Alprostadil development

A few dozen potential products are in clinical development for male and/or female sexual disorders. Several of these potential products are novel delivery systems of already marketed compounds, such as two topical delivery systems of alprostadil developed by NexMed and Macro Chem, and a fyophilized liposomal delivery system for urethral administration of alprostadil, developed by Harvard Scientific. 

A neonate with transposition of the great vessels developed urticaria during treatment with alprostadil (7). While flushing and peripheral edema are well recognized, urticaria has not been described before. 

Tolerance does not appear to develop with continued use of intracavernosal alprostadil at home. 

Answer A. During fetal development, the ductus arteriosus is kept open by prostaglandins. For temporary maintenance of patency in the infant, the PGE1 analog alprostadil is used. Closure of the ductus in the infant can often be accomplished by IV indomethacin, which decreases PG synthesis by inhibiting COX. Epoprostenol is a prostacyclin analog used in primary pulmonary HTN. 

---