Thursday 15 September 2016

Caverject Impulse injectable and transurethral


Generic Name: alprostadil (injectable and transurethral) (al PROS ta dil)

Brand Names: Caverject, Caverject Impulse, Edex, Muse


What is alprostadil?

Alprostadil is used to treat erectile dysfunction (impotence) and to help diagnose certain causes of this disorder. Alprostadil is also used to improve blood flow in newborn babies with a certain genetic heart condition. This alprostadil medication guide addresses only the adult male use of this medication in erectile disorders.


Alprostadil relaxes blood vessels and muscles in the penis. This increases blood flow into the penis, causing an erection.


Alprostadil may also be used for purposes not listed in this medication guide.


What is the most important information I should know about alprostadil?


Alprostadil is used to treat erectile dysfunction (impotence) and to help diagnose certain causes of this disorder. Alprostadil is also used to improve blood flow in newborn babies with a certain genetic heart condition. This alprostadil medication guide addresses only the adult male use of this medication in erectile disorders.


You should not use this medication if you are allergic to alprostadil, or if you have sickle cell anemia, leukemia, a bone marrow tumor, a curved or deformed penis, penile fibrosis or Peyronie's disease, a penile implant, or if you have been told you should not have sexual intercourse for health reasons.

Before using alprostadil, tell your doctor if you have heart disease, high blood pressure, a bleeding disorder, a history of blood clots, or a disease that could be passed in blood (such as hepatitis or HIV).


The injectable form of alprostadil is injected into the side of the penis. The transurethral pellet is a very small suppository that is inserted into the opening of the penis (the urethra).


Use this medication exactly as it was prescribed for you. Using too much alprostadil can be very dangerous. The medicine comes with patient instructions for safe and effective use. Follow these directions carefully.


Your first dose of this medicine will be given in your doctor's office so you can be observed for how well the medication works and if it causes any side effects.


Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes. Call your doctor, nurse, or pharmacist if you have any questions. Using an alprostadil transurethral pellet improperly could cause damage to your urethra.

Alprostadil is used only when needed to get an erection. An erection should occur within 5 to 20 minutes after you use the medication, and should last for 30 to 60 minutes.


Seek emergency medical attention if you have a painful or prolonged erection lasting 4 hours or longer.

What should I discuss with my healthcare provider before using alprostadil?


You should not use this medication if you are allergic to alprostadil, or if you have:

  • sickle cell anemia or the sickle cell anemia trait;




  • leukemia;




  • a tumor of the bone marrow (multiple myeloma);




  • a curved or deformed penis;




  • penile fibrosis or Peyronie's disease;




  • if you have a penile implant; or




  • if you have been told you should not have sexual intercourse for health reasons.



To make sure you can safely use alprostadil, tell your doctor if you have any of these other conditions:



  • a history of blood clots;




  • heart disease, high blood pressure (hypertension);




  • a bleeding or blood-clotting disorder; or




  • a disease that could be passed in blood (such as hepatitis or HIV).



Use a condom to prevent transfer of this medication to your sexual partner if she is pregnant or could become pregnant.


Caverject, Caverject Impulse, Edex, or Muse should not be used by women or by anyone under 18 years old.

How should I use alprostadil?


Your first dose of this medicine will be given in your doctor's office so you can be observed for how well the medication works and if it causes any side effects. You will then be shown how to properly give the medication to yourself. Wait at least 1 day after your first dose before using the medicine again.


Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Using too much alprostadil can be very dangerous.


Alprostadil is used only when needed to get an erection. An erection should occur within 5 to 20 minutes after you use the medication, and should last for 30 to 60 minutes. The length of time your erection lasts may be slightly different.


The injectable form of alprostadil is injected into the side of the penis.


The transurethral pellet is a very small suppository that is inserted into the opening of the penis (the urethra).


Do not use more than 2 alprostadil pellets in one day (24 hours). Do not use more than 3 alprostadil injections per week. Allow at least 24 hours to pass between injections.

Alprostadil comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.


Alprostadil injectable is a powder medicine that comes with a sterile liquid for mixing it. Caverject Impulse is a brand of alprostadil injectable supplied as a needle and syringe that contains both the powder medicine and the sterile liquid. The dose is automatically mixed when you turn a dial on the end of the syringe. The Caverject Impulse syringe is designed for only one use. Carefully follow the instructions provided with this product.


Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.


Prepare your alprostadil dose only when you are ready to use the medicine. Do not shake the mixed medicine. After mixing, the medication should be clear. Do not use the medication if it looks cloudy or has particles in it. Call your doctor for a new prescription. Do not give yourself an alprostadil injection or pellet if you do not understand the instructions for proper use. Call your doctor, nurse, or pharmacist for help with injection instructions. Using an alprostadil transurethral pellet improperly could cause damage to your urethra.

The Caverject Impulse device uses a very thin needle, which could break easily. If the needle breaks during injection and you can see and grasp the broken end, remove it and contact your doctor. If you cannot remove the broken end, call your doctor right away.


An alprostadil injection can cause bleeding where the needle is placed. This can make it easier for your sexual partner to be exposed to your blood. Before using this medication, tell your doctor if you have a virus such as hepatitis or HIV, which can be passed to another person who comes into contact with your blood.


To be sure this medication is not causing harmful effects, your penis may need to be examined every 3 months. Visit your doctor regularly.

Storing this medicine:


  • Keep each urethral pellet in its original foil pouch until you are ready to use it. Store the foil pouches in the refrigerator. You may store the pouches at room temperature for up to 14 days.

  • Store alprostadil injectable at room temperature. The 40 microgram strength of unmixed alprostadil can be stored at room temperature for up to 3 months, or until the expiration date on the label, whichever happens first.

  • Do not expose alprostadil products to freezing or very hot temperatures. Do not store your medication in a closed automobile, or pack it into luggage that will be placed into a cargo area during travel.

What happens if I miss a dose?


Since alprostadil is used as needed, you will not be on a dosing schedule.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include feeling light-headed, fainting, or having a painful or prolonged erection lasting 4 hours or longer.


What should I avoid while using alprostadil?


This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Taking this medication will not prevent you from passing a disease such as hepatitis or HIV to your sexual partner. Avoid having unprotected sex. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.


Alprostadil side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Stop using alprostadil and call your doctor at once if you have a serious side effect such as:

  • feeling light-headed, fainting;




  • trouble urinating, blood in your urine;




  • bleeding, bruising, or swelling where you injected the medication;




  • a painful erection that lasts 4 hours or longer;




  • severe pain or irritation of your penis or urethra; or




  • redness, lumps, tenderness, unusual shape or curving of the erect penis.



Less serious side effects may include:



  • unusual discharge from your penis; or




  • mild pain in your penis, urethra, or testicles;




  • headache, dizziness;




  • back pain;




  • a rash on the skin of your penis;




  • itching, warmth, or numbness of your penis;




  • cough, stuffy nose, cold symptoms, flu symptoms.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Your sexual partner may also have side effects such as burning, itching, or irritation of the body areas that come into contact with your penis.


What other drugs will affect alprostadil?


Tell your doctor about all other medicines you use, especially:



  • blood pressure medication; or




  • a blood thinner such as heparin or warfarin (Coumadin, Jantoven).



This list is not complete and other drugs may interact with alprostadil. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More Caverject Impulse resources


  • Caverject Impulse Side Effects (in more detail)
  • Caverject Impulse Use in Pregnancy & Breastfeeding
  • Caverject Impulse Drug Interactions
  • Caverject Impulse Support Group
  • 3 Reviews for Caverject Impulse - Add your own review/rating


Compare Caverject Impulse with other medications


  • Erectile Dysfunction


Where can I get more information?


  • Your pharmacist can provide more information about alprostadil.

See also: Caverject Impulse side effects (in more detail)


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