Alexandra Forrest

Alprostadil

Alprostadil Purpose
Alprostadil is also known as prostaglandin E1. It is a drug that is intended to diagnose and treat erectile dysfunction.
Alprostadil Usage
Alprostadil is used to treat patients who suffer from erectile dysfunction. According to the Mayo Clinic (2010) erectile dysfunction can occur because of problems with the “brain, hormones, emotions, nerves, muscles, and blood vessels” (para. 5). Men get erections because of blood flowing into the penis. When the vessels dilate, blood is able to stream in. However, there is an enzyme that works against the dilation. Erectile dysfunction medicines, (like alprostadil), work by restraining that enzyme which lets the vessels dilate easier and helps the erection last longer (Newman, 2011). Alprostadil can be applied in two ways: Injection and intraurethral pellets. If applied by injection, the medicine must be directly injected directly into the penis. If applied with suppository, it must be placed into the opening of the penis. Both types are effective within 5-20 minutes and intercourse should be attempted within 10-30 minutes. The erection will last about an hour (Baird, 2007). With both options, users must make sure that the hands and penis are clean. Also, patients who use syringes must never use the same syringe more than once. Both of these precautions will help to prevent possible infections.
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Alprostadil Side Effects
Linet and Ogring (1996) found that penile pain is the most common side effect reported with use of alprostadil. Many who experienced pain, though, did so after several injections. Pain can range from mild, which is the most common, to severe enough to stop using the medicine. Researchers have found that the most likely reason for this pain is because of the prostadil itself because “prostaglandins of the E group have a pain-sensitizing action” (p. 876). Prolonged erection is also a side effect, but is not common. Moreover, priapism, a painful and long-lasting erection has also been shown to occur, but is even more of a rare occurrence. Penile fibrosis was also noted as a rare side effect. Other sides effects reported which were possibly related to alprostadil usage have been “testicular pain and swelling, scrotal pain and edema, decreased or increased urinary frequency, hematuria, and pelvic pain” (p. 876).


A bottle of alprostadil that is to be injected into the penis with a syringe

CAVERJECT
CAVERJECT is the intracavernous injection of alprostadil which was approved by the Food and Drug Administration in July 1995. The first dosage of this medicine is to be administered in a physician’s office to determine the proper dosage. After the patient and doctor find the minimum amount required to facilitate an erection and the patient feels comfortable enough to inject the medication by himself, the medication can be administered at home (Food and Drug Administration, n.d.). Items needed to use CAVERJECT are a syringe, alprostadil medication to inject, alcohol swabs, soap to wash hands, and a clean surface to place the medicine on. According to Baird (2007) any unused amount of alprostadil and the syringe must be thrown away immediately, as it will not be able to be used again.
MUSE
MUSE (Medicated Urethral System for Erection) is an alprostadil intraurethral suppository which was approved by the Food and Drug Administration in October 1996. MUSE is taken in throughout the body in about 10 minutes and is completely gone in 60 minutes. These suppositories are obtainable in dosages of 125 micrograms, 250 micrograms, 500 micrograms, and 1000 micrograms. Again, the first dosage will be administered under physician care to determine the lowest dosage necessary to be able to have intercourse (Food and Drug Administration, n.d.)
Alprostadil Compared to other Erectile Dysfunction Medicines
Other common medicines that treat erectile dysfunction are Viagra, Cialis, and Levitra. In order to obtain an erection from these medications, you must take the pill at least 30 minutes in advance of intercourse (Mayo Clinic staff, 2010). Alprostadil has been compared to Viagra and these other oral medications, and is even preferred by some as even a better option. While Viagra can take as long as 60-90 minutes to work, alprostadil works within minutes so one would not have to plan ahead to have sex.
Obtaining Alprostadil
In order to receive a form of alprostadil, one must contact and make an appointment with a health care provider or specialist in erectile dysfunction. When preparing for the appointment, the Mayo Clinic (2010) suggests following these steps:
1. “Ask what you need to do ahead of time.” Be sure that you do not need to follow any special instructions before coming to your appointment.
2. “Write down any symptoms you’ve had.” Make sure to write down any symptoms that you think are related and not related to erectile dysfunction.
3. “Write down key personal information,” like any changes in lifestyle or stress levels.
4. “Make a list of all medications” you are currently taking. This includes vitamins, supplements, etc.
5. “Take your wife or partner along, if possible.”
6. “Write down questions to ask your doctor.”
(What you can do, para. 7)
Additionally, one should be prepared to ask the provider questions as well. The Mayo Clinic (2010) suggests asking some of the following questions:
1. “What is the best course of action?”
2. “What kinds of tests do I need?”
3. “Are there any restrictions I need to follow?”
(What you can do, para. 7)
You may also want to consider talking to your doctor about how the side effects of alprostadil can affect you. As discussed earlier, side effects are usually mild and not common. However, a man using alprostadil may still be affected. By following these steps and asking questions, you and your provider will be able to determine if starting a treatment of alprostadil is right for you.
References
Baird, J. M. (January 1, 2007). Erectile dysfunction: alprostadil to treat ED. Retrieved from http://www.webmd.com/erectile-dysfunction/alprostadiltreat-
ed?page=3
Bedford Laboratories (2011) Product Catalog. Retrieved from http://www.bedfordlabs.com/products/ViewProductDetails?genericName=Alprostadil

Food and Drug Administration (n.d.). Background on erectile dysfunction. FDA Docket (Section 1) Retrieved from http://www.fda.gov/ohrms/dockets/ac/00
/transcripts/3602b1c.pdf
Linet, O. I., Ogring, F. G. (April 4, 1996). Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. The New England Journal of
Medicine, 334 (14). Retrieved from http://www.nejm.org/doi/pdf/10.1056/NEJM199604043341401
Mayo Clinic staff. (January 15, 2010). Erectile dysfunction. Retrieved from http://www.mayoclinic.com/print/erectile-dysfunction/DS00162/DSECTION=all&
METHOD=print
Mayo Clinic staff. (April 1, 2010). Erectile dysfunction: viagra and other oral medications. Retrieved from http://www.mayoclinic.com/health/erectile-dysfunction
/MC00029
Newman, J. (2011, May). Love in the time of viagra. Prevention, May 2011, 110.