Generic Name and Formulations:
Alprostadil (in alfadex inclusion complex) 10mcg, 20mcg, 40mcg; per cartridge; pwd for intracavernous inj after reconstitution.
Inject over 5–10 seconds into the lateral aspect of the proximal third of the penis, avoid visible veins; rotate injection side and site. Determine optimum dose in office. If no response occurs, may give next higher dose in 1 hour. If response occurs, must wait 24 hours before next dose. Vasculogenic, psychogenic, or mixed etiology: initially 2.5mcg. If partial response to initial dose, may give 2nd dose of 5mcg and then may increase by increments of 5–10mcg until desired response achieved. If no response to initial dose, may give 2nd dose of 7.5mcg and then may increase by increments of 5–10mcg until desired response achieved. Neurogenic etiology: initially 1.25mcg. May give 2nd dose of 2.5mcg, and 3rd dose of 5mcg, and then may increase by increments of 5mcg until desired response achieved. Max: 40mcg and 3 self-injections per week; allow at least 24 hours between doses. Reduce dose if erection lasts over 1 hour.
Predisposition to priapism. Fibrotic conditions of the penis (eg, cavernosal fibrosis, Peyronie's disease). Penile implants.
Treat priapism immediately. Reevaluate every 3 months. Discontinue if penile fibrosis occurs. Preexisting cardiovascular disease. Renal impairment. Elderly. Pregnancy, nursing mothers: not indicated.
Concomitant vasoactive agents: not recommended. Caution with concomitant heparin.
Penile pain, priapism, inj site reactions, penile angulation or fibrosis, hypertension, headache, dizziness, upper respiratory infections, others.
2-cartridge pack (w. 1 inj device & supplies)—1; 6-cartridge pack (w. 1 inj device & supplies)—1
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