Alprostadil Urogenital : Uses, Side Effects, Interactions & More

Why is this medication prescribed?

Alprostadil injection and suppositories are used to treat certain types of erectile dysfunction (impotence; inability to get or keep an erection) in men. Alprostadil injection is also sometimes used in combination with other tests to diagnose erectile dysfunction. Alprostadil is in a class of medications called vasodilators. It works by relaxing the muscles and blood vessels in the penis to keep enough blood in the penis for an erection to occur.

Alprostadil does not cure erectile dysfunction or increase sexual desire. Alprostadil does not prevent pregnancy or the spread of sexually transmitted diseases such as the human immunodeficiency virus (HIV).

How should this medicine be used?

Alprostadil comes as a powder that is mixed with the liquid included in the package and injected into the penis and as a urethral suppository (granule that is placed in the urinary opening of the penis). Alprostadil is used as needed before sexual activity. An erection can occur within 5 to 20 minutes after using the injection and within 5 to 10 minutes after using the granule. The erection should last approximately 30 to 60 minutes. Alprostadil injection should not be used more than three times a week, with at least 24 hours between uses. Alprostadil granules should not be used more than twice in a 24 hour period. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any parts you don’t understand. Use alprostadil exactly as directed. Do not use more or less or use it more often than prescribed by your doctor.

Your doctor will give you the first dose of alprostadil in his office to determine the right dose for you. After you start using alprostadil at home, your doctor may gradually increase or decrease your dose. Tell your doctor if you do not experience satisfactory erections or if your erections last too long, but do not change your dose without talking to your doctor.

You should be trained by your doctor before using alprostadil at home. Make sure you understand exactly how to use alprostadil. Ask your doctor or pharmacist if you have any questions about how to use your medicine.

Do not reuse needles, syringes, cartridges, vials, granules, or applicators. Dispose of used needles and syringes in a puncture resistant container. Ask your doctor or pharmacist how to dispose of the container.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using alprostadil,

  • Tell your doctor and pharmacist if you are allergic to alprostadil; other prostaglandin medications such as misoprostol (Cytotec, in Arthrotec), bimatoprost (Lumigan), latanoprost (Xalatan), and travoprost (Travatan); or any other medication.
  • Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as heparin and warfarin (Coumadin); appetite suppressants; medications for allergies, colds, high blood pressure, or sinus problems; and any other treatment for erectile dysfunction. Your doctor may need to change the doses of your medications or monitor you closely for side effects.
  • Tell your doctor if you have ever been advised by a healthcare professional to avoid sexual activity for medical reasons and if you have or have ever had problems with your blood cells such as sickle cell anemia (a disease of the red blood cells), leukemia (cancer of the white blood cells), multiple myeloma (cancer of the plasma cells), thrombocythemia (a condition in which too many platelets are made), or polycythemia (a condition in which too many red blood cells are made); conditions that affect the shape of the penis (angulation, cavernous fibrosis, or Peyronie’s disease); a penile implant (device that is surgically placed inside the penis to treat erectile dysfunction); or heart failure. Also tell your doctor if you or any member of your family has ever had a blood clot in the legs or lungs and if you have recently had major surgery. Your doctor may tell you not to use alprostadil.
  • If you are using the alprostadil pill, tell your doctor if you have or have ever had narrowing, scarring, or swelling of the urinary opening of the penis or the tip of the penis. Your doctor will probably tell you not to use alprostadil tablets.
  • Tell your doctor if you have or have ever had a bleeding disorder; a history of fainting; or kidney, liver, or lung disease.
  • Tell your doctor if your partner is pregnant or planning to become pregnant. Do not use alprostadil granules before sexual activity with a pregnant woman or a woman who can become pregnant without using a condom barrier.
  • You should know that alprostadil can cause dizziness, lightheadedness, and fainting. Do not drive a car or operate machinery after using alprostadil until you know how this medicine affects you.
  • Talk to your doctor about drinking alcohol during your treatment with alprostadil. Alcohol can make this medicine less effective.
  • You should know that a small bleeding may occur in the area where the medicine was administered. This can increase the risk of transmitting blood-borne diseases (conditions that are transmitted through contaminated blood) such as HIV, hepatitis B, and hepatitis C between you and your partner. Tell your doctor if you or your partner have a blood-borne disease.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Alprostadil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • bleeding or bruising in the place where you administered the medication
  • pain or aching in the penis, testicles, legs, or perineum (area between the penis and rectum)
  • warmth or burning sensation in the urinary opening of the penis
  • redness of the penis
  • headache
  • back pain
  • skin problems
  • vision problems

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

  • erection lasting more than 4 hours
  • redness, swelling, tenderness, or unusual curving of the erect penis
  • nodules or hard areas on the penis
  • fast heartbeat
  • fainting
  • swollen veins in the legs

If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medicine in the container it came in, tightly closed, and out of the reach of children. Store alprostadil vials and cartridges at room temperature and away from excess heat and moisture (not in the bathroom). Read the manufacturer’s instructions for information on how long alprostadil solution can be stored after mixing and where it should be stored. Alprostadil granules should be stored in the original package in the refrigerator, but can be kept at room temperature for up to 14 days before use. Do not expose the medicine to high temperatures or expose it to direct sunlight, as this will make it ineffective.

It is important to keep all medicines out of the sight and reach of children, as many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not resistant to children and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach. http://www.upandaway.org

When traveling, do not store alprostadil in checked luggage or leave it in the car where it will be exposed to extreme temperatures. Store the alprostadil granules in a portable ice pack or cooler.

Unnecessary medications must be disposed of in special ways to ensure they cannot be consumed by pets, children, and others. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. See the FDA Safe Drug Disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of emergency/overdose

If someone uses too much alprostadil, call your local poison control center at 1-800-222-1222. If the victim has passed out or is not breathing, call your local emergency services at 911.

Symptoms of overdose may include:

  • fainting
  • dizziness
  • blurred vision
  • nausea
  • pain in the penis that does not go away
  • erection lasting longer than 6 hours

What other information should I know?

Keep all your appointments with your doctor. It is important to have regular follow-up visits with your doctor (for example, every 3 months).

Do not let anyone else use your medicine, needles, or syringes. Ask your pharmacist any questions you have about refilling your prescription.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.

Brand Names

  • Caverject®
  • Caverject Impulse®
  • Edex®
  • Muse®

Other Names

  • Prostaglandin E1(PGE1)

Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.

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