Pharm

Intraurethral Alprostadil

search

Intraurethral Alprostadil, MUSE

  • Indications
  1. Psychogenic Impotence
  2. Neurogenic Impotence
  3. Vasculogenic Impotence
  • Contraindications
  1. Penile deformity (e.g Peyronie's Disease)
  2. Sexual intercourse with pregnant women
    1. Risk of Preterm Labor
  3. Priapism risk
    1. Sickle Cell Disease or Sickle Cell Trait
    2. Leukemia
    3. Multiple Myeloma
    4. Polycythemia Vera
    5. Thrombocythemia
    6. Anticoagulant use
  • Preparation
  1. Transurethral preparation
    1. Inserted 3 cm into Urethra with plastic applicator
  2. Semi-solid pellet
    1. Diameter: 1.4 mm
    2. Length: 3-6 mm
  • Efficacy
  1. Successful intercourse in 65% of 1511 tested
  2. Placebo success rate: 19%
  3. Less effective than injectable alprostadil
  • Adverse effects
  1. Hypotension (3%)
  2. Dizziness (2%)
  3. Mild Erectile discomfort (32%)
  4. Minor Urethral burning or bleeding
  5. Priapism is rare
  • Dosing
  1. Dose 125-1000 ug ($114-$137 for 6 units)
  • Reference
  1. Padma-Nathan (1997) N Engl J Med 336(1):1-7 [PubMed]