Alprostadil: Restoring Erectile Function Medically
| Product dosage: 500mcg | |||
|---|---|---|---|
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| 1 | $302.80
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Alprostadil is a synthetic prostaglandin E1 analog used primarily in the management of erectile dysfunction (ED) and certain neonatal cardiovascular conditions. As a vasodilator, it works by relaxing smooth muscle tissue and dilating blood vessels, facilitating increased blood flow to specific areas. Its clinical applications are well-established, offering a non-hormonal, locally acting therapeutic option for patients where oral therapies are contraindicated or ineffective. Available in multiple formulations, including intracavernosal injection, intraurethral pellet, and topical cream, it provides tailored solutions based on individual patient needs and preferences.
Features
- Synthetic prostaglandin E1 analog with potent vasodilatory properties
- Multiple administration routes: intracavernosal, intraurethral, and topical
- Rapid onset of action, typically within 5–15 minutes for erectile applications
- Does not depend on nitric oxide pathways, making it suitable for diverse patient populations
- Available in precise dosage forms to minimize systemic exposure and side effects
Benefits
- Effectively induces erection sufficient for sexual intercourse in patients with various etiologies of ED
- Provides a therapeutic option when phosphodiesterase type 5 inhibitors are contraindicated or ineffective
- Allows for dose titration to achieve optimal response with minimal adverse effects
- Can be used as a diagnostic tool to differentiate between vascular and non-vascular causes of ED
- Offers flexibility with different formulations to accommodate patient comfort and clinical scenario
- May aid in penile rehabilitation post-prostatectomy or radiation therapy
Common use
Alprostadil is most frequently prescribed for the treatment of erectile dysfunction in adult males. It is particularly valuable in cases where oral agents like sildenafil are not suitable due to contraindications, intolerable side effects, or lack of efficacy. In neonatal medicine, it is used to maintain patency of the ductus arteriosus in infants with congenital heart defects awaiting surgical correction. Off-label uses include the treatment of peripheral vascular disease and as an adjunct in certain diagnostic vascular studies.
Dosage and direction
For erectile dysfunction, dosage varies by formulation:
- 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 pellet: Initial dose 125–250 mcg, adjusted based on response. Maximum dose is 1000 mcg.
- Topical cream: Applied in measured doses onto the glans penis; specific dosing depends on product strength.
Administer exactly as prescribed, with careful attention to injection technique or application instructions. For neonatal use, alprostadil is administered via continuous intravenous infusion, typically starting at 0.05–0.1 mcg/kg/min, adjusted based on clinical response.
Precautions
- Proper training in injection technique is essential to minimize risk of tissue injury or fibrosis
- Use with caution in patients with anatomical penile deformities (e.g., Peyronie’s disease)
- Monitor for priapism (erection lasting >4 hours); seek immediate medical attention if occurs
- Caution advised in patients with bleeding disorders or on anticoagulant therapy
- Topical formulations may transfer to sexual partner; use barrier protection if recommended
- Storage conditions must be strictly adhered to maintain stability
Contraindications
- Hypersensitivity to alprostadil or any component of the formulation
- Conditions predisposing to priapism (e.g., sickle cell anemia, multiple myeloma)
- Anatomical deformities of the penis that make injection unsafe
- Use in women or children except for specific neonatal indications
- Concurrent use with other treatments for erectile dysfunction unless supervised by a physician
Possible side effect
- Penile pain (most common with intraurethral formulation)
- Local bleeding or hematoma at injection site
- Prolonged erection or priapism
- Urethral burning or minor bleeding (with intraurethral administration)
- Dizziness or hypotension
- Fibrosis or plaques at injection sites with chronic use
- Systemic effects rare but may include headache, respiratory distress, or fever
Drug interaction
- Anticoagulants (warfarin, heparin) may increase bleeding risk at injection sites
- Other vasodilators may potentiate hypotensive effects
- No significant interactions with cytochrome P450 system
- Use with other ED treatments may increase risk of priapism and is generally not recommended
Missed dose
Not applicable for as-needed use for erectile dysfunction. For neonatal continuous infusion, follow institutional protocols for interruption and restarting therapy.
Overdose
Symptoms may include prolonged painful erection, severe hypotension, or syncope. For priapism, seek immediate urological care. Supportive measures for hypotension including Trendelenburg positioning and IV fluids if needed.
Storage
- Store at controlled room temperature (20–25°C)
- Protect from light
- Do not freeze
- Keep in original container
- Discard reconstituted solutions according to package instructions
- Keep out of reach of children
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment decisions. Individual response to medication may vary, and proper training is essential for safe administration.
Reviews
Clinical studies demonstrate efficacy rates of 70-80% in appropriate patient populations. Many patients report satisfaction with the reliability of response, though some discontinue due to invasive administration route. Neonatal use shows significant success in maintaining ductal patency when carefully monitored. Long-term studies indicate good safety profile with proper use and monitoring.