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Alprostadil

Alprostadil is a medication used in the management and treatment of erectile dysfunction in males and for temporary patency of ductus arteriosus in newborns with congenital heart diseases before surgical intervention. It is in the prostaglandin analog class of medications.

Other names for this medication:
Alpostin, Caverject, Edex, Muse, Prostin, Vitaros

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Description

Alprostadil injection is used to treat certain heart, lung, and blood vessel problems in infants. It is used to temporarily keep the ductus arteriosus (blood vessel in the heart) open before having a surgery.

Alprostadil is to be given only by or under the supervision of your child's doctor.

Dosage

Alprostadil is given as a shot into your penis. You will receive the first dose of Alprostadil in your doctor's office to find out the best dose for you. You will need to stay in the doctor's office until your erection is gone.

Special patient directions come with the suppositories and some of the injection medicines. Read the directions carefully before using the medicine.

For the injections—There are several Alprostadil products that can be injected. Although the injection method is the same, the mixing procedures are different. Be sure you know which of these products you will be using and the proper way to mix the injection.

One product called Alprostadil for Injection (brand names Caverject® and Edex®) is available as a powder in a vial. Caverject® must be mixed with a solution called Bacteriostatic Water for Injection USP. Edex® must be mixed with a solution called Sodium Chloride Injection USP. The solution for mixing comes with your product and may be already loaded into a syringe or contained in a vial.

It is important to follow several steps to prepare your Alprostadil injection correctly. Before drawing up the medicine into the syringe:

Wash your hands with soap and water. Set the bottles on a clean surface. Wipe the top of the injection bottles with an alcohol swab. Do not wipe the needle. Throw away the alcohol swab. You may need to attach the needle to the syringe. Do not take the cap off yet.

How to mix Caverject®:

If the syringe already contains the Bacteriostatic Water for Injection USP, then you need only add the plunger to the syringe. To do this: Pick up the rod-like plunger and place it within the barrel of the syringe until it touches the rubber piece. Gently screw the plunger into the rubber piece until it seems secure. Do not use a lot of force. Hold the syringe by the barrel (not the plunger) and take the cap off the needle. You are now ready to mix the water and the powder. Skip to the directions under the title, “To mix the water and powder." If the syringe does not already contain the Bacteriostatic Water for Injection USP, you must withdraw 1 milliliter (mL) of it from the bottle provided. To do this: Pick up the syringe and take the cap off the needle. Pull the plunger back to the 1-mL mark on the syringe. This pulls air into the syringe. Insert the needle into rubber top of the bottle while it is upright and inject the 1 mL of air into the bottle. Turn the bottle upside down using one hand. Be sure the tip of the needle is covered by solution. With your other hand, pull the plunger back slowly to withdraw 1 mL of solution into the syringe. Remove the needle and skip to the directions under the title, "To mix the water and powder." To mix the water and powder: Insert the needle into the bottle of Alprostadil and inject 1 milliliter of Bacteriostatic Water for Injection USP from your syringe into the bottle of Alprostadil. Remove the needle from the bottle, holding the barrel of the syringe. Gently swirl the bottle to mix the powder into the solution, turning it upside down to wet all the powder in the bottle. Follow the directions below, “How to draw your dose into the syringe."

How to mix Edex®:

The syringe already contains the Sodium Chloride Injection USP. You need only attach the needle to the syringe and add the plunger. To do this: Remove the needle from its package. Do not remove the needle cap. Gently screw the needle into place on the syringe tip. Pick up the rod-like plunger and place it within the barrel of the syringe until it touches the rubber piece. Gently screw the plunger into the rubber piece until it seems secure. Do not use a lot of force. Hold the syringe by the barrel (not the plunger) and take the cap off the needle. You are now ready to mix the Sodium Chloride Injection USP and the powder. Insert the needle into the bottle of Alprostadil and inject 1.2 milliliters of the Sodium Chloride Injection USP from your syringe into the bottle of Alprostadil. Remove the needle from the bottle, holding the barrel of the syringe. Gently swirl the bottle to mix the powder into the solution, turning it upside down to wet all the powder in the bottle. Use the mixture within 24 hours of mixing it. Follow the directions below, “How to draw your dose into the syringe."

How to draw your dose into the syringe (for all injection products):

Check the solution to make sure it is clear. Do not use the mixture if you can see anything solid in the solution or if the solution is cloudy or colored. After the Alprostadil solution is mixed and the needle is inserted into the Alprostadil bottle, turn the bottle with the syringe as a unit upside down in one hand. Be sure the tip of the needle is covered by the solution. With your other hand, pull the plunger back slowly to draw the correct dose of the medicine into the syringe. Hold the syringe with the measuring scale at eye level to see that the proper dose is withdrawn and to check for air bubbles. To remove air bubbles, tap gently on the measuring scale of the syringe to move any bubbles to the top of the syringe near the needle. If your dose measures too low in the syringe, withdraw more solution from the bottle. If there is too much medicine in the syringe, put some back into the bottle. Then check your dose again. Remove the needle from the bottle, holding the barrel of the syringe, not the plunger. Place the cover back on the needle. You are now ready to inject your dose. Follow the directions below, “How to give the Alprostadil injection."

How to give the Alprostadil injection:

Choose a spot on your penis as directed by your doctor where you will give the injection. Clean the injection site with alcohol. Sitting upright or slightly reclined, hold your penis against the side of your thigh so that it cannot move. Remove the cover from the needle and hold the needle at a 90-degree angle to the place of injection. Insert the needle until almost all of the metal part of the needle is inserted into the penis. Do not inject the medicine just under the surface of the skin, at the top or head of the penis, or at the base of the penis near the scrotum or testes. Avoid injecting the medicine into blood vessels that you can see. Press the plunger down slowly, taking 5 to 10 seconds to release the dose into the penis. The injection is usually not painful. If the injection is very painful or if you notice bruising or swelling at the place of injection, that means you are injecting the medicine under the skin. Stop, withdraw the needle, and reposition it properly before continuing with the injection. Remove the needle and recap it. After you have completed the injection, put pressure on the place of injection for about 5 minutes or until any bleeding stops. This will prevent bruising. Then massage your penis as instructed by your doctor. This helps the medicine spread to all parts of the penis, so that the medicine will work better.

Choose a different place of injection each time you use the medicine to prevent skin problems. This includes switching the place of injection from the right side of the penis for one injection to the left side for the next injection.

After a single-use injection is mixed, the medicine must be used immediately. Throw away any unused mixture in the syringe. It cannot be stored for a later injection.

Do not reuse or share your needles or cartridges.

Never use a bent needle and never try to straighten a bent needle prior to injecting.

How to throw away the syringes and bottles safely:

Dispose of your materials properly. Caverject® comes in a plastic case that can be permanently locked with the red locking device that is included with the packaging. When the case label is removed, you can see a hole in the center of the case. The red locking device can be inserted and, by firmly pressing it down with your thumb, you will permanently lock the case. The locked case is safe to be thrown away.

Alprostadil usually begins to work in about 5 to 10 minutes. You should attempt intercourse within 10 to 30 minutes after using the medicine. An erection may continue after ejaculation.

The dose of Alprostadil will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Alprostadil. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For the treatment of erectile dysfunction: For injection dosage form: Adults—1.25 to 60 micrograms (mcg) as a single dose once a day. Your exact dose will be determined by your doctor. Inject Alprostadil very slowly into your penis as shown to you by your doctor 10 to 30 minutes before intercourse. Allow 5 to 10 seconds to completely inject the dose. Do not inject more than one dose within 24 hours. Also, do not use Alprostadil for more than 2 days in a row or more than 3 times a week.

Overdose

If an overdose occurs and you are not feeling well, you should seek emergency medical attention or contact your healthcare provider immediately. The overdose of the medication may be followed by feeling light-headed, fainting, having a painful or prolonged erection lasting 4 hours or longer.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store in the refrigerator. Do not freeze.

Alprostadil for Injection while in the powder form can be stored at room temperature (between 15 and 25 °C or 59 and 77 °F) for 3 months. After it is mixed, the solution must be used immediately or within 24 hours and not refrigerated or frozen. Suppositories may be stored at room temperature.

Side effects

The most common side effects associated with Alprostadil are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Use of Alprostadil is not indicated for geriatric patients.

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A Combination of Radiation and the Hypoxia-Activated Prodrug Evofosfamide (TH-302) is Efficacious against a Human Orthotopic Pancreatic Tumor Model. Optical coherence tomography angiography artifacts in retinal pigment epithelial detachment. Relating TCR-peptide-MHC affinity to immunogenicity for the design of tumor vaccines. Increases in PKC activity and in Type 2 (beta) and Type 3 (alpha) PKC protein levels also accompanied differentiation. There is strong link between some pulmonary and skin manifestations in PAPS patients, suggesting complexity and evolutionary nature of APS. Mice deficient in complement receptors 1 and 2 fail to produce a component of the natural antibody repertoire that binds to ischemia-conditioned tissues and activate complement.

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Secondary medicinal prevention of uncomplicated hypertension in an outpatient clinic. A case of symmetrical and bilateral tuberculoma of both lung apices. Results support the efficacy of MDFT, a relatively short-term, multicomponent, multitarget, family-based intervention in significantly reducing adolescent drug prevacid 30 mg side effects abuse and facilitating adaptive and protective developmental processes. Overall, recent studies indicate that treatment interruption is associated with a variable degree of net harm. In this paper we review brain responses to sexual arousal and orgasm in such women, and further hypothesize that the afferent pathway for this unexpected perception is provided by the Vagus nerves, which bypass the spinal cord. The primary outcome measure was anesthesia-controlled operating room time, defined as time from patient arrival to the operating room to time of surgical site sterile preparation. In a prospective observational design, 600 patients with influenza-like illness (ILI) or with severe acute respiratory illness (SARI) who were referred to the Influenza Clinic of a tertiary care hospital in Srinagar, India from September 2012 to April 2013, were enrolled for diagnostic testing for influenza using QuickVue or RT-PCR. We have previously developed more specific quantitative classifiers of vertebral fracture using shape and appearance models. Universal newborn hearing screening in Mexico: results of the first 2 years. tropicalis is allergenic and should be considered as a cause of allergic rhinitis when evaluating a patient who lives in an area where it is endemic.

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Theoretical and experimental limits of triple photon energy absorptiometry in the measurement of bone mineral. Decreased influx represents one of the major resistance mechanisms of platinum complexes. One presented anaphylactic reaction to RCM despite premedication and another presented with angina. Life table analysis of attendance at an outpatient clinic indicates levels of attrition similar to those reported by ambien side effects with alcohol follow-up and other studies of treatment for drug dependence. Several studies have investigated the relationship between asymmetrical EEG activity over the frontal cortex and mood. The vibration levels of 87 axes in 29 conventional vehicles were measured, recorded, and analyzed.

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In the present study, we established airway remodeling model mice and examined the mechanism of fibrotic change by measuring chemotactic activity of lung fibroblasts and quantifying collagen content in lung tissues. HPLC-SRM-MS (selected reaction monitoring-mass spectrometry) has several theoretical advantages over immunoassays with improved specificity, minimal cross-reaction and higher sensitivity. The purpose of the present study was to determine the microsatellite variability of EmsB as well as six other microsatellites in major taeniid species infecting dogs in Iran. Thirteen cysts treated by enucleation followed by collapsing an osteoperiosteal flap to eliminate dead space are presented. There is currently no widely agreed-upon definition of clinical orthostatic hypertension, the current definitions being operational within the context of particular studies. Myocardial fractional flow reserve is a functional index of coronary stenosis severity that takes into account both antero-grade and collateral flow and may therefore be a more appropriate standard for comparison. Specific binding of the two MAbs to recombinant ChIL-2 produced by Escherichia coli and COS-7 cells was demonstrated in an indirect ELISA, Western blotting and dot blots.

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Despite extensive, recent research on the development of dendritic cells (DCs), their origin is a controversial issue in immunology, with important implications regarding their use in cancer immunotherapy. The Schedule for the Deficit Syndrome (SDS) was developed to categorize schizophrenia patients into deficit and non-deficit subtypes. In this work, a site-specific ERA methodology based on the TRIAD approach was applied to contaminated soil surrounding a closed non-sealed landfill, as a case study to implement and validate such ERA methodology in the Basque Country (northern Spain). Acute thrombopenia during treatment with sulfamethoxazole-trimethoprim. The latter modify substantially the stability diagrams and select patterns with wave numbers quite different from the critical value. Mitochondrial DNA (mtDNA) has depakote 250 mg side effects been proposed to be involved in carcinogenesis and ageing. During and after restructuring of the economy disparities in mortality between income groups in New Zealand increased in relative terms (but not in absolute terms), but it is difficult to confidently draw a causal link with structural reforms.

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