Alprostadil administration technique

Initiation of therapy - T trate dose under the supervision of a physician to test a patient s response to alprostadil, to demonstrate proper administration technique and to monitor for evidence of hypotension. Individually titrate patients to the lowest dose that is sufficient for sexual intercourse. If necessary, increase the dose (or decrease) on separate occasions in a stepwise manner until the patient achieves an erection that is sufficient for sexual intercourse. 

Intracavernosal alprostadil is most commonly associated with local adverse effects, which occur most often during the first year of therapy. However, improved administration technique with continued use is believed to account for the lower frequency of adverse effects during subsequent treatment periods. 

Intraurethral Administer as needed to achieve an erection. The onset of effect is within 5 to 10 minutes after administration. The duration of effect is approximately 30 to 60 minutes. A medical professional should instruct each patient on proper technique for administering alprostadil prior to self-administration. The maximum... 

FIGURE 81-8. Technique for administration of intraurethral alprostadil with a MUSE appi icator. Reprinted with permission from Kirby R, Carson C, Goldstein I. Erectile Dysfunction, A Clinical Guide. Oxford, England, ISIS Medical Media, 1999 62.)... 

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