Alprostadil
Erectile Dysfunction Products · Prostaglandin
Indications
Treatment and diagnosis of erectile dysfunction.
Dosage
Inj: Adults: Initially 2.5 mcg by intra-cavernosal injection. If necessary increase in 2.5 mcg increments to max 60 mcg. Max frequency of use, once daily and 3 times per wk. Children: Not applicable. Suppository: Adults: Initially 250 mcg by intraurethral administration. Increase or decrease for subsequent doses according to response. Max 2 doses in 24 hr and not more than 7 doses in 7 days. See literature. Children: Not recommended.
Administration
The intracavernosal injection must be done under sterile conditions. The injection site is usually along the dorsolateral aspect of the proximal third of the penis. Avoid visible vein. Alternate the side of the penis that is injected and the injection site, cleanse the injection site with an alcohol swab. Stability: All formulations of alprostadil are intended for single use only and should be discarded after use. Aqueous solution: Store alprostadil injection frozen at 20°C-10°C (4°F-14°F) until dispensed. After dispensing, store in a freezer at 20°C-10°C for upto 3 months. During this 3-month period, alprostadil injection may be moved to and kept in a refrigerator at 2°C-8°C for up to 7 days. Once refrigerated, use within 7 days or discard; do not refreeze once removed from the foil wrapping, use the solution in the ampule immediately after allowing it to warm to room temperature or…
Adverse Effects
Inj: Burning sensation or tension in penis during erection. Fibrosis, erythema, testicular or perineal pain, penile deviations, haemosiderin deposits in penis. Priapism. Changes in blood pressure, cardiac arrhythmias, dizziness, headache, vagal shock, collapse. Suppository: Penile pain. Haematoma and other injection sites reactions. Fibrosis, erythema, testicular or perineal pain, penile deviations, haemosiderin deposits in penis, Peyronie's disease. Priapism. Muscle spasm. Changes in BP, cardiac arrhythmias, dizziness, headache, peripheral vascular disorders. Urethral application; urethral irritation.
Risk Factor (Pregnancy/Lactation)
Contraindications: Inj: Sickle cell anaemia, multiple myeloma, leukaemia. Suppository: Predisposition to prolonged erection (for e.g. in sickle cell anaemia, multiple myeloma, leukaemia), penile implants, abnormal penile anatomy (for e.g. severe hypospadia, severe curvature, cavernosal fibrosis, Peyronie's disease), balanitis, urethritis. Precautions: Inj: Advise patient to seek medical attention if erection persists for more than four hours. Angulation, phimosis, cavernosal fibrosis, Peyronie's disease. Suppository: Priapism; advise patients to seek medical help if erection last over 4 hours. Anatomical deformation of penis. Transient ischaemic attacks, unstable cardiovascular disorders.
Interactions
Inj: Warfarin, heparin. Suppository: Other erectile dysfunction agents, sympathomimetics.
Advice to Patient
Do not use more than 3 times per week. A gap of 24 hours must be given between injections. Contact prescriber if there are penile problems (such as nodule, pain, rash, redness, bruising, swelling, numbness, abnormal ejaculations, infection), hypotension or hypertension, palpitations, irregular heartbeat, chest pain, fever, flu or flu like symptoms, flushing, difficulty in breathing, wheezing. Avoid alcohol during therapy. Discontinue medication and inform prescriber immediately if erection remains for more than 4 hours or if there is severe penile pain. If you are using suppository, urinate just before inserting suppository and insert it with applicator supplied with drug. Use condom to prevent sexually transmitted diseases. Have periodic follow-up appointments as advised by prescriber.
Pharmacokinetics
Onset of action: Erectile dysfunction: 5-20 mins. Duration: Ductus arteriosus will begin to close within 1-2 hrs after drug is stopped; Erectile dysfunction: Intended duration <1 hr. Metabolism: IV: Approx. 70%-80% by oxidation during a single pass through the lungs. Half-life elimination: 30 sec-10 mins. Time to peak: Acyanotic congenital heart disease: Usual: 1.5-3 hrs. Cyanotic congenital heart disease: Usual: Approx. 30 mins. Erectile dysfunction: Intracavernosal 30-60 mins; Transurethral: Approx. 16 mins. Excretion: Primarily urine (90%). Faeces.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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