Treatment and diagnositic test for erectile dysfunction
#仿單變更2022

Prostaglandin; Vasodilator
Causes vasodilation by means of direct effect on vascular and ductus arteriosus smooth muscle; relaxes trabecular smooth muscle by dilation of cavernosal arteries when injected along the penile shaft, allowing blood flow to and entrapment in the lacunar spaces of the penis.

1. Onset of action: (Erectile dysfunction) 5 to 20 minutes
2. Duration: Ductus arteriosus will begin to close within 1 to 2 hours after drug is stopped; Erectile dysfunction: <1 hour
3. Distribution: Insignificant following penile injection; Protein binding: 81% to albumin
4. Metabolism: ~70% to 80% by oxidation during a single pass through the lungs; metabolite (13,14 dihydro-PGE1) is active and has been identified in neonates
5. Half-life elimination: 30 seconds to 10 minutes
6. Time to peak: (Acyanotic congenital heart disease) 1.5 to 3 hours; (Cyanotic congenital heart disease) ~30 minutes; (Erectile dysfunction) 30 to 60 minutes
7. Excretion: Primarily urine (90% as metabolites) within 24 hours; feces

1. Hypersensitivity to alprostadil or any component (contains benzyl alcohol)<20220317>
2. Conditions predisposing patients to priapism (sickle cell anemia or trait, multiple myeloma, leukemia)
3. Patients with anatomical deformation of the penis (eg, angulation, cavernosal fibrosis, or Peyronie's disease), or penile implants
4. Men for whom sexual activity is inadvisable or contraindicated
5. Pregnancy; women; children; newborns

C

Not indicated for use in women.

Penile pain, prolonged erection, penile rash or swelling, Peyronie's disease; Bruising at injection site, hematoma at injection site; Dizziness, headache, hypertension

Initial dose titration:
1. Initiate titration at 2.5 mcg
2. If there is a partial response, increase dose by 2.5 mcg to a dose of 5 mcg and then, in increments of 5 to 10 mcg (depending on erectile response) until the dose that produces an erection suitable for intercourse and not exceeding a duration of 1 hour is reached; doses >60 mcg are not recommended
3. If there is a response, then there should be at least a 24-hour interval before the next dose is given. (No more than 2 doses should be given within a 24-hour period during the initial titration.)
Maintenance:
Once an appropriate dose has been determined, patient may self-administer injections at a frequency of no more than 3 times/week with at least 24 hours between doses

1. There are no dosage adjustments provided in the manufacturer's labeling.
2. Contains benzyl alcohol which may cause accumulative toxicity; use with caution<20220317>

1. There are no dosage adjustments provided in the manufacturer's labeling.
2. Contains benzyl alcohol which may cause accumulative toxicity; use with caution<20220317>

Caverject Sterile Powder should be stored at or below 25 degree C