Adult Dosing
Erectile dysfunction due to vasculogenic, psychogenic, or mixed etiology
- Start the dose at 2.5 mcg intracavernous
- Titrate the dose to 5 mcg (with partial response) or 7.5 mcg (with no response); then increase in increments of 5-10 mcg depending upon erectile response, until the dose produces an erection suitable for intercourse and not exceeding a duration of 1 hour is reached
- Max: 40 mcg/dose (Edex) or 60 mcg/dose (Caverject)
Erectile dysfunction of pure neurogenic etiology (spinal cord injury)
- Start the dose at 1.25 mcg intracavernous
- Titrate the dose to 2.5 mcg (partial response) or 5 mcg (no response); then increase in 5-mcg increments depending upon erectile response, until the dose produces an erection suitable for intercourse and not exceeding a duration of 1 hour is reached
- Max: 40 mcg (Edex) or 60 mcg (Caverject)
Adjunct to the diagnosis of erectile dysfunction
- Use a single dose of Caverject that is adequate to induce an erection with firm rigidity to allow visualization and assessment of penile vasculature as an adjunct for lab investigations such as duplex or Doppler imaging, Xenon washout tests, radioisotope penogram, and penile arteriography
Note:
- Do not use more than 3 times/wk
- There should be at least 24-hr gap between doses
- The patient must stay in the physician's office until complete detumescence occurs
- Self-injection therapy by the patient may be started only after the patient is given appropriate instructions and training in the self-injection technique
- Use lowest effective dose
Pediatric Dosing
[Outline]
See Supplemental Patient Information
- Prolonged erections (4-6 hrs) may occur following intracavernous administration of vasoactive substances including alprostadil
- Priapism (erections >6 hrs) has also been reported in a few patients taking alprostadil
- To minimize the chances of priapism or prolonged erection, titrate the dose gradually to the lowest effective dose
- If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result
- Increased peripheral blood levels of PGE1 and its metabolites were seen in patients with significant corpora cavernosa venous leakage which may lead to hypotension and/or dizziness
- Regular follow-up and careful examination of the patients at the start of the therapy and q3 months is recommended to identify any penile changes
- Discontinue treatment if patients develop penile angulation, cavernosal fibrosis, or Peyronie's disease
- Do not use in combination with other vasoactive agents
- Diagnose underlying treatable medical causes of erectile dysfunction prior to initiation of therapy with alprostadil
- Do not re-use/share needles or cartridges; patient should not allow others to use the medicine
Caution: Use cautiously in
- Patients on warfarin or heparin therapy
Supplemental Patient Information
- Instruct patients to promptly report to their physicians any penile pain that was not present before therapy or that increased in intensity, as well as the appearance of hard tissue or nodules on the penis
- Inform patients and their partners that alprostadil does not offer any protection from the transmission of sexually transmitted diseases; advise patients to undergo counseling regarding the protective measures required to guard against the spread of sexually transmitted agents, including HIV
- Caution patients about the small amount of bleeding that may occur at the site of injection; this could increase the risk of transmission of blood-borne diseases between partners
- Advise patients to maintain regular follow-ups at the physician’s office for assessment of the therapeutic benefit and safety of the treatment
Pregnancy Category: Not Applicable
Breastfeeding: Not Applicable
Pricing data from www.DrugStore.com in U.S.A.
- Caverject 40 MCG SOLR [Vial] (PFIZER U.S.)
1 mcg = $65.99
3 mcg = $178.98 - Caverject Impulse 20 MCG KIT [Box] (PFIZER U.S.)
2 mcg = $96.99
6 mcg = $265.96 - Edex 10 MCG KIT [Box] (ACTIENT PHARMACEUTICALS)
1 mcg = $92.99
3 mcg = $255.98 - Caverject 20 MCG SOLR [Vial] (PFIZER U.S.)
1 mcg = $55.99
3 mcg = $145.97 - Edex 40 MCG KIT [Box] (ACTIENT PHARMACEUTICALS)
1 mcg = $449.98
3 mcg = $1315.02 - Edex 40 MCG KIT [Box] (ACTIENT PHARMACEUTICALS)
1 mcg = $157.99
3 mcg = $447.95 - Edex 20 MCG KIT [Box] (ACTIENT PHARMACEUTICALS)
1 mcg = $117.99
3 mcg = $332.96 - Edex 20 MCG KIT [Box] (ACTIENT PHARMACEUTICALS)
1 mcg = $324
2 mcg = $636.97 - Edex 10 MCG KIT [Box] (ACTIENT PHARMACEUTICALS)
1 mcg = $266.98
3 mcg = $774
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
