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Alprostadil Brand Names
Caverject | Caverject Impulse | Edex | Muse | Prostin VR
What is Alprostadil
Alprostadil is used to treat erectile dysfunction (ED) in adult males.
The efficacy of alprostadil in treating ED varies with the cause; response rate is generally lower in patients with ED due to mixed etiologies compared to those with ED due to neurogenic, psychogenic, or vasculogenic causes.
Two dosage forms are marketed for treating ED: a transurethral product (Muse) which uses a medicated pellet administered into the urethra and an injection (Caverject or Edex) that is directly injected into the corpus cavernosa.
Other dosage forms such as a topical gel and a non-invasive liposomal delivery system are under investigation.
According to ED treatment guidelines, oral phosphodiesterase type 5 inhibitors (PDE5 inhibitor) are considered first-line therapy.
Second-line treatment options include intracavernous injection and intra-urethral therapy.
Intracavernous injection therapy is the most effective nonsurgical treatment for ED, with predictable and sustained response. However, it is invasive and caries notable side-effects including priapism and penile fibrosis.
FDA approvals are as follows: Caverject in July 1995, MUSE in October 1996, and Edex in June 1997.
Indications
- ductus arteriosus maintenance
- erectile dysfunction (ED)
For the treatment of neonates with congenital heart defects to maintain the patency of the ductus arteriosus (ductus arteriosus maintenance) until palliative or corrective surgery can be performed
Side Effects
- anemia
- anuria
- apnea
- back pain
- bleeding
- bradycardia
- cardiac arrest
- diaphoresis
- diarrhea
- disseminated intravascular coagulation (DIC)
- dizziness
- ecchymosis
- edema
- erythema
- fever
- flushing
- gastroesophageal reflux
- headache
- heart failure
- hematoma
- hematuria
- hyperbilirubinemia
- hypercholesterolemia
- hyperemia
- hyperglycemia
- hyperkalemia
- hypertension
- hypertriglyceridemia
- hypoesthesia
- hypoglycemia
- hypotension
- hypothermia
- increased urinary frequency
- injection site reaction
- irritability
- lethargy
- muscle cramps
- mydriasis
- myocardial infarction
- nausea
- penile edema
- penile fibrosis
- penile pain
- perineal pain
- peripheral edema
- peripheral vasodilation
- phimosis
- priapism
- pruritus
- rash
- respiratory depression
- rhinitis
- seizures
- sinus tachycardia
- supraventricular tachycardia (SVT)
- syncope
- tachypnea
- testicular pain
- thrombocytopenia
- urethral pain
- urinary retention
- urinary urgency
- vaginal irritation
- ventricular fibrillation
- visual impairment
- weakness
- wheezing
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- anticoagulant therapy
- apnea
- balanitis
- benzyl alcohol hypersensitivity
- bleeding
- breast-feeding
- cardiac disease
- children
- coagulopathy
- contraception requirements
- driving or operating machinery
- females
- geriatric
- GI obstruction
- hypospadia
- hypotension
- infants
- labor
- leukemia
- multiple myeloma
- neonates
- penile implants
- penile structural abnormality
- Peyronie’s disease
- polycythemia
- pregnancy
- premature neonates
- priapism
- renal impairment
- requires a specialized care setting
- respiratory depression
- respiratory distress syndrome
- sexually transmitted disease
- sickle cell disease
- syncope
- thrombocytosis
- urethral stricture
- urethritis
Interactions
- Acebutolol
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Atenolol
- Atenolol; Chlorthalidone
- Bendroflumethiazide; Nadolol
- Beta-blockers
- Betaxolol
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Brimonidine; Timolol
- Calcium-channel blockers
- Carteolol
- Carvedilol
- Central-acting adrenergic agents
- Dorzolamide; Timolol
- Doxazosin
- Eplerenone
- Epoprostenol
- Esmolol
- Heparin
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Ibuprofen lysine
- Iloprost
- Labetalol
- Levobetaxolol
- Levobunolol
- Loop diuretics
- Mecamylamine
- Metoprolol
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Penbutolol
- Phenoxybenzamine
- Pindolol
- Potassium-sparing diuretics
- Prazosin
- Propranolol
- Reserpine
- Sotalol
- Terazosin
- Thiazide diuretics
- Timolol
- Treprostinil
- Vasodilators
