Generic Name and Formulations:
Alprostadil 20mcg, 40mcg; per vial; lyophilized pwd for intracavernous inj after reconstitution; contains benzyl alcohol.
Indications for CAVERJECT:
Treatment of erectile dysfunction. Adjunct to other diagnostic tests in the diagnosis of erectile dysfunction.
Inject into the dorso-lateral aspect in the proximal third of penis, avoid visible veins; rotate inj side and site. Determine optimum dose and give 1st injections in office. Use lowest effective dose. Vasculogenic, psychogenic, or mixed etiology: initially 2.5mcg; if partial response, may increase dose to 5mcg within 1hr; during titration: max 2 doses within 24hr period; if more titration is needed, may give in increments of 5–10mcg at least 24hrs apart until optimal dose is achieved. Usual max: 60mcg. Neurogenic etiology: initially 1.25mcg; if partial response, may increase dose to 2.5mcg within 1hr; during titration: max 2 doses within 24hr period; if more titration is needed, may give 5mcg during the next 24hrs; thereafter, may give doses in increments of 5mcg at least 24hrs apart until optimal dose is achieved. Usual max: 60mcg. Maintenance for home use: max 3 injections/week; allow at least 24hrs between doses. Adjunct in diagnosis: see full labeling.
Predisposition to priapism (eg, sickle cell anemia or trait, multiple myeloma, leukemia). Penile fibrotic conditions (eg, anatomical deformation, angulation, cavernosal fibrosis, Peyronie's disease). Penile implants. Females.
Preexisting cardiovascular disease. Evaluate and treat underlying causes prior to initiating therapy. Treat priapism immediately. Patient must not adjust dose on own. Reevaluate every 3 months. Hypotension; avoid in those with known cavernosa venous leakage. Monitor for signs of penile fibrosis. Discontinue if penile angulation or cavernosal fibrosis develops. Risk of needle breakage; use proper handling and injection techniques. Does not protect against sexually transmitted diseases.
Concomitant vasoactive agents: not established. Concomitant with anticoagulants may increase inj site bleeding.
Penile pain, prolonged erection, penile fibrosis, inj site hematoma or ecchymosis, penis disorder, penile rash or edema, other local effects, dizziness.
Single-dose vials—6; Caverject Impulse 10mcg, 20mcg—2 (dual chamber syringe systems + supplies)