Nitrosoprodenafil (NPD)

Nitrosoprodenafil is a designer drug found in "herbal" aphrodisiac products, which is a novel nitrosated analogue of sildenafil (Viagra). It has an innovative structure which acts as a prodrug, breaking down in the body to release both the PDE5 inhibitor aildenafil as well as free nitric oxide, which have powerfully synergistic effects. This dual mechanism of action has never been exploited by conventional pharmaceutical companies because of the risks involved; usually combining PDE5 inhibitors with nitric oxide releasers like amyl nitrite is contraindicated as it can cause a precipitous drop in blood pressure that can potentially result in death. Nitrosamines are also generally avoided in drug development as they can often be hepatotoxic, so while the combined mechanisms of action are likely to be effective, this drug also has severe risks of toxicity.