INTRA PENILE INJECTION OF ALPROSTADIL [also called as PGE1], which is a VASO-ACTIVE DRUG USED FOR BRINGING ERECTION and sometimes used for diagnosis of ERECTILE DYSFUNCTION.
- mild pain,
- irritation or
- slight bleeding at the injection site.
- tenderness or swelling of the penis,
- redness/lumps/unusual curving of the penis.
- The erection should last about one hour. If an erection lasts more than 4 hours, it is a medical emergency, since it leads to death of tissues of penis. Seek immediate medical attention.
USED FOR DIAGNOSIS
Caverject ©as an Adjunct to the Diagnosis of Erectile Dysfunction:
On the simplest diagnostic test for erectile dysfunction (pharmacologic testing), patients are monitored for the occurrence of an erection after an intracavernosal injection of alprostadil. Extensions of this testing are the use of alprostadil as an adjunct to laboratory investigations, such as duplex or Doppler imaging. 133Xenon washout tests, radioisotope penogram, and penile arteriography, to allow visualization and assessment of penile vasculature.
How to use Caverject©:
HOW TO USE this medication to treat impotence.
This medication is administered by injection into the penis as directed. It is recommended that this medication be used no more than 3 times a week allowing at least 24 hours between uses. You must be trained on proper injection technique for self-injection. Do not change your dose or use this more often than directed. Alternate sides of the penis when injecting and vary the site of the injection. Properly discard needles, syringes and unused solution after each use.
CAVERJECT©Injection is packaged in a one milliliter polyethylene ampoule containing 10.2 or 20.2 mcg per mL of alprostadil, depending on ampoule strength. The deliverable amount of alprostadil is 10 or 20 mcg/mL because approximately 0.2 mcg is lost due to adsorption to the syringe during administration. CAVERJECT©Injection is also available in two milliliter ampoules containing 40.4 mcg/2 mL (20.2 mcg/mL) of alprostadil. The deliverable amount of alprostadil is 40 mcg/2 mL (20 mcg/mL) because approximately 0.4 mcg is lost due to adsorption to the syringe during administration.
The dose of alprostadil should be individualized for each patient by careful titration under supervision by the physician. In clinical studies, patients were treated with alprostadil in doses ranging from 0.2 to 140 micrograms; however, since 99% of patients received doses of 60 micrograms or less are not recommended. In general, the lowest possible effective dose should always be employed. In clinical studies, over 80% of patients experienced an erection sufficient for sexual intercourse after intracavernosal injection of alprostadil. A 1/2 inch, 27- to 30-gauge needle is generally recommended.
Initial Titration in Physician’s Office:
Erectile Dysfunction of Vasculogenic, Psychogenic, or Mixed Etiology.
Dosage titration should be initiated at 2.5 micrograms of alprostadil. If there is a partial response, the dose may be increased by 2.5 micrograms, depending upon erectile response, until the dose that produces an erection suitable for intercourse and not exceeding a duration of 1 hour is reached. If there is no response to the initial 2.5-microgram dose, the second dose may be increased to 7.5 micrograms, followed by increments of 5 to 10 micrograms. The patient must stay in the physician’s office until complete detumescence occurs. If there is no response, then the next higher dose should be given within 1 hour. If there is a response, then there should be at least a 1-day interval before the next dose is given.
Erectile Dysfunction of Pure Neurogenic Etiology (Spinal Cord Injury):
Dosage titration should initiated at 1.25 micrograms of alprostadil. The dose may be increased by 1.25 micrograms to a dose of 2.5 micrograms, followed by an increment of 2.5 micrograms to a dose of 5 micrograms, and then in 5-microgram increments until the dose that produces an erection suitable for intercourse and not exceeding a duration of 1 hour is reached. The patient must stay in the physician’s office until complete detumescence occurs. If there is no response, then the next higher dose may be given within 1 hour. If there is a response, then there should be at least a 1-day interval before the next dose is given.
The first injections of alprostadil must be done at the physician’s office by medically trained personnel. Self-injection therapy by the patient can be started only after the patient is properly instructed and well trained in the self-injection technique.
Pharmacia & Upjohn Company
Kalamazoo, MI 49001, USA
Pharmacia & Upjohn (Perth) Pty Limited
Bentley, WA 6102, Australia
817 587 102
Other use of Alprostadil in Babies
Alprostadil is used in Congenital Heart Disease to improve blood flow to lungs in babies.
Prostin VR Pediatric Sterile Solution
Prostin VR Pediatric Sterile Solution is indicated for palliative, not definitive, therapy to temporarily maintain the patency of the ductus arteriosus until corrective or palliative surgery can be performed in neonates who have congenital heart defects and who depend upon the patent ductus for survival. Such congenital heart defects include pulmonary atresia, pulmonary stenosis, tricuspid atresia, tetralogy of Fallot, interruption of the aortic arch, coarctation of the aorta, or transposition of the great vessels with or without other defects.
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