Generic Name and Formulations:
Alprostadil 10mcg, 20mcg, 40mcg; per vial; pwd for intracavernous inj after reconstitution.
Treatment of erectile dysfunction. Adjunct to other diagnostic tests in the diagnosis of erectile dysfunction.
Inject into the dorso-lateral aspect of the proximal third of penis, avoid visible veins; rotate inj side and site. Determine optimum dose in office. If no response, may give 2nd dose after 1hr; if partial response occurs, wait 24hrs before next dose. Vasculogenic, psychogenic, or mixed etiology: initially 2.5mcg; if partial response, may give 2nd dose of 5mcg; may increase in increments of 5–10mcg until desired response. If no response to 1st dose, may give 2nd dose of 7.5mcg within 1hr; may increase in increments of 5–10mcg until desired response. Neurogenic etiology: initially 1.25mcg; may give 2nd dose of 2.5mcg, and 3rd dose of 5mcg; may increase in increments of 5mcg until desired response. Usual max: 60mcg and 3 inj/week; allow at least 24hrs between doses. Reduce dose if erection lasts over 1hr. Adjunct in diagnosis: see full labeling.
Not recommended; see Contraindications.
Predisposition to priapism. Anatomical penile deformation. Penile implants. Patients for whom sexual activity is inadvisable or contraindicated. Women. Children. Newborns.
Evaluate and treat underlying causes prior to initiating therapy. Treat priapism immediately. Patient must not adjust dose on own. Reevaluate every 3 months. Significant corpora cavernosa venous leakage. Monitor for signs of penile fibrosis. Discontinue if penile angulation, cavernosal fibrosis, or Peyronie's disease develops.
Concomitant vasoactive agents: not recommended. Caution with anticoagulants.
Priapism, prolonged erection, penile pain or fibrosis, inj site hematoma or ecchymosis, prostatic disorder, penile rash or edema, other local effects, hypertension, headache, increased risk of blood-borne diseases, others.
Vials 20mcg, 40mcg—6; Caverject impulse 10mcg, 20mcg—2 (dual chamber syringe systems + supplies)