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These medications work by enhancing the effects of nitric oxide, promoting smooth muscle relaxation and increased blood flow to the penis

Hasegawa S, Goto S, Tsuji H, Okuno T, Asahara T, Nomoto K, Shibata A, Fujisawa Y, Minato T, Okamoto A, Ohno K, Hirayama M

Uehara T, Choong C-J, Nakamori M, Hayakawa H, Nishiyama K, Kasahara Y, Baba K, Nagata T, Yokota T, Tsuda H et al (2019) Amido-bridged nucleic acid (AmNA)-modified antisense oligonucleotides targeting -synuclein as a novel therapy for Parkinsons disease

These are short-chain peptides, typically just 2 to 4 amino acids in length, with molecular weights well under 1,000 Daltons