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Alprostadil is derived from a natural substance, prostaglandin E1, which opens blood vessels. This medicine is an effective treatment for some men. It can be administered by:
Candidates. Alprostadil is not an appropriate choice for men with:
Injected Alprostadil. Injected alprostadil (Caverject, Edex) uses a very small needle that the man injects into the erectile tissue of his penis. About 80% of men describe the pain of administering the injection as very mild.
The drug should not be injected more than 3 times a week or more than once within a 24-hour period.
MUSE System. The MUSE system delivers alprostadil through the urethra. It works in the following way:
The MUSE system should not be used more than twice a day and is not appropriate for men with abnormal penis anatomy.
Side Effects of Most Alprostadil Methods. Certain side effects are common to all methods of administration, although they may differ in severity depending on how the drug is given:
Until the introduction of alprostadil, the two drugs used for injection therapy had been papaverine (Pavabid, Cerespan) and phentolamine (Regitine). Adverse reactions are usually minor but include pain, ulcers, and prolonged erections (priapism). These drugs are rarely used now.
Testosterone replacement therapy works best for men with ED who have been diagnosed with hypogonadism (low testosterone levels). Men who have ED and normal testosterone levels are not likely to benefit from testosterone therapy. Studies indicate that testosterone therapy can modestly improve erectile function and libido.
Forms of testosterone therapy include:
Side effects may include acne, breast enlargement, headache, and emotional instability. Testosterone therapy may increase the risk for the following serious side effects:
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