This article features an extensive coverage of alprostadil, an erectile dysfunction (ED) medicine. The drug is available in form of injections (commercialized as Caverject and injected through injection directly into the corpus cavernosum of the penis) or suppositories administered intraurethrally (by way of inserting a drug-containing pellet into the urethra channel opening). It addresses questions most of patients have concerning approved alprostadil uses, application, benefits, safety, contraindications, and other product essentials that will help you determine if Muse therapy is for you and help you get started.
Alprostadil (Prostaglandin E1) Benefits
Alprostadil is a class in itself, being qualitatively a whole new method of short-term ED correction. It acts locally, just like injectable drugs, but unlike those latter, it does not require any basic medical skills or specific digital dexterity necessary to perform injection on the penis and may on top of that result in bruising, injuring and scarring if gone wrong. Thus, you get the benefits of a genuinely quick-acting drug with none of the downsides associated with injecting method of administration.
Alprostadil has an edge over oral ED pills because of its functional practicality: while oral agents can be introduced into the body only once during the period of 24 hours, their effect wearing off after 4 hours in average, alprostadil can be used as needed twice a day, each activity duration period lasting up to 2 hours.
Rather than having to deal with multiple hassles that you inevitably face when trying to figure out the best timing to take your ED pill following the elusive ‘as needed’ instruction, you might want to consider a course ED therapy that will have you ready at any moment. And here is how this is a win-win situation where both your mind and your body benefit, multifold. Many of you would agree that from the practical point of view, you restore that proverbial peace of mind by eliminating the need to intuit when and where you will need your erectile function to shape up for an action that is entirely spontaneous by definition. Alprostadil therapy in place makes sure that hard and stable erection occurs any time when you are naturally aroused, and here is where the beneficial part for your body fits in.
The side effects of alprostadil are minimal due to the method of administration: unlike oral pills, intraurethral agents do not get into the stomach and have no effect on general blood flow. They are absorbed directly in the corpus spongiosum of the penis, dissolving there within 5-10 minutes and never spreading from the genital area. This makes alprostadil into a perfect ED solution for persons with blood pressure problems and other comorbidities associated with blood cells.
Summarized, the benefits of alprostadil can be outlines as follows:
- The shortest onset time among existing ED treatments;
- Graded dosing strengths allowing room for customizable therapies;
- Simplicity and discretion of use;
- Daily dose allowance that equals two max dose pellets to be used during 24 hours;
- Erectile stability and hardness are restored in fullness;
- Stamina; self-esteem and virility experience a major boost
Alprostadil Suppository Instructions
Always use this medicine exactly as your doctor has told you. Ask your doctor or pharmacist if you are unsure about anything. Keep in mind that professional prescriber may appoint alprostadil for purposes not indicated in the original instructions (off-label use). The dose is determined by the doctor who will adjust it individually for you. When marketed as Muse cream contained in pellets, alprostadil is available in four strengths: alprostadil 125 mcg, alprostadil 250 mcg, alprostadil 500 mcg and alprostadil 1000 mg. Any increase in dose should be initiated by a licensed healthcare provider. Normally the necessity to step up Muse dose is determined by patient’s inability to maintain sufficient erectile hardness during sexual intercourse. As a rule, the therapy is initiated at 500 mcg dose.
You should not use more than the maximum of two doses within a period of 24 hours. The maximum single dose is 1000 mcg. Alprostadil should be at room temperature when in use. Urinate before alprostadil application. It is easier to insert the applicator of the urethra is lubricated. The drug is dissolved in the liquid remaining in the urethra.
Alprostadil should be at room temperature when in use. Urinating before using alprostadil. It is easier to insert the applicator of the urethra is damp. The drug is dissolved in the liquid remaining in the urethra.
- Open the foil pouch and let the applicator to slip out of the pouch. Try not to touch the stem or its end.
- Twist the cap on the applicator. Do not push or pull the button at the top of the applicator! The drug is in the end of the tube.
- Sit or stand and stretch the penis upward, gently press together the glans. This is to straighten and open the urethra.
- Then gently insert the applicator tube in the urethra. It is important that the tube is inserted up to the applicator collar for you to have a good effect. If you feel uncomfortable, pull out the stem slightly and then insert it again.
- When the stem is inserted, press the button on the applicator until it stops. Hold the applicator in this position for 5 seconds. This is important for ensuring that the applicator is emptied of all drugs.
- Twist the applicator delicately, so that the applicator can be emptied of the drug. Then pull out the applicator while still keeping the penis erect
- Holding the penis upright and stretched and massage at least 10 seconds for the drug to be spread along the urethral walls. If you feel that it hurts, rub in a further 30-60 seconds or until the pain subsides. Erection starts within 5-10 minutes. An active foreplay affect erection is possible.
Possible Alprostadil Side Effects
Like any other drug, alprostadil can cause side effects, although not everybody gets them. The side effects are generally mild and disappear shortly.
If you experience any of these symptoms, you should immediately contact your doctor:
- You have a prolonged erection that lasts longer than four hours, which is uncommon
- Your penis gets scarred or curved
- Your testicles or scrotum becomes red, swollen, painful, or if tissue nodules arise. These are called spermatocele and cysts containing sperm (uncommon)
|Common (occurring in more than 1 in 10 users)|
|Uncommon (occur in fewer than 1 in 100, more than 1 in 1000)|
Rare (affects less than 1 in 1000, more than 1 in 10 000 users)
|Very Rare (affects less than 1 in 10 000 users|
In order to bring the risk of side effects, such as priapism, to the minimum, you should not fluctuate from the lowest dose that yields meaningful health benefits. When erection lasts longer than six hours, it gives grounds to diagnose priapism which may occur following administration of alprostadil. Discontinue the use of alprostadil immediately and do not postpone a visit to an emergency ward or any other readily available healthcare provider; make sure that the delay does not last longer than 4-6 hours. Left unattended, priapism may cause permanent damage to the penis. Priapism is a recognized medical condition requiring proper treatment.
Safe Use Of Alprostadil
Anatomical penile deformation can result in individual’s increased susceptibility to developing painful erections; such conditions include angulation, phimosis, cavernosal fibrosis, Peyronie’s disease or plaques.
Alprostadil erroneous insertion can cause superficial mucosal lesions in the urethra and minor urethral bleeding. In patients infected with a blood-borne disease can lead to potential transmitting of the disease to the partner.
Alprostadil administration is reported to be able to trigger the onset of such conditions as penile fibrosis, including angulation, cavernous fibrosis, fibrotic nodules and Peyronie’s disease. There is a direct relation between the increase in alprostadil use and the occurrence of conditions mentioned above. In this connection it is best to show up for regular medical monitoring, with careful examination of the penis recommended to ensure that the signs of penile fibrosis or Peyronie’s disease are discovered and treated early. Patients with penile angulation, cavernosal fibrosis or Peyronie’s disease should discontinue receiving alprostadil.
Caution should be practiced in patients with transient ischemic attacks (TIAs) in the history or those with unstable cardiovascular disease; regular checkups and possible dose adjustment should be in place.
Alprostadil is potentially habit-forming, which gives grounds to suggest a more sensible use in individuals with mental health issues or those with substance abuse problems.
Persons with cardiovascular disease issues may experience additional health difficulties associated with compromised ability to engage in physically strenuous activities. As long as sexual activity is viewed as such while it involves increase in heart rate, the use of alprostadil may aggravate risks related to heart problems.
There is a possibility to experience an insignificant and fleeting drop in blood pressure while taking alprostadil at a treatment dose of 1,000 micrograms.
The evidence is sparse for a combined use of alprostadil and penile implants, but reported cases are known to have passed uneventfully.
Cases of alprostadil overdose or ingestion by minors should be attended to by healthcare personnel without delay. Full information about the drug should be received from a licensed healthcare practitioner.
Note that due to the nature of alprostadil application, insufficient amounts of it can leak with physiology fluids and infiltrate into the vagina of your partner, which is not dangerous per se. However, partner’s pregnancy during a sexual act unprotected by barrier contraceptives may lead to fetus exposure towards the drug’s effects, the research on which is too sparse to estimate possible risks.
There is a number of conditions to contend with when considering alprostadil therapy. You will find the list of alprostadil contraindications below, but you should consult your prescriber for a complete enumeration of the drug’s contraindications and pharmacological incompatibilities before proceeding with the transurethral agent application.
Alprostadil contraindications concern the groups of individuals that suffer from comorbidity conditions listed below:
- Hypersensitivity to the active substance alprostadil or any of the excipients.
- Penile anomaly (deformation of the penis) such as angulation, which can be brought on either by Peyronie’s disease or by other similar conditions like stenosis of the distal urethra, advanced stage hypospadias or curvature, balanitis, urethritis in its chronic or acute stage or cavernous fibrosis.
- Risk factors making patient prone to priapism development; here belong anemia or predisposition for this, thrombocythemia, polycythemia, multiple myeloma, propensity for venous thrombosis or a history of recurrent priapism in the past
- Unstable cardiovascular or cerebrovascular conditions that make any physically challenging activity, sexual activity included, potentially life-threatening.
Alprostadil And Other Drugs
There is limited information available on the concomitant use of Alprostadil and sildenafil in the treatment of erectile dysfunction. It is therefore not possible to draw any conclusions about the safety or efficacy of the combination therapy.
Muscle-relaxant drugs, such as papaverine or other drugs cause erections, such as alpha-adrenergic blockers, administered alongside with alprostadil, can predispose the taker to priapism occurrence but the body of evidence for that is scarce.
In individuals using anticoagulants or having a bleeding disorder there may be an increased risk of urethral bleeding occurrence.
While sympathomimetic drugs are known to diminish alprostadil efficacy, the latter can make the effects of high blood pressure drugs more pronounced. In this regard vasodilators, concomitant use of alprostadil with anticoagulants and inhibitors of platelet aggregation should be avoided at all events.
The use of alprostadil of patients with penile implants are described in a few cases. It is therefore not possible to draw any conclusions regarding the safety or efficacy of this combination.