Erectile dysfunction (ED) can be tough to talk about, but it’s a very common problem for men. It can have a real impact on your quality of life. Fortunately, there are a variety of treatment options available.
One such treatment is alprostadil, a medication that helps improve blood flow to the penis, which can result in an erection. There are a few ways to take alprostadil. It’s available as a pellet you insert into the tip of your penis or as an injection you administer directly into the penis.
This article focuses on intracavernosal alprostadil, or alprostadil administered via injection. We’ll cover how it works, potential side effects, warnings, and how to use it properly.
Understanding Alprostadil and Its Mechanism of Action
Alprostadil is a manufactured form of prostaglandin E1 (PGE1). Prostaglandin E1 is a naturally occurring substance in your body, similar to a hormone.
Alprostadil is considered a vasodilator. That means it widens your blood vessels.
How Alprostadil works
Alprostadil causes an erection by relaxing the smooth muscles in the arteries of your penis. When those muscles relax, more blood can flow into your penis.
Here’s a little more detail about how it works:
Alprostadil causes the levels of something called cyclic AMP (cAMP) to increase in your body. Cyclic AMP then causes the smooth muscles in your penis to relax, allowing blood to flow in and create an erection.
Uses and Dosage of Intracavernosal Alprostadil
Alprostadil is a medication with a few different applications, but it’s primarily prescribed for erectile dysfunction (ED).
Approved Uses
- Erectile Dysfunction: Alprostadil is a common treatment option for ED, no matter the cause. It can be effective for ED stemming from vascular issues (blood flow problems), psychogenic factors (psychological issues), or neurogenic factors (nerve damage).
Dosage and Administration
Alprostadil is usually administered via intracavernosal injection — that means you inject it directly into the penis.
It’s really important to find the lowest effective dose to minimize side effects. Your doctor will likely start you on a low dose and then gradually increase it until you achieve the desired effect.
The typical dose range for intracavernosal injection is 2.5 mcg to 40 mcg for Edex, or up to 60mcg for Caverject.
When you inject alprostadil, you should inject it into the dorsolateral aspect of the proximal third of the penis, taking care to avoid any visible veins. Also, alternate sides of the penis with each injection.
Potential Side Effects of Intracavernosal Alprostadil
Like any medication, intracavernosal alprostadil can cause side effects. It’s crucial to be aware of these before starting treatment and to discuss any concerns with your doctor.
Common Side Effects
One of the most frequent side effects is penile pain, reported by about 37% of men using this treatment. The pain is usually mild and temporary, often subsiding within a few hours. If the pain is severe or persistent, talk to your doctor about adjusting the dosage or exploring other pain management strategies.
Injection site reactions are also common. These can include hematoma (a collection of blood under the skin), bruising, and rash. Studies show injection site hematoma occurs in about 3% of users and injection site bruising occurs in about 2% of users. Penile rash is less common, occurring in about 1% of users. These reactions are usually mild and resolve on their own. Applying pressure to the injection site after the injection can help minimize bruising and hematoma formation.
Serious Side Effects
Although less common, some serious side effects can occur with intracavernosal alprostadil. Priapism, a prolonged erection lasting longer than four hours, is a medical emergency. It can occur in about 4% of users and priapism lasting longer than six hours occurs in less than 1% of users. If you experience an erection lasting longer than four hours, seek immediate medical attention to prevent potential damage to the penis.
Penile fibrosis, the development of scar tissue in the penis, is another potential complication, occurring in about 3% of users. If you’re considering other solutions such as an ED ring, be sure to consult our size chart. Signs of penile fibrosis include penile curvature, pain, or the development of hard lumps in the penis. Regular self-examination and reporting any changes to your doctor are essential. In some cases, treatment may need to be discontinued.
Other potential side effects include hypotension (low blood pressure) and severe allergic reactions, though these are rare.
Warnings, Precautions, and Contraindications
Like any medication, intracavernosal alprostadil isn’t right for everyone. Here’s what you should know:
Contraindications
You should not use alprostadil if you:
- are allergic or hypersensitive to alprostadil
- have a medical condition that makes you likely to develop priapism, a prolonged erection that can be dangerous
- have a physical condition that affects the shape of your penis, such as Peyronie’s disease
- are a woman, especially if you are pregnant or breastfeeding
Warnings and Precautions
Talk to your doctor before using alprostadil if you:
- have a heart condition: Alprostadil can put extra strain on your cardiovascular system.
- are at risk of sexually transmitted infections (STIs): Alprostadil doesn’t protect you from STIs like HIV, chlamydia, or gonorrhea. Always use condoms and practice safe sex.
Drug Interactions and Special Considerations
It’s important to talk to your doctor about any other medications you’re taking, especially anticoagulants, before starting intracavernosal alprostadil. There’s a risk of drug interactions, and your doctor needs to know everything you’re taking to make sure alprostadil is safe for you.
Before you start using alprostadil, tell your doctor about all your medications, any health conditions you have, and your complete medical history. This will help them determine if alprostadil is the right treatment option for you and minimize potential risks.
Storage and Disposal
Keep your alprostadil at room temperature, around 77°F (25°C), though it’s okay if the temperature fluctuates between 59°F and 86°F (15°C to 30°C) before you mix it.
A couple of important notes about using and disposing of the medication:
- Always use a fresh, new needle for each injection. Never reuse needles.
- Dispose of used needles safely in a designated sharps container to prevent accidental sticks and potential infections.
Frequently Asked Questions
What is the average cost of Caverject?
The cost of Caverject can vary depending on your location, pharmacy, and insurance coverage. Generally, you can expect to pay anywhere from $30 to $75 per injection. It’s best to check with your local pharmacy for specific pricing and to explore potential discounts or assistance programs.
Do you stay hard after coming with Caverject?
Yes, it’s common to maintain an erection even after ejaculation when using Caverject, but if you’re wondering, does Caverject increase size, it’s important to know the facts first. The erection will typically subside gradually as the medication wears off, usually within an hour or two. If the erection lasts longer than four hours, it’s important to seek immediate medical attention.
Where is the best place to inject Caverject?
Caverject should be injected into one of the sides of the penis, alternating injection sites with each use. Your doctor will provide specific instructions on the proper technique and location during your initial training. Following these instructions carefully is crucial for safety and effectiveness.
What is the success rate of Caverject injections?
Caverject injections generally have a high success rate, with many studies reporting effectiveness in 70-90% of men with erectile dysfunction. However, individual results can vary depending on the underlying cause of ED and other factors.
What is the downside of Trimix?
While Trimix can be very effective, potential downsides include a higher risk of priapism (prolonged erection), penile pain, and scarring compared to single-agent injections like Caverject. Because Trimix is a compounded medication, consistency and quality can sometimes be a concern as well. It’s crucial to discuss the risks and benefits with your doctor to determine if it’s the right option for you.
Key Takeaways
Intracavernosal alprostadil is a prescription medication for erectile dysfunction that you inject directly into your penis. It can be effective for people who haven’t had success with other treatments.
If you’re considering this option, it’s essential to talk with your doctor about whether it’s right for you and how to use it safely. Always seek medical advice before starting any new treatment.
It’s also important to use the medication responsibly by following your doctor’s instructions, storing and disposing of it properly, and understanding the potential risks.