Alprostadil is also used in maintaining a
patent ductus arteriosus in
newborns, primarily for an infant with ductal-dependent congenital heart disease, including cyanotic lesions and acyanotic lesions.
Sexual dysfunction
Alprostadil is sold in the United States as
urethral suppositories and in injectable form. The suppositories are sold under the brand name Muse.[8] The injectable forms are Edex[9] and Caverject.[10] Muse delivers alprostadil as a penile suppository, inserted into the urethra, at least ten minutes before the erection is needed. Caverject and Edex are similarly fast-acting, but instead are injected by the syringe directly into the
corpus cavernosum of the penis.
Alprostadil is also available as a generic. It must be mixed by a
compounding pharmacy. The different formulations, including Bimix and
Trimix, may include
papaverine and/or
phentolamine. A typical mix might be 30 mg of papaverine, 2 mg of phentolamine, and 20 μg alprostadil.
The compound has been made into an applicable
topical cream form known as Vitaros.[11] Made by Takeda UK Ltd., it contains either 200 or 300 μg of alprostadil in 100 mg of cream. The tip of the device is placed in the
urethral meatus, and the cream is delivered into the urethra. Clinical trials for the treatment showed positive results in around 3,000 men that it was tested on; it is said to be usable by men with diabetes or heart problems and those who have undergone a
prostatectomy.[12] It has no known interactions with food, alcohol or other medications.
Critical limb ischemia
Prostanoids, including alprostadil, do not reduce the risk of limb amputation but may offer a slight improvement in rest-pain and leg ulcer healing in persons with critical limb ischemia.[13]
Contrast-induced nephropathy
Preventative administration of alprostadil may reduce the risk of kidney injury (specifically contrast-induced nephropathy) in persons having cardiac angiography or percutaneous coronary intervention.[14][15]
Misoprostol is another synthetic prostaglandin E1 analog used to prevent gastric ulcers when taken on a continuous basis,[16] to treat missed miscarriage,[17] to induce labor,[18] and to induce abortion.[19]
^World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization.
hdl:
10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^Xie J, Jiang M, Lin Y, Deng H, Li L (August 2019). "Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials". Angiology. 70 (7): 594–612.
doi:
10.1177/0003319719825597.
PMID30669852.
S2CID58950588.
^Walt RP (November 1992). "Misoprostol for the treatment of peptic ulcer and antiinflammatory-drug-induced gastroduodenal ulceration". The New England Journal of Medicine. 327 (22): 1575–1580.
doi:
10.1056/NEJM199211263272207.
PMID1435885.