, much of the criticism surrounding apomorphine’s usage in ED treatment requires additional context. What we do know about the medication is this: apomorphine is not an opiate, not addictive, and should not be written off as a treatment specific for Parkinson’s Disease. (Auffret, 2018) (Kendirci, 2005)
In fact, apomorphine is one of the most forward-thinking approaches to ED we’ve seen in decades, because it focuses on an aspect of sexual arousal often overlooked by typical ED treatments: the brain. (Melis, 2022)
Let’s unpack the name, the history, the science, and why this misunderstood treatment may be the key to solving ED in those who fail to see results with traditional treatments.
Don’t Let the Name Scare You
Let’s talk about the elephant in the room—the “morphine” suffix.
Despite the name, apomorphine is not the same thing as morphine. It does not bind to opioid receptors, it isn’t used to block pain, and it does not produce a high or carry a risk of addiction. (Carbone, 2019)(Kendirci, 2005)
The name stems from the fact that apomorphine is a morphine derivative D2 dopamine agonist. In other words, APO can be synthesized from morphine through a chemical transformation, but the compound itself does not interact with the body the same way morphine does. Rather, apomorphine increases the amount of dopamine (the “feel-good” hormone) in the brain. (Melis, 2022)
When used for ED, apomorphine works by activating the dopamine receptors in the parts of your brain associated with sexual function, getting you primed for sexual arousal.
The History of Apomorphine
Apomorphine’s origins stretch back far beyond Parkinson’s Disease, ED, and emetic drugs. APO is a compound that occurs naturally in the blue lotus flower (Nymphaea caerulea), a plant that was well known and used in ancient Egypt for its calming and aphrodisiac effects. (Poklis, 2018) (Bertol, 2004)
Historical data suggests that the blue lotus was consumed for both its sedative and libido-enhancing properties. This tells us that long before modern researchers began studying APO’s effects on sexual dysfunction, the compound had already been effectively used and consumed by many. (Poklis, 2018) (Bertol, 2004)
Fast forward to the 19th and 20th centuries, and apomorphine was being studied and used for a variety of applications, from treating movement disorders to acting as a powerful emetic in poisoning cases. (Auffret, 2018)
Today, apomorphine is widely used to help patients with Parkinson’s disease (PD) struggling with motor fluctuations. APO is also currently being prescribed in Europe for the treatment of erectile dysfunction, and can be prescribed off-label in the United States as well. (Brock, 2002)
Targeting Mental Arousal
So what makes APO such a unique treatment for ED? While most traditional treatment options like sildenafil or tadalafil encourage the physical side of an erection, the mental side is often overlooked.
Mental arousal is where an erection and sexual gratification begin. For those who struggle to get in the mood or achieve long-lasting, satisfying erections, targeting the mental aspects of arousal may be a more effective treatment model.
That sense of desire triggers a cascade of activity in your brain and body, including a surge of dopamine, and eventually leading to increased blood flow to the penis, which causes an erection. (Melis, 2022)
Dopamine doesn’t just make you feel pleasure—it motivates you to seek it. And it plays a crucial role in sexual arousal. If your brain isn’t releasing enough dopamine or isn’t responding properly to it, the body doesn’t get the signal to start the chain reaction that leads to an erection.
This is where apomorphine comes in, and why a combination ED treatment really shines. Apomorphine stimulates mental arousal and encourages the flow of dopamine, and PDE5 inhibitors like sildenafil (Viagra®) and tadalafil (Cialis®) help increase blood flow to the penis. (Dhaliwal A, 2023) (Melis, 2022)
At Rugiet, we embrace the idea that sexual gratification requires more than just a physical response. That’s why apomorphine plays a role in some of our ED formulations.
Rugiet Ready is a sublingual (under the tongue) tablet that includes two PDE5 inhibitors (sildenafil and tadalafil) with apomorphine. This innovative approach addresses both the mental aspects of arousal and the physical, ensuring your brain and body are both primed for better sex.
Why Traditional ED Meds Aren’t Always Effective
There’s no denying that PDE5 inhibitors like sildenafil and tadalafil have revolutionized the treatment of ED. They’re effective, widely available, and have helped millions of men regain confidence in the bedroom. But they have their limitations:
They require sexual stimulation to work.
They don't initiate mental arousal.
They don’t necessarily address ED rooted in psychological or neurological issues.
And for some men, they just don’t work well, particularly if the brain-body connection is disrupted.
This is especially relevant for men dealing with stress, anxiety, depression, or neurological conditions that can influence dopamine signaling. (Cleveland Clinic, 2022) (Ciaccio, 2022) For these men, boosting blood flow alone isn’t enough, because the brain isn’t sending the right signal in the first place.
The Future of ED Treatment
Apomorphine is a compound that has been around for thousands of years and is still widely misunderstood. While the name might sound intimidating and the history might seem confusing, when used appropriately and under the guidance of a licensed healthcare provider, apomorphine is a useful, safe, and effective treatment for ED.
At Rugiet, we believe men deserve more than a one-size-fits-all solution. That means embracing treatments that work with the brain, not just the body.
Remember to speak with a healthcare provider before starting or changing any medication routine. Our team at Rugiet is here to help guide you through what’s right for your body, your goals, and your sex life.
Citations:
Auffret, M., Drapier, S., & Vérin, M. (2018). The Many Faces of Apomorphine: Lessons from the Past and Challenges for the Future. Drugs in R&D, 18(2), 91–107. https://doi.org/10.1007/s40268-018-0230-3
Kendirci, M., Walls, M. M., & Hellstrom, W. J. (2005). Central nervous system agents in the treatment of erectile dysfunction. The Urologic clinics of North America, 32(4), 487–vii. https://doi.org/10.1016/j.ucl.2005.08.006
Melis, M. R., Sanna, F., & Argiolas, A. (2022). Dopamine, Erectile Function and Male Sexual Behavior from the Past to the Present: A Review. Brain sciences, 12(7), 826. https://doi.org/10.3390/brainsci12070826
Carbone, F., Djamshidian, A., Seppi, K. et al. Apomorphine for Parkinson’s Disease: Efficacy and Safety of Current and New Formulations. CNS Drugs 33, 905–918 (2019). https://doi.org/10.1007/s40263-019-00661-z
Poklis, J. L., Mulder, H. A., Halquist, M. S., Wolf, C. E., Poklis, A., & Peace, M. R. (2017). The Blue Lotus Flower (Nymphea caerulea) Resin Used in a New Type of Electronic Cigarette, the Re-Buildable Dripping Atomizer. Journal of psychoactive drugs, 49(3), 175–181. https://doi.org/10.1080/02791072.2017.1290304
Bertol, E., Fineschi, V., Karch, S. B., Mari, F., & Riezzo, I. (2004). Nymphaea cults in ancient Egypt and the New World: a lesson in empirical pharmacology. Journal of the Royal Society of Medicine, 97(2), 84–85. https://doi.org/10.1177/014107680409700214
Brock, Gerald. (November 2002) . Oral Agents: First-Line Therapy for Erectile Dysfunction, European Urology Supplements, Volume 1, Issue 8, 12 - 18. https://www.eu-openscience.europeanurology.com/article/S1569-9056(02)00113-6/fulltext
Dhaliwal A, Gupta M. PDE5 Inhibitors. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/
Cleveland Clinic. (2022, March 23). Dopamine https://my.clevelandclinic.org/health/articles/22581-dopamine
Ciaccio, V., & Di Giacomo, D. (2022). Psychological Factors Related to Impotence as a Sexual Dysfunction in Young Men: A Literature Scan for Noteworthy Research Frameworks. Clinics and Practice, 12(4), 501-512. https://doi.org/10.3390/clinpract12040054
