Side effects include hypotension, reflex tachycardia, and nasal congestion. It has been used in combination with papaverine to increase blood flow. Phentolamine mesylate is a competitive nonselective α-adrenergic receptor antagonist. Papaverine, however, causes priapism and fibrosis in as many as 35% and 33% of men, respectively, with an increased incidence in young and neurogenic patients. Kapoor and colleagues 50 reported on the use of papaverine in men with spinal cord injuries, who obtained satisfactory erections capable of successful penetration in 98%. Papaverine inhibits phosphodiesterase, leading to increases in cyclic adenosine monophosphate, elevated nitric oxide, and eventual relaxation of cavernosal smooth muscle and arterial dilation. Other agents used alone or in combination with prostaglandin E 1 include papaverine and phentolamine mesylate (Regitine, CIBA Pharmaceuticals). Side effects include pain (17%), hematoma or ecchymosis (1.5%), and priapism or prolonged erection (1.3%).
Caverject vs edex full#
48 Linet and Neff 49 concluded that alprostadil produced full erections in 70% to 80% of patients. No change in peripheral blood levels occurs because of extensive pulmonary metabolism.
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Approximately 96% of alprostadil is locally metabolized within 60 minutes. Alprostadil causes smooth muscle relaxation, vasodilation, and inhibition of platelet aggregation. Carson III, in Therapy in Nephrology & Hypertension (Third Edition), 2008 Intracavernosal Injection TherapyĪlprostadil (Caverject, Edex), an exogenous form of prostaglandin E 1, administered by intracavernosal injection is the only approved agent.