Edex
Alprostadil injection is a prescription medication that treats erectile dysfunction (ED). It's given as a shot into the base of the penis before sexual intercourse. A common side effect of this medication is penile pain. Alprostadil injection is available under a few different brand names, including Caverject and Edex.
What is Alprostadil injection?
What is Alprostadil injection used for?
- Treatment of erectile dysfunction (ED)
- Add-on to other lab tests for the diagnosis of erectile dysfunction - Caverject and Caverject Impulse only
How Alprostadil injection works
Alprostadil injection is a prostaglandin analog. It relaxes the muscles around your penis and opens the blood vessels to allow more blood to flow into the penis, resulting in the ability to have an erection.
Drug facts
Side effects of Alprostadil injection
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Penile pain (up to 37%)
Less Common Side Effects
- Bleeding at injection site
- Penile curvature
- Scar tissue in the penis
- Erections lasting longer than 4 hours
- Bruising at injection site
- Blood pooling (hematoma) at or near the injection site
Alprostadil injection serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Prolonged erection (erection lasting longer than 4 hours)
- Heart problems: chest pain, dizziness, nausea
The following Alprostadil injection side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Rare
Bruising or clotted blood in the penis at the injection site, usually caused by an incorrect injection
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Alprostadil injection
Pros
- Starts to work quickly within 5 to 20 minutes
- Can last for up to 1 hour
- Caverject Impulse and Edex are available in dual chamber syringes or cartridges that make them easier to prepare
Cons
- Needs to be injected directly into the penis
- Might be difficult for some people to administer correctly
- Can cause pain in the penis
Pharmacist tips for Alprostadil injection
- Alprostadil injection shouldn't be used more than 3 times per week and shouldn't be given more often than 1 time every 24 hours.
- You should receive training from your provider on how to give yourself alprostadil injection. Make sure you know how to give yourself alprostadil injection to avoid accidentally hurting yourself or wasting the medication. Contact your provider if you have any questions on how to use this medication.
- Store Edex, Caverject Impulse, Caverject 20 mcg vials at room temperature before mixing. If you have Caverject 40 mcg vials, store them in the refrigerator before mixing.
- If you're using Caverject, after the medication is mixed, store it at or below 77ºF (but don't refrigerate or freeze the medication) and use the dose within 24 hours. If you're using Caverject Impulse, after the medication is mixed, store it between 36ºF to 77ºF (but don't freeze the medication) and use the dose within 24 hours. If you're using Edex, use the dose right away after mixing it, don't store it for future use.
- Wipe the site of injection with an alcohol wipe before injection in order to clean the area. After injecting, hold a sterile gauze or alcohol wipe to the injection site for 5 minutes to prevent or stop bleeding.
- Only inject alprostadil injection into the side or base, on the lower one-third of your penis. Make sure to alternate injection sites and the sides of your penis that's injected to avoid skin irritation and pain. Don't inject into visible veins. Doing so can cause the medication to get into your blood stream, which can cause serious heart side effects.
- After giving yourself the medication, throw the needle and syringe away in a sharps container or something made of heavy-duty plastic, such as an empty milk carton or laundry detergent bottle, to lower the risk of needle-stick injuries. Don't throw away needles or syringes in your trash can. When your sharps container is almost full, close it tightly with the cap. For more information on how to throw away your sharps container safely and guidance for your specific state, visit the FDA's website.
- Each alprostadil injection vial (Caverject), syringe (Caverject Impulse), and cartridge (Edex) should only be used once. Throw them away after you administer the injection. Don't save any leftover medication to avoid infections.
- Always check the medication solution to make sure it's clear and colorless before using it. If it's cloudy, discolored, or has particles (solid chunks), don't use it.
- If the needle is bent, throw it away into a sharps container and attach a new, unused needle. Don't try to straighten it because you might poke yourself. Don't re-use or share needles to avoid spreading infections.
- Get medical help right away if you have an erection that lasts longer than 4 hours so you can receive treatment to prevent permanent damage to your penis.
- Using alprostadil injection doesn't protect you from sexually transmitted infections (STIs) and doesn't prevent pregnancy.
- You should see your provider every 3 months for check-ups to make sure it's safe for you to continue taking alprostadil injection and to examine your penis for side effects, such as scarring, skin irritation, and changes in skin color.
Common questions about Alprostadil injection
Yes. In clinical studies looking at how well the medication works, 94% of males using alprostadil injection reported they were able to have sex after the injection. Over 85% of the males and their partners reported the sexual experience to be satisfactory.
Alprostadil injection typically starts to work within 5 to 20 minutes. It should last no longer than 1 hour. Contact your provider if your erection lasts longer than 1 hour. This might mean your alprostadil injection dose is too high and having an erection for a long time (priapism) can cause damage your penis.
At the appropriate dose, the effects of alprostadil injection should last up to an hour. If the erection lasts more than an hour, let your provider know right away. This likely means that your dose is too high and needs to be adjusted. Your provider will check in with you every 3 months to see if the dose of alprostadil injection is safe and working well for you, and make changes as needed.
You can use alprostadil injection up to 3 times per week, with each injection separated by at least 24 hours.
Ask your provider if it's safe and appropriate for you to take both sildenafil (Viagra) and alprostadil injection at the same time. There have been studies that looked at combining a phosphodiesterase-5 (PDE-5) inhibitor, like sildenafil (Viagra), with alprostadil injection. Research suggest that this combination can be an option for people who didn't get good results from either medication. Talk to your provider if you have more questions about this combination.
Both Edex and Caverject are brand names of alprostadil injection. The main difference is how they're packaged, which can affect ease of injection. Caverject comes in a vial containing a powder. You'll need to mix it before you use it, using syringe with needle, and sterile water. Both Caverject Impulse and Edex come in dual chambers syringe, which make mixing and injecting easier.
Both Caverject and Muse contain the same active ingredient, alprostadil. A major difference between them is Caverject is given as an injection into the base of the penis, whereas Muse is a suppository that's inserted into the urethra (the tube that drains the bladder) of the penis. Some people might prefer Muse because it's not an injection, studies comparing both medications found that about 70% of males using Muse reported poor erection quality, compared to 12% of males using Caverject. Another important difference is that Muse shouldn't be used for sexual intercourse with a pregnant female unless a condom barrier is used to protect the unborn baby from exposure to the medication.
The technique needed to properly inject alprostadil injection differs based on the specific brand-name medication you're using. Read the instructions (Caverject, Caverject Impulse, or Edex) for use for the medication you're prescribed and contact your provider or pharmacist if you have any questions on how to use this medication safely and correctly.
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Risks and warnings for Alprostadil injection
Alprostadil injection can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Prolonged erection (priapism)
- Risk factors: History of conditions that raise the risk of prolonged erections | Higher doses of alprostadil injection
Get medical help right away if you get an erection that lasts longer than 4 hours after using alprostadil injection. If this isn't treated right away, it can lead to permanent damage to your penis. Alprostadil injection shouldn't be used by people who have a history of medical conditions that raise the risk of prolonged erections, such as sickle cell anemia, multiple myeloma, and leukemia. To minimize your risk of a prolonged erection, your provider will only prescribe the lowest dose of alprostadil injection needed produce an erection that lasts for at most 1 hour. Your provider will check in with you every 3 months to see if your dose of alprostadil injection needs to be adjusted. Contact your provider if you want to try and lower your dose, but don't change it on your own.
Penile scarring
- Risk factors: Taking alprostadil injection for a long time
Although rare, alprostadil injection can cause scarring on your penis, which can lead to penile curvature. Your provider will do physical examinations regularly to see if there's scarring. If so, they'll ask you to stop taking alprostadil injection.
Low blood pressure
- Risk factors: Taking other medications that lower your blood pressure
Taking alprostadil injection can cause low blood pressure. This can lead to symptoms such as dizziness, lightheadedness, or fainting. If you feel any of these symptoms, make sure to sit down right away so you don't fall. To lower your risk of low blood pressure, you should take the lowest dose possible of alprostadil injection.
Bleeding at the injection site
Using alprostadil injection can lead to minor bleeding at the injection site. If you're taking blood thinners or have a condition where you bleed more easily, your risk of bleeding after using alprostadil injection might be higher. After injection, make sure to hold a sterile gauze or alcohol swab over the injection site for 5 minutes to stop the bleeding. Talk to your provider about the risks and benefits of using alprostadil injection if you're taking blood thinners.
Heart problems from sex
- Risk factors: History of heart problems
Having sexual intercourse can put a lot of stress on your heart, which can be especially problematic if you have a history of heart problems. Alprostadil injection shouldn't be used if your provider advised you not to participate in sexual activity because of your heart problems. Contact your provider right away if you get symptoms of a heart problem, such as chest pain, dizziness, or nausea.
Needle breakage
- Risk factors: Injecting alprostadil injection incorrectly
Alprostadil injection must be injected with a very thin needle. It's possible that these needles can break in your penis while you're giving yourself the injection. In some cases, people have had to go the hospital and have surgery to get the needle removed. Make sure you understand how to give yourself alprostadil injection and ask your provider or pharmacist if you have any questions.
Not for children
Caverject and Caverject Impulse contains an ingredient, called benzyl alcohol, that can cause serious and life-threatening side effects such as "gasping syndrome" in children. Only Prostin VR, a specific brand name of intravenous alprostadil injection, is used in hospital for newborns with certain heart conditions. But Caverject, Caverject Impulse, and edex should never be used in children.
Sexually transmitted infections
Alprostadil injection doesn't protect you from sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). To protect yourself and others from STIs, you should use condoms, get tested for STIs regularly, and limit your number of sexual partners. Female partners who are of childbearing age should consider using birth control.
Alprostadil injection dosage
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2 cartridges of 10mcg | 1 package | $190.19 | $190.19 |
| 6 cartridges of 10mcg | 6 packages | $3,317.43 | $552.91 |
| 2 cartridges of 20mcg | 1 package | $236.07 | $236.07 |
| 6 cartridges of 20mcg | 1 package | $719.07 | $719.07 |
| 2 cartridges of 40mcg | 1 package | $330.73 | $330.73 |
| 6 cartridges of 40mcg | 1 package | $979.65 | $979.65 |
Typical dosage for Alprostadil injection
Treatment of ED: Your provider will give you the first few alprostadil injections at their office to determine the right dose for you. The typical starting dose ranges from 1.25 mcg to 2.5 mcg injected into the base of the penis. If needed, your provider will adjust the dose based on your response.
- Inject the dose determined at your provider's office into the base of the penis. This can range from 1 mcg to 40 mcg for edex, and up to 60 mcg for Caverject and Caverject Impulse. Don't use alprostadil injection more than 3 times a week. Make sure there's at least 24 hours in between each dose.
Diagnosis of ED (Caverject and Caverject Impulse only):
- Together with lab testing, your provider will inject 1 dose of Caverject or Caverject Impulse into the base of your penis and monitor for an erection.
Interactions between Alprostadil injection and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Heparin
How much does Alprostadil injection cost?
$190.19
Alprostadil injection contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Alprostadil injection will not be safe for you to take.
- Conditions that can cause long-lasting erections (e.g., sickle cell anemia, leukemia, or multiple myeloma)
- Abnormally-formed penis or Peyronie's disease
- Men with implants in the penis
What are alternatives to Alprostadil injection?
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