Alprostadil intraurethral

Intraurethral Alprostadil MUSE 125-1000 meg 5-10 minutes prior to intercourse0 Two times daily... 

Intraurethral Alprostadil (MUSE) 125-mcg 250-mcg 500-mcg 1,000-mcg pellet 125-1,000 meg 5-10 minutes before intercourse... 

Alprostadil is approved as monotherapy for the management of ED. It is generally prescribed after failure of VEDs and phosphodiesterase inhibitors and for patients who cannot use these therapies. Of the available routes, the intracavern os al route is preferred over the intraurethral route because of better efficacy. 

Intraurethral alprostadil, 125 to 1,000 meg, should be administered 5 to 10 minutes before intercourse. Before administration, the patient should empty his bladder and void completely. No more than two doses per day are recommended. 

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... 

Absorption - For treatment of erectile dysfunction, alprostadil is administered by injection into the corpora cavernosa or inserted intraurethrally. 

Intraurethral The transurethral absorption of alprostadil is rapid, with... 

A 57-year-old man with erectile impotence, who had previously been treated with intracorporeal injections of papaverine and alprostadil, resulting in recurrent episodes of priapism necessitating aspiration, decided to try intraurethral alprostadil (MUSE). The dose needed to achieve a full erection in the clinic was titrated to 1 ig, but after 5 months this was found to be inadequate unless supplemented by a hot bath before MUSE administration. The patient stated that with MUSE alone the erection lasted for 5-10 minutes but on the two previous occasions when he had had a hot bath for 20 minutes and then used MUSE, the erection had lasted 3-4 hours. However, on the third occasion, priapism lasted 20 hours and necessitated corporeal aspiration for detumescence. 

Alprostadil Caveqect Muse Pharmacia Upjohn AstraZeneca PGE, Ductus arteriosus 50-100 ngkg min Erectile dysfunction 5-20 fxg intracavemosally Erectile dysfunction 125-1000 fig intraurethrally... 

Intraurethral Alprostadil (MUSE) 125-mcg, 250-mcg, 500-mcg, 1000-mcg pellets 125-1000 meg 5 to 10 minutes before intercou rse... 

Alprostadil is commercially available as an intracavernosal injection (Caverject and Edex) and as an intraurethral insert (medicated urethral system for erection MUSE). 

Both commercially available formulations of alprostadil are FDA-approved as monotherapy for the management of erectile dysfnnc-tion. Alprostadil is more effective by the intracavernosal than by the intraurethral route. ... 

The enhanced efficacy of the intracavernosal inj ection may be related to the excellent bioavailability of the drug when injected directly into the corpora cavernosum. In contrast, intraurethral alprostadil doses generally are several hundred times larger than intracavernosal doses. Intraurethral alprostadil must be absorbed from the urethra. 

Both formulations of alprostadil are considered more invasive than VEDs or phosphodiesterase inhibitors. For this reason, intracavernosal alprostadil is generally prescribed after patients fail to respond to or cannot use the less invasive interventions. Intracavernosal alprostadil is preferred over intraurethral alprostadil because the former is more effective than the latter. Also, intracavernosal alprostadil may be preferred in patients with diabetes mellitus, who are accustomed to injectable drug therapy and may suffer from peripheral neuropathies, which decreases the patient s perception of pain upon injection. Intraurethral alprostadil is generally reserved as a treatment of last resort for patients who fail other less invasive and more effective forms of therapy and also refuse surgery. 

Intraurethral alprostadil inserts are marketed as MUSE, which contains a pellet inside a prefllled urethral applicator. Multiple studies show this product to have an overall effectiveness rate of 43% to 60%, " as compared with 70% to 90% for intracavernosal alprostadil. Its decreased effectiveness and inconvenient administration method have resulted in this product being considered a second-line treatment option for patients with erectile dysfunction. However, some patients respond to intraurethral alprostadil even when intracavernosal alprostadil did not work for them. ... 

To improve treatment response to intraurethral alprostadil, it has been combined with an adjustable penile constriction band. " ... 

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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