Alprostadil erectile dysfunction

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

Erectile dysfunction Alprostadil Muse Polyethylene glycol 1450... 

Erectile dysfunction Alprostadil injected into the corpus caver-nosum of the penis provides effective treatment of some forms of male impotence. The drug increases arterial inflow through vasodilation and decreases venous outflow by causing relaxation of the corporal smooth muscle that occludes draining venules. Possible side effects include pain at the site of injection and, rarely, prolonged erection. 

Alprostadil is used in erectile dysfunction. Alprostadil relaxes smooth muscle of ductus arteriosus. It produces vasodilation, inhibits platelet aggregation, and stimulates intestinal and uterine smooth muscle. Alprostadil induces erection by relaxation of trabecular smooth muscle and by dilation of cavemosal arteries (see Erectile Dysfunction— Treatment of). 

Intracavernosal alprostadil may be a useful adjunct to other diagnostic tests in the diagnosis of erectile dysfunction (Cave/yecf only). 

Adjunct to the diagnosis of erectile dysfunction (Caverject only) - Patients are monitored for the occurrence of an erection after an intracavernosal injection of alprostadil. Use a single dose of alprostadil that induces a rigid erection. 

The newer drug of same category are alprostadil, vardenafil and tadalafil which are recently introduced for erectile dysfunction in man. Apomorphine is... 

Intracavernosal injection or urethral suppository therapy with alprostadil (PGE1) is a second-line treatment for erectile dysfunction. Doses of 2.5-25 meg are used. Penile pain is a frequent side effect, which may be related to the algesic effects of PGE derivatives however, only a few patients discontinue the use because of pain. Prolonged erection and priapism are side effects that occur in less than 4% of patients and are minimized by careful titration to the minimal effective dose. When given by injection, alprostadil may be used as monotherapy or in combination with either papaverine or phentolamine. 

The European Alprostadil Study Group. The long-term safety of alprostadil (prostaglandin-El) in patients with erectile dysfunction. Br J Urol 1998 82(4) 538-43. 

Colli E, Calabro A, Gentile V, Mirone V, Soli M. Alprostadil sterile powder formulation for intracavernous treatment of erectile dysfunction. Eur Urol 1996 29(1) 59-62. 

Linet OI, Ogrinc FG. Efficacy and safety of intracavemo-sal alprostadil in men with erectile dysfunction. The Alprostadil Study Group. N Engl J Med 1996 334(14) 873-7. 

Intracavernosal alprostadil was effective and well tolerated in the treatment of erectile dysfunction, according to the results of a 6-month study (funded by Pharmacia Upjohn) in 848 men (mean age 52 years) with at least a 4-month history of erectile dysfunction (12). This is provided that the individual dose is established by titration and patients receive training in injection techniques and periodic supervision during treatment. An initial dose was established for each patient and the patients then administered the alprostadil themselves at home. Of 727 evaluable patients, 682 (94%) had at least one erectile response after the injection of alprostadil, and 88% of injections lead to a satisfactory sexual response. The most commonly reported adverse event was penile pain, reported by 44% of patients, but only after 8% of injections. In just over half of the patients who had penile pain, the condition was reported as mild. Prolonged erection, penile fibrosis, and priapism occurred in 8,4, and 0.9% of patients respectively. Treatment was withdrawn because of medical events in 4% of patients, and drug-related events accounted for treatment withdrawal in 2% of patients. 

There has been a report of a long-term follow-up program for treatment of erectile dysfunction in 32 patients who used alprostadil for a minimum of 5 years under... 

English JC 3rd, King DH, Foley JP. Penile shaft hypopig-mentation lichen sclerosus occurring after the initiation of alprostadil intracavernous injections for erectile dysfunction. J Am Acad Dermatol 1998 39(5 Pt l) 801-3. 

Williams G, Abbou CC, Amar ET, Desvaux P, Flam TA, Lycklama a Nijeholt GA, Lynch SF, Morgan RJ, Muller SC, Porst H, Pryor JP, Ryan P, Witzsch UK, Hall MM, Place VA, Spivack AP, Todd LK, Gesundheit N. The effect of transurethral alprostadil on the quality of life of men with erectile dysfunction, and their partners. MUSE Study Group. Br J Urol 1998 82(6) 847-54. 

Erectile dysfunction, that is, the inability to maintain penile erection for the successful performance of sexual activity, has both organic and psychogenic causes, including as a sequelae to prostatic surgery. Erectile dysfunction is estimated to affect up to 30 million men in the United States. Previous therapies have included penile implants, and intrape-nile injections of alprostadil (see p. 420). Sildenafil [sil DEN a HI], the first oral drug approved for the treatment of erectile dysfunction in males, was introduced in early 1998. 

PGE alprostadil (used to maintain the patency of the ductus arteriosus in neonates with congenital heart defects, and for erectile dysfunction by injection into the corpus cavemosum of the penis) misoprostol (used for prophylaxis of peptic ulcer associated with NSAIDs) gemeprost (used as pessaries to soften the uterine cervix and dilate the cervical canal prior to vacuum aspiration for termination of pregnancy). 

Penile shaft lichen sclerosus has been reported in a 63-year-old man in association with alprostadil intraca-vernous injection for erectile dysfunction (5). The authors suggested that the lichen sclerosus had been caused by (1) an isomorphic response to the trauma of repeated needle injection (2) a local cutaneous response to alprostadil-induced collagen synthesis or alprostadil-induced fibroblast production of IL-6, with secondary paracrine/ autocrine-induced collagen synthesis by improper skin exposure by direct injection to the skin or by retrograde flow of alprostadil through the needle puncture tract or (3) a random occurrence of separate events. 

Alprostadil (Cavcijecl) is also available in glass vials for reconstitution to provide 1.0 niL of. solution containing either 10 or 20 /xg/mL for intcrcnvemosal penile injection to diag-no.se or cotreel erectile dysfunction in certain cases of impotence. A urethral suppository is also available this therapeutic use has been all but eliminated, how ever. by the availability of orally administered Viagra. 

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... 

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