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Alprostadil: Uses, Dosage, Treatment, and Side Effects Explained
Summary of Key Points
Alprostadil is a medication used to treat several conditions, including erectile dysfunction, heart problems, and poor circulation. It works by widening blood vessels, which improves blood flow. Alprostadil is available in various forms, such as injections and topical solutions. Always consult a healthcare provider before starting or adjusting your dosage. Our telemedicine providers are available to assist in managing your treatment plan.
Names of Alprostadil Medication
US Brand Names: Caverject, Edex, Muse
Generic Name: Alprostadil
The generic name refers to the active ingredient, while the brand name is the name under which the drug is marketed. In this case, the generic name is listed in parentheses.
Pharmacologic Category of Alprostadil
Vasodilator
Prostaglandin E1 (PGE1) analog
Alprostadil Dosage
Alprostadil is prescribed for a variety of conditions. The dosage and frequency depend on the specific condition being treated. Always consult your doctor or one of our telemedicine providers before making any changes to your dose.
Alprostadil for Erectile Dysfunction
Dosage: 2.5 mcg to 20 mcg via intracavernosal injection (injection into the penis)
Frequency: As needed, no more than 3 times per week, with at least 24 hours between doses
Length of Treatment: Based on individual response and your doctor’s recommendation
Alprostadil for Patent Ductus Arteriosus (PDA)
Dosage: 0.05 to 0.1 mcg/kg/min via continuous IV infusion
Frequency: Continuous until the ductus arteriosus closes or surgery is performed
Length of Treatment: Short-term, under hospital supervision
Alprostadil for Pulmonary Arterial Hypertension (PAH)
Dosage: 0.01 to 0.05 mcg/kg/min via continuous IV infusion
Frequency: Continuous infusion
Length of Treatment: Long-term, as prescribed by your doctor
Alprostadil for Raynaud’s Phenomenon
Dosage: 10 to 20 mcg via intracavernosal injection (off-label use)
Frequency: As needed, based on symptoms
Length of Treatment: As directed by your healthcare provider
Alprostadil for Peripheral Vascular Disease
Dosage: 0.01 to 0.05 mcg/kg/min via continuous IV infusion
Frequency: Continuous infusion
Length of Treatment: Based on response and your doctor’s recommendation
Alprostadil for Ischemic Heart Disease
Dosage: 0.01 to 0.05 mcg/kg/min via continuous IV infusion
Frequency: Continuous infusion
Length of Treatment: As directed by your healthcare provider
Alprostadil for Congestive Heart Failure
Dosage: 0.01 to 0.05 mcg/kg/min via continuous IV infusion
Frequency: Continuous infusion
Length of Treatment: Based on response and your doctor’s recommendation
Alprostadil for Diabetes-Related Erectile Dysfunction
Dosage: 2.5 mcg to 20 mcg via intracavernosal injection
Frequency: As needed, no more than 3 times per week, with at least 24 hours between doses
Length of Treatment: Based on individual response and your doctor’s recommendation
Alprostadil for Hypotension (Low Blood Pressure)
Dosage: 0.01 to 0.05 mcg/kg/min via continuous IV infusion
Frequency: Continuous infusion
Length of Treatment: As directed by your healthcare provider
Alprostadil for Atherosclerosis
Dosage: 0.01 to 0.05 mcg/kg/min via continuous IV infusion
Frequency: Continuous infusion
Length of Treatment: Based on response and your doctor’s recommendation
Alprostadil Dosage Forms and Strengths
Intracavernosal Injection: 2.5 mcg, 5 mcg, 10 mcg, 20 mcg
Intraurethral Suppository: 125 mcg, 250 mcg, 500 mcg, 1000 mcg
IV Infusion: 0.01 mcg/kg/min to 0.05 mcg/kg/min
Alprostadil Administration Instructions
Alprostadil can be administered in different ways depending on the condition being treated. For erectile dysfunction, it is typically injected into the penis or inserted as a suppository into the urethra. For heart and circulation issues, it is usually given through an IV infusion in a hospital setting. Always follow your healthcare provider’s instructions carefully, and consult our telemedicine providers if you have any questions about your treatment plan.
Contraindications for Alprostadil
A contraindication is a specific situation where a medication should not be used due to potential harm. Alprostadil is contraindicated in certain conditions because of the risk of serious side effects or complications. If any of the following apply to you, discuss them with your healthcare provider before starting Alprostadil.
Hypersensitivity to Alprostadil: If you have had an allergic reaction to Alprostadil or any of its components, you should not use this medication. Allergic reactions can range from mild skin rashes to severe anaphylactic reactions, which can be life-threatening.
Conditions that predispose to priapism: Alprostadil can cause prolonged erections (priapism), which can be dangerous. If you have conditions like sickle cell anemia, multiple myeloma, or leukemia, you may be at higher risk for priapism, and Alprostadil should be avoided.
Penile deformities: Men with anatomical deformities of the penis, such as Peyronie’s disease, should not use Alprostadil, as it may worsen the condition or increase the risk of injury.
Men with a penile implant: Alprostadil is not recommended for men with a penile implant, as it may interfere with the implant’s function or cause complications.
Pregnancy and breastfeeding: Alprostadil is not recommended during pregnancy or breastfeeding (see sections below for more details).
Drug to Drug Interactions
Alprostadil can interact with other medications, potentially leading to harmful effects or diminishing the effectiveness of either drug. It’s important to inform your healthcare provider about all the medications you are currently taking, including prescription drugs, over-the-counter medications, and supplements. Some known drug interactions include:
Anticoagulants (blood thinners): Medications such as warfarin (Coumadin) or heparin may increase the risk of bleeding when used alongside Alprostadil, particularly if administered via injection.
Antihypertensives: Blood pressure medications like amlodipine (Norvasc) or lisinopril (Zestril) can interact with Alprostadil, raising the risk of hypotension (low blood pressure).
Vasodilators: Drugs that widen blood vessels, such as sildenafil (Viagra) or tadalafil (Cialis), may amplify Alprostadil’s blood pressure-lowering effects, potentially causing dizziness or fainting.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs): Medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) may reduce the effectiveness of Alprostadil when used for conditions such as Raynaud’s phenomenon or peripheral vascular disease.
Alprostadil in Pregnancy
Although Alprostadil is not commonly used in women, it may be considered in rare cases for specific medical conditions. However, it is generally not considered safe during pregnancy. Alprostadil can cause uterine contractions, which may lead to premature labor or miscarriage. If you are pregnant or planning to become pregnant, it’s crucial to discuss alternative treatment options with your healthcare provider.
Alprostadil while Breastfeeding
There is limited information regarding the safety of Alprostadil during breastfeeding. Due to the potential for serious side effects in a nursing infant, it is generally recommended to avoid using Alprostadil while breastfeeding. If you are breastfeeding and considering Alprostadil as a treatment option, consult your healthcare provider to explore safer alternatives.
Estimated Cost of Alprostadil Medication
The cost of Alprostadil can vary depending on the form (injection or urethral suppository) and the pharmacy. Without insurance, a 30-day supply of Alprostadil typically ranges between $200 and $500 with a GoodRx coupon. Prices may fluctuate, so it’s advisable to check with your pharmacy or use a discount program like GoodRx to find the most affordable option.
Possible Alternatives to Alprostadil Treatment
Depending on the condition being treated, several alternative treatments or lifestyle changes may be available. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these options in more detail.
Erectile Dysfunction: Alternatives include oral medications such as sildenafil (Viagra) or tadalafil (Cialis), vacuum erection devices, or lifestyle changes like improving diet, exercising, and quitting smoking.
Patent Ductus Arteriosus (PDA): In infants, treatment options may include NSAIDs like indomethacin or ibuprofen, or surgical intervention if the PDA does not close naturally.
Pulmonary Arterial Hypertension (PAH): Alternatives include medications such as bosentan (Tracleer) or sildenafil (Revatio), along with lifestyle changes like reducing salt intake and managing stress.
Raynaud’s Phenomenon: Treatment options include calcium channel blockers like nifedipine (Procardia) or lifestyle adjustments such as avoiding cold exposure and managing stress.
Peripheral Vascular Disease: Alternatives include medications like cilostazol (Pletal) or lifestyle changes such as regular exercise, quitting smoking, and managing cholesterol levels.
Ischemic Heart Disease: Treatment options may include medications like nitroglycerin or beta-blockers, along with lifestyle changes such as maintaining a heart-healthy diet and engaging in regular physical activity.
Congestive Heart Failure: Alternatives include medications like ACE inhibitors (e.g., lisinopril) or diuretics, as well as lifestyle changes such as reducing salt intake and monitoring fluid levels.
Diabetes-related Erectile Dysfunction: Alternatives include oral medications like sildenafil (Viagra), managing blood sugar levels, and lifestyle changes such as weight loss and regular exercise.
Hypotension (Low Blood Pressure): Treatment may involve increasing fluid and salt intake, wearing compression stockings, or using medications like fludrocortisone (Florinef).
Atherosclerosis: Alternatives include statin medications like atorvastatin (Lipitor) or lifestyle changes such as following a heart-healthy diet, exercising regularly, and quitting smoking.
Recent Updates on Alprostadil Research
Recent studies on Alprostadil have explored its potential use in treating conditions beyond erectile dysfunction. For instance, ongoing research is investigating Alprostadil’s role in managing pulmonary arterial hypertension (PAH) and peripheral vascular disease. Early findings suggest that Alprostadil may help improve blood flow and alleviate symptoms in these conditions, though further research is needed to confirm these results.
Additionally, new formulations of Alprostadil are being developed to enhance ease of use and minimize side effects. Researchers are currently exploring topical formulations that could be applied directly to the skin, potentially offering a less invasive alternative to injections or suppositories.
As always, it’s important to stay informed about the latest research and discuss any new treatment options with your healthcare provider. If you have questions about Alprostadil or would like to explore the latest treatment options, consider scheduling a telemedicine appointment with one of our providers today.
