Formulary
Alprostadil: Indications, Dosing, Side Effects and Interactions
Alprostadil clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Alprostadil: Indications, Dosing, Side Effects and Interactions
Alprostadil clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Maintaining patency of the ductus arteriosus for alprostadil**
- **Neonate** (By continuous intravenous infusion): Initially 5 nanograms/kg/minute, adjusted according to response, adjusted in steps of 5 nanograms/kg/minute (max. per dose 100 nanograms/kg/minute), maximum dose associated with increased side-effects.
Cautions
Anatomical deformations of penis (painful erection more likely)-follow up regularly to detect signs of penile fibrosis (consider discontinuation if angulation, cavernosal fibrosis or Peyronie's disease develop); priapism (patients should be instructed to report any erection lasting 4 hours or longer); risk factors for cardiovascular disorders; risk factors for cerebrovascular disorders
Contraindications
General contra-indications: Not for use in patients with penile implants or when sexual activity medically inadvisable (e.g. orthostatic hypotension, myocardial infarction, and syncope); not for use with other agents for erectile dysfunction; predisposition to prolonged erection (as in thrombocythaemia, polycythaemia, sickle cell anaemia, multiple myeloma or leukaemia); urethral application contra-indicated in balanitis; urethral application contra-indicated in severe curvature; urethral application contra-indicated in severe hypospadia; urethral application contra-indicated in urethral stricture; urethral application contra-indicated in urethritis Specific contra-indications: With topical use Balanitis; severe curvature; severe hypospadia; urethral stricture; urethritis
Side effects
General side-effects: Common or very common Balanoposthitis; hypotension; penile disorders; sexual dysfunction Specific side-effects: Common or very common With intracavernosal use Haemorrhage; muscle spasms; skin reactions With topical use Genital abnormalities; rash; urinary tract pain With urethral use Dizziness; haemorrhage; headache; muscle spasms; urethral burning Uncommon With intracavernosal use Asthenia; dry mouth; extrasystole; hyperhidrosis; increased risk of infection; inflammation; mydriasis; nausea; oedema; pelvic pain; peripheral vascular disease; presyncope; scrotal disorders; sensation abnormal; spermatocele; testicular disorders; urinary disorders; vascular disorders; vasodilation With topical use Dizziness; hyperaesthesia; pain in extremity; scrotal pain; syncope; urinary tract disorders With urethral use Hyperhidrosis; increased risk of infection; leg pain; nausea; pelvic pain; perineal pain; peripheral vascular disease; scrotal disorders; sensation abnormal; skin reactions; spermatocele; syncope; testicular disorders; urinary disorders; vascular disorders; vasodilation Frequency not known With intracavernosal use Myocardial ischaemia; stroke
Interactions
**Other interactions (4):**
- The effects of combinations of alprostadil with other treatments for erectile dysfunction (e.g.
- Such agents should not be used in combination with alprostadil due to the potential for inducing prolonged erections.
- Sympathomimetics may reduce the effect of alprostadil.
- Alprostadil may enhance the effects of antihypertensives, vasodilative agents, anticoagulants and platelet aggregation inhibitors.
Medicinal forms
Solution,Cream
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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