Alprostadil: Restoring Vascular Function and Erectile Health
| Product dosage: 500mcg | |||
|---|---|---|---|
| Package (num) | Per injection | Price | Buy |
| 1 | $301.37
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Alprostadil is a synthetic prostaglandin E1 (PGE1) analogue, representing a cornerstone in the management of vascular and erectile dysfunction. As a potent vasodilator and antiplatelet agent, it is utilized across multiple clinical settings, from critical care to urology. Its mechanism of action involves direct relaxation of smooth muscle in blood vessels and cavernosal tissues, facilitating increased blood flow. Available in various formulations—including injectable, intraurethral, and topical—alprostadil offers tailored therapeutic options based on individual patient needs and clinical contexts. This agent is distinguished by its efficacy, rapid onset, and well-characterized pharmacokinetic profile.
Features
- Synthetic analogue of prostaglandin E1
- Multiple administration routes: intracavernosal injection, intraurethral pellet, topical cream
- Potent vasodilator with direct action on vascular smooth muscle
- Exhibits antiplatelet properties
- Rapid onset of action; effects typically observed within 5–20 minutes depending on formulation
- Short half-life, allowing for controlled duration of effect
- Available in sterile, single-use formulations for precise dosing
Benefits
- Effectively induces penile erection by dilating cavernosal arteries and relaxing trabecular smooth muscle
- Provides a non-hormonal, locally acting option for erectile dysfunction management
- Used therapeutically to maintain patency of ductus arteriosus in neonates with congenital heart defects
- May be employed diagnostically to assess vascular erectile capacity
- Offers flexibility with various formulations to accommodate patient preference and tolerance
- Avoids systemic hormonal effects common with other erectile dysfunction therapies
Common use
Alprostadil is primarily indicated for the treatment of erectile dysfunction (ED) of vascular, neurogenic, or psychogenic origin. It is particularly valuable for patients who do not respond to oral phosphodiesterase type 5 inhibitors or for whom such agents are contraindicated. In neonatal intensive care, it is used to temporarily maintain patency of the ductus arteriosus in neonates with ductal-dependent congenital heart defects until surgical correction can be performed. Off-label, it is sometimes utilized intra-arterially to treat severe peripheral vascular disease and in certain diagnostic vascular studies.
Dosage and direction
Dosage varies significantly based on formulation and indication:
For erectile dysfunction:
- Intracavernosal injection: Initial dose typically 2.5 mcg, titrated upward in 2.5–5 mcg increments to achieve erection lasting no longer than 1 hour. Maximum dose generally 60 mcg.
- Intraurethral pellet: Initial dose 125–250 mcg, titrated to effect. Maximum dose 1000 mcg.
- Topical cream: Applied in measured doses (100–300 mcg) to the urethral meatus.
For neonatal ductus arteriosus patency:
- Continuous intravenous infusion: Initial dose 0.05–0.1 mcg/kg/min, titrated to response. Maintenance dose typically 0.01–0.4 mcg/kg/min.
Administration must be performed using proper aseptic technique. Patients must receive thorough training in injection technique or pellet insertion from a qualified healthcare professional.
Precautions
- Strict aseptic technique is mandatory to prevent infection
- Priapism (erection lasting >4 hours) requires immediate medical attention to prevent permanent tissue damage
- Use with caution in patients with anatomical penile deformities (Peyronie’s disease, cavernosal fibrosis)
- Monitor for hypotension when used systemically
- Caution in patients with bleeding disorders or on anticoagulant therapy
- Regular follow-up required to assess efficacy and adjust dosage
- Storage must adhere to manufacturer specifications (some formulations require refrigeration)
Contraindications
- Hypersensitivity to alprostadil or any component of the formulation
- Conditions predisposing to priapism (sickle cell anemia, multiple myeloma, leukemia)
- Anatomical penile deformities that may make injection hazardous
- Not for use in women or children except for specific neonatal cardiac indications
- Patients with implanted penile prostheses
- Use in neonates with respiratory distress syndrome
Possible side effect
- Penile pain (most common, occurring in up to 30% of users)
- Prolonged erection (priapism) (2–5% of users)
- Local hematoma or bleeding at injection site
- Urethral burning (with intraurethral formulation)
- Dizziness or hypotension (particularly with systemic use)
- Fibrosis or plaques at injection sites with long-term use
- Urinary tract infections (with intraurethral administration)
- Rare cases of syncope
Drug interaction
- Antihypertensive agents: enhanced hypotensive effects
- Anticoagulants/antiplatelet drugs: increased bleeding risk
- Other vasodilators: additive effects
- Phosphodiesterase type 5 inhibitors: contraindicated due to risk of profound hypotension
- No significant interactions with hepatic enzyme inducers/inhibitors due to rapid metabolism
Missed dose
Not applicable for as-needed use in erectile dysfunction. For continuous infusion in neonatal settings, interrupted therapy requires immediate medical attention to re-establish infusion at proper rate.
Overdose
Symptoms may include prolonged painful erection, severe hypotension, flushing, or headache. Priapism requires emergent urological consultation and possible intracavernosal aspiration and irrigation with alpha-adrenergic agonists. Systemic overdose may require supportive care including volume expansion and vasopressors. There is no specific antidote.
Storage
- Injectable formulations: refrigerate at 2–8°C (36–46°F); some products may be stored at room temperature for limited periods
- Intraurethral pellets: store at room temperature
- Protect from light
- Do not freeze
- Discard any solution that appears discolored or contains particulate matter
- Note expiration dates carefully
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Alprostadil is a prescription medication that must be used under the supervision of a qualified healthcare professional. Individual response and appropriate dosing may vary. Patients should discuss their complete medical history and current medications with their physician before beginning therapy. Proper training in administration technique is essential to minimize risks and optimize therapeutic outcomes.
Reviews
“After failing with oral agents due to side effects, alprostadil injection has restored my sexual function with predictable results. The initial apprehension about self-injection was overcome with proper training.” – Male, 58, using for 2 years
“In our NICU, alprostadil infusion has been lifesaving for maintaining ductal patency in neonates with critical congenital heart disease until surgical intervention. Dosing requires careful titration and monitoring.” – Neonatal intensivist
“The intraurethral formulation offers an alternative for patients averse to injections, though efficacy may be somewhat lower and urethral irritation can be an issue for some.” – Urology specialist