Alprostadil

Alprostadil injection is used to treat men who have erectile dysfunction (also called sexual impotence). Alprostadil should not be used as a sexual aid by men who do not have erectile dysfunction. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.

Product dosage: 500mcg
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Alprostadil is a synthetic prostaglandin E1 analog used primarily in the treatment of erectile dysfunction (ED) and for maintaining patency of the ductus arteriosus in neonates with congenital heart defects. As a vasodilator, it works by relaxing smooth muscle tissue and dilating blood vessels, facilitating increased blood flow. Available in various formulations including injectable, intraurethral, and topical forms, it offers targeted therapeutic options based on patient needs and clinical indications. Its efficacy is well-documented in clinical settings, providing a reliable solution for specific vascular and urological conditions.

Features

• Synthetic prostaglandin E1 analog with potent vasodilatory properties
• Multiple administration routes: intracavernosal injection, intraurethral suppository, topical cream
• Rapid onset of action, typically within 5–10 minutes for injectable forms
• Does not require sexual stimulation for efficacy in erectile applications
• FDA-approved for both erectile dysfunction and neonatal ductus arteriosus patency
• Available in precise dosage formulations to minimize adverse effects

Benefits

• Effectively induces erection in men with various causes of erectile dysfunction, including neurogenic, vasculogenic, and psychogenic origins
• Provides a non-oral alternative for patients who cannot use or do not respond to PDE5 inhibitors
• Allows for predictable timing of erectile response, enhancing sexual spontaneity and planning
• Can be used in combination with other agents for synergistic effects in treatment-resistant cases
• Offers a therapeutic option for neonates with congenital heart defects requiring maintained ductus arteriosus patency
• May aid in penile rehabilitation post-prostatectomy or radiation therapy

Common use

Alprostadil is most commonly prescribed for the treatment of erectile dysfunction in adult males, particularly in cases where oral phosphodiesterase type 5 inhibitors are contraindicated, ineffective, or not preferred by the patient. It is also used in neonatal intensive care units to maintain patency of the ductus arteriosus in infants with congenital heart defects who require temporary blood flow augmentation before surgical correction. Off-label uses include diagnostic testing for vascular causes of erectile dysfunction and as part of combination therapy for severe ED.

Dosage and direction

For erectile dysfunction:

• Intracavernosal injection: Initial dose typically 2.5–5 mcg, titrated upward in 2.5–5 mcg increments to achieve erection not exceeding 1 hour. Maximum recommended dose is 60 mcg.
• Intraurethral suppository: Initial dose 125–250 mcg, titrated to effective dose not exceeding 1000 mcg.
• Topical cream: Applied in measured doses to the urethral meatus (dosing varies by formulation).

For neonatal ductus arteriosus patency:

• Continuous intravenous infusion: Initial dose 0.05–0.1 mcg/kg/min, titrated to maintain patency.

Administration technique training is essential for self-injection patients. All formulations should be used precisely as prescribed, with careful attention to dosing intervals (typically not more than once daily for ED treatment).

Precautions

Patients should receive thorough instruction on proper injection technique or suppository placement to minimize complications. Regular follow-up is necessary to assess efficacy and adjust dosing. Priapism (erection lasting more than 4 hours) requires immediate medical attention to prevent permanent tissue damage. Use with caution in patients with penile anatomical deformities, bleeding disorders, or those taking anticoagulants. Cardiovascular status should be evaluated before initiation, as sexual activity poses cardiac risk in some patients. Storage conditions must be strictly maintained according to product specifications.

Contraindications

Hypersensitivity to alprostadil or any component of the formulation. Men with conditions that predispose to priapism (sickle cell anemia, multiple myeloma, leukemia). Patients with penile implants or anatomical deformities that make injection dangerous. Neonates with respiratory distress syndrome. Use in women or children for erectile purposes is contraindicated. Patients with known hyperviscosity syndromes.

Possible side effects

• Penile pain (most common, occurring in up to 30% of patients)
• Prolonged erection or priapism (2-5% of cases)
• Penile fibrosis or nodules with chronic injection use
• Local bleeding or hematoma at injection site
• Urethral burning or minor bleeding with intraurethral administration
• Dizziness or hypotension
• Upper respiratory tract infection (reported in some studies)
• Cavernositis or infection (rare with proper technique)

Drug interaction

Anticoagulants (warfarin, heparin) may increase bleeding risk at injection sites. Antihypertensive medications may potentiate hypotensive effects. Other erectile agents used concomitantly may increase risk of priapism. No significant interactions with hepatic enzyme inducers or inhibitors noted, as alprostadil is primarily metabolized locally.

Missed dose

Alprostadil is used as needed for erectile dysfunction, so missed dose concepts do not apply. For neonatal infusion, any interruption in therapy should be immediately addressed by medical personnel to maintain ductus arteriosus patency.

Overdose

Symptoms may include prolonged painful erection, severe hypotension, dizziness, or syncope. Priapism lasting more than 4 hours requires emergency treatment, possibly including aspiration of blood from the corpus cavernosum or injection of alpha-adrenergic agonists. Supportive care for hypotension including IV fluids and monitoring. There is no specific antidote.

Storage

Store at controlled room temperature (20-25°C/68-77°F). Protect from light. Reconstituted solutions should be used immediately or as directed by manufacturer specifications. Do not freeze. Keep all formulations out of reach of children. Discard any unused portion according to medical waste guidelines, particularly needles and injection devices.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Alprostadil is a prescription medication that should be used only under supervision of a qualified healthcare provider. Individual results may vary. Proper diagnosis and treatment planning by a medical professional are essential before initiation of therapy. Patients should report any adverse effects or concerns to their prescribing physician promptly.

Reviews

Clinical studies demonstrate alprostadil’s efficacy in 70-80% of patients with erectile dysfunction, with satisfaction rates varying by formulation and patient population. Many urologists consider it a valuable second-line therapy when oral agents fail. Neonatal use shows successful maintenance of ductus arteriosus patency in approximately 80% of cases. Patient-reported outcomes highlight the effectiveness but note the learning curve associated with self-injection. Long-term studies show maintained efficacy with proper dose titration and monitoring.