Drug reference

Alprostadil

Vasodilator · Erectile Dysfunction Treatment; Maintenance of Patent Ductus Arteriosus

Also known as prostaglandin E1, CAVERJECT, EDEX, MUSE, PROSTIN VR PEDIATRIC, PGE1

VasodilatorErectile Dysfunction Treatment; Maintenance of Patent Ductus Arteriosus

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

FDA category + note

Mechanism

Alprostadil, a prostaglandin E1 (PGE1) analog, exerts its effects primarily through vasodilation. For erectile dysfunction, it is directly administered to the penis, where it increases blood flow to the cavernosal tissue to facilitate an erection. In neonates with congenital heart disease, Alprostadil induces vasodilation of the ductus arteriosus, thereby maintaining its patency to ensure adequate hemodynamic function until corrective surgery can be performed.

Indications

Erectile dysfunction (second-line therapy, especially in non-responders to PDE5 inhibitors)Maintenance of patent ductus arteriosus in neonates with congenital heart disease (palliative therapy)Maintain patency of ductus arteriosus in neonates with congenital heart defects (until surgery)Impotence (erectile dysfunction)erectile dysfunction (ED) (especially in patients not responding to PDE-5 inhibitors, such as neurogenic and psychogenic ED)

Dosing

Adult: should receive six doses of an individual phosphodiesterase type-5 inhibitor at the maximum dose (with sexual stimulation) before being classiﬁed as a non-responder. Patients who fail to respond to the maximum dose of at least two different phosphodiesterase type-5 inhibitors should be referred to a specialist.…

Pharmacokinetics

Duration

1-3 hours (for erection)

Side effects

Common

Apnoea (in neonates for PDA)local tenderness

Serious

Priapism (prolonged erection lasting four hours or more)
Apnea (observed in ~10% of neonates, particularly those weighing <2 kg at birth)
penile fibrosis (rare)
priapism (rare)