Generic Name: alprostadil (injectable and transurethral) (al PROS ta dil)
Brand Name: Caverject, Caverject Impulse, Edex, Muse, Prostin VR Pediatric, Edex Refill
What is alprostadil?
Alprostadil is used to treat erectile dysfunction (impotence) and to help diagnose certain causes of this disorder. Alprostadil is also used to improve blood flow in newborn babies with a certain genetic heart condition. This alprostadil medication guide addresses only the adult male use of this medicine in erectile disorders.
Alprostadil relaxes blood vessels and muscles in the penis. This increases blood flow into the penis, causing an erection.
Alprostadil may also be used for purposes not listed in this medication guide.
What is the most important information I should know about alprostadil?
You should not use this medicine if you are allergic to alprostadil, or if you have sickle cell anemia, leukemia, a bone marrow tumor, a curved or deformed penis, penile fibrosis or Peyronie's disease, a penile implant, or if you have been told you should not have sexual intercourse for health reasons.
Using too much alprostadil can be very dangerous. Follow all directions on your prescription label.
Seek emergency medical attention if you have a painful or prolonged erection lasting 4 hours or longer.
What should I discuss with my healthcare provider before using alprostadil?
You should not use alprostadil if you are allergic to it, or if you have:
sickle cell anemia or the sickle cell anemia trait;
a tumor of the bone marrow (multiple myeloma);
a curved or deformed penis;
penile fibrosis or Peyronie's disease;
if you have a penile implant; or
if you have been told you should not have sexual intercourse for health reasons.
To make sure alprostadil is safe for you, tell your doctor if you have:
a history of blood clots;
heart disease, high blood pressure (hypertension);
a bleeding or blood-clotting disorder; or
a disease that could be passed in blood (such as hepatitis or HIV).
Use a condom to prevent transfer of this medicine to your sexual partner if she is pregnant or could become pregnant.
Caverject, Caverject Impulse, Edex, or Muse should not be used by women or by anyone under 18 years old.
How should I use alprostadil?
Your first dose of this medicine will be given in your doctor's office so you can be watched for how well the medicine works and if it causes any side effects. You will then be shown how to properly give the medication to yourself. Wait at least 1 day after your first dose before using the medicine again.
Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Alprostadil is used only when needed to get an erection. An erection should occur within 5 to 20 minutes after you use the medication, and should last for 30 to 60 minutes. The length of time your erection lasts may be slightly different.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
The injectable form of alprostadil is injected into the side of the penis.
The transurethral pellet is a very small suppository that is inserted into the opening of the penis (the urethra).
Do not use more than 2 alprostadil pellets in one day (24 hours). Do not use more than 3 alprostadil injections per week. Allow at least 24 hours to pass between injections.
Alprostadil injectable is a powder medicine that comes with a sterile liquid for mixing it. Caverject Impulse is a brand of alprostadil injectable supplied as a needle and syringe that contains both the powder medicine and the sterile liquid. The dose is automatically mixed when you turn a dial on the end of the syringe. The Caverject Impulse syringe is designed for only one use. Carefully follow the instructions provided with this product.
Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.
Prepare your alprostadil dose only when you are ready to use the medicine. Do not shake the mixed medicine. After mixing, the medicine should be clear. Do not use the medicine if it looks cloudy or has particles in it. Call your pharmacist for new medicine.
Do not give yourself an alprostadil injection or pellet if you do not understand the instructions for proper use. Call your doctor or pharmacist for help with injection instructions. Using an alprostadil transurethral pellet improperly could cause damage to your urethra.
The Caverject Impulse device uses a very thin needle, which could break easily. If the needle breaks during injection and you can see and grasp the broken end, remove it and contact your doctor. If you cannot remove the broken end, call your doctor right away.
An alprostadil injection can cause bleeding where the needle is placed. This can make it easier for your sexual partner to be exposed to your blood. A virus such as hepatitis or HIV can be passed to another person who comes into contact with your blood.
To be sure alprostadil is not causing harmful effects, your penis may need to be examined every 3 months. Visit your doctor regularly.
Storing this medicine:
Keep each urethral pellet in its original foil pouch until you are ready to use it. Store the foil pouches in the refrigerator. You may store the pouches at room temperature for up to 14 days.
Store alprostadil injectable at room temperature. The 40 microgram strength of unmixed alprostadil can be stored at room temperature for up to 3 months, or until the expiration date on the label, whichever happens first.
Do not expose alprostadil products to freezing or very hot temperatures. Do not store your medication in a closed automobile, or pack it into luggage that will be placed into a cargo area during travel.
What happens if I miss a dose?
Since alprostadil is used as needed, you will not be on a dosing schedule.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include feeling light-headed, fainting, or having a painful or prolonged erection lasting 4 hours or longer.
What should I avoid while using alprostadil?
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Taking this medicine will not prevent you from passing a disease such as hepatitis or HIV to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.
Alprostadil side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using alprostadil and call your doctor at once if you have:
a light-headed feeling, like you might pass out;
trouble urinating, blood in your urine;
bleeding, bruising, or swelling where you injected the medication;
a painful erection that lasts 4 hours or longer;
severe pain or irritation of your penis or urethra; or
redness, lumps, tenderness, unusual shape or curving of the erect penis.
Common side effects may include:
mild pain in your penis, urethra, or testicles;
unusual discharge from your penis; or
cough, stuffy nose, cold symptoms, flu symptoms.
Your sexual partner may also have side effects such as burning, itching, or irritation of the body areas that come into contact with your penis.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Alprostadil dosing information
Usual Adult Dose for Erectile Dysfunction:
1 to 40 mcg intracavernous injection into the lateral penis given over 5 to 10 seconds
Maximum dose: 3 times per week, with at least 24 hours between each use
-Erectile dysfunction of vasculogenic, psychogenic, or mixed etiology: Initiate at 2.5 mcg; if there is partial response to initial dose, may increase to 5 mcg and then by increments of 5 to 10 mcg, depending upon erectile response, until the dose that produces an erection suitable for intercourse and not exceeding duration of 1 hour is reached; if there is no response to initial dose, may increase to 7.5 mcg and then by increments of 5 to 10 mcg.
-Erectile dysfunction of pure neurogenic etiology (spinal cord injury): Initiate at 1.25 mcg; may increase to 2.5 mcg, then 5 mcg, and then in 5 mcg increments until the dose that produces an erection suitable for intercourse and not exceeding duration of 1 hour is reached.
-The patient must remain in the physician's office following the first dose until complete detumescence occurs. If there is a response, the next dose may be given after a 1-day interval. If there is no response, the next higher dose may be given within 1 hour.
Initial dose: 125 or 250 mcg inserted into the urethra
Maximum dose: 2 systems per 24-hour period
-Titrate to the lowest dose that elicits an erection suitable for intercourse.
Usual Pediatric Dose for Patent Ductus Arteriosus:
0.05 to 0.1 mcg/kg/min continuous IV infusion
-The preferred route is continuous IV infusion into a large vein; may also be administered through an umbilical artery catheter placed at the ductal opening.
-Once a therapeutic response is achieved (increased partial oxygen pressure in patients with restricted pulmonary blood flow or increased systemic blood pressure and blood pH in patients with restricted systemic blood flow), reduce the infusion rate to the lowest dose that maintains the desired response.
-If response to initial dose is inadequate, dosage can be increased up to 0.4 mcg/kg/min. However, in general, higher infusion rates do not produce greater effects.
Use: Palliative, not definitive, therapy to temporarily maintain ductus arteriosus patency until corrective or palliative surgery can be performed in neonates with congenital heart defects who depend upon the patent ductus for survival. Such congenital heart defects include pulmonary atresia, pulmonary stenosis, tricuspid atresia, tetralogy of Fallot, aortic arch interruption, aorta coarctation, or transposition of the great vessels with or without other defects.
What other drugs will affect alprostadil?
Other drugs may interact with alprostadil, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
More about alprostadil
- Alprostadil injection
- Alprostadil suppository
- Alprostadil Intraurethral, Intravenous, Intracavernosal (Advanced Reading)
- Alprostadil Intravenous (Advanced Reading)
- Alprostadil Urethral (Advanced Reading)
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about alprostadil.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 8.01. Revision Date: 2015-06-25, 11:18:47 AM.