How does this medication work? What will it do for me?

Alprostadil belongs to a family of medications known as prostaglandins. Prostaglandins like alprostadil cause increased blood flow to certain areas of the body by causing the blood vessels in the area to widen. This medication is used to treat erectile dysfunction by causing increased blood flow to the penis in particular.

The goal of this medication is to achieve erections that last from 30 minutes or up to one hour. Alprostadil relaxes the smooth muscle of the penis, allowing more blood to flow into the penis to produce an erection. It can produce an erection in about 5 to 10 minutes, but this varies from person to person.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

250 µg
Each transurethral delivery system contains alprostadil 250 µg. Nonmedicinal ingredients: polyethylene glycol 1450 USP.

500 µg
Each transurethral delivery system contains alprostadil 500 µg. Nonmedicinal ingredients: polyethylene glycol 1450 USP.

1,000 µg
Each transurethral delivery system contains alprostadil 1,000 µg. Nonmedicinal ingredients: polyethylene glycol 1450 USP.

How should I use this medication?

The MUSE system uses an applicator to insert a pellet of medication into the urethra (the tube that urine passes through in the penis). This is usually done just after urination. The pellet then dissolves and the medication enters the blood-filled spaces of the penis (corpora cavernosa), where it works to cause an erection.

Your doctor will choose the appropriate dose of alprostadil for you.Once the correct dose has been found, the doctor will teach you to insert the medication properly. Once your doctor is assured that you are comfortable with the procedure, you will be given a prescription for a kit to use at home. Please refer to the package insert for details on how to use the medication properly.

The usual starting dose of alprostadil is 250 µg, and depending on your response to the medication, it may be increased up to 1,000 µg as directed by your doctor. The medication should not be used more than twice in a 24-hour period. The applicator should be used only once and then discarded safely. For best results, sit, stand, or walk for the first 10 minutes after you use the medication.

If the erection lasts for 2 hours, try to reduce the erection by methods suggested by your doctor. A prolonged erection (4 hours or more) should be reported to your doctor immediately.

Do not insert alprostadil into an erect penis. Never increase or decrease the dose without consulting your doctor. It is important to visit your doctor regularly, at least every 3 months during therapy, to ensure that the medication is working safely and effectively.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor.

Store unopened foil pouches in a refrigerator. Do not expose this medication to temperatures over 30°C. MUSE can be stored at room temperature (below 30°C) for up to 14 days prior to use. Protect this medication from light and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use alprostadil suppositories if:

  • you are allergic to alprostadil or any of the ingredients of the medication
  • you are a woman or child
  • you are prone to venous thrombosis
  • you have an anatomical deformation of the penis, such as angulation, cavernosal fibrosis, or Peyronie's disease
  • you have a condition that increases the risk of priapism, such as sickle cell anemia, multiple myeloma, or leukemia
  • you have a penile implant
  • you have priapism (a condition where erections are painful and last for over 6 hours)
  • your doctor has advised you not to have sex
  • your sexual partner is pregnant (unless a condom is used)

What side effects are possible with this medication?

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Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dizziness
  • flu-like symptoms or general body aches
  • infection
  • lowering of blood pressure
  • mild bleeding or spotting from urethra
  • pain at site of insertion
  • pain of the penis, urethra, or testes
  • painful erection
  • runny nose
  • stinging of urethra
  • vaginal itching and burning (in female partners of men taking alprostadil for erectile dysfunction; it is unknown whether these side effects are a result of the medication itself)

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • fainting
  • rapid pulse
  • swelling or pain in the testes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • curving of penis with pain during erection
  • priapism (erection that lasts over 6 hours with severe and continuing pain of the penis)
  • prolonged erection (lasting for 4 to 6 hours)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Bleeding: If the medication is not inserted properly, you may have small cuts or scrapes in the urethra. People with bleeding disorders or those taking blood thinners may be at a higher risk of bleeding and should be closely monitored by their doctor while they are taking this medication. The small cuts or scrapes in the urethra also increases the risk of passing sexually transmitted infections between sexual partners.

Fainting: Fainting may occur up to one hour after the medication is inserted. Avoid activities such as driving or operating machinery during this time.

Prolonged erections: If your erection lasts for 2 hours, try to reduce the erection by methods suggested by your doctor (such as applying ice packs to the inner thighs). If your erection lasts for 4 hours or more, call your doctor immediately.

Women and children: This medication is not recommended for women or children. Men who are having intercourse with a pregnant woman should use a condom to protect the developing child from being exposed to this medication.

What other drugs could interact with this medication?

There may be an interaction between alprostadil (MUSE) and any of the following:

  • anticoagulants (e.g., warfarin, heparin)
  • blood pressure medications (for high blood pressure)
  • other medications that act on the blood vessels (including those taken by mouth to enhance or cause an erection)
  • phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.