Prostin Vr Injection
Alprostadil
0.5mg/ml
PFIZER MANUFACTURING BELGIUM N.V.
| Pack size | 1ml Ampoule x 5 |
|---|---|
| Dispensing mode | POM |
| Source | BELGIUM |
| Agent | Modern Pharmaceutical Co. |
| Retail Price | 1736.00 AED |
Indications
Prostin Vr Injection is used for:
Maintain Patency of Ductus Arteriosus, Erectile dysfunction
Adult Dose
Intracavernosal
Erectile dysfunction
Adult: Initially, 2.5 mcg, followed by 5 mcg if there is partial response or 7.5 mcg if there is no response. Subsequent increments of 5-10 mcg are given until suitable dose is reached. Usual dose range: 5-20 mcg. Max: 60 mcg. For neurogenic origin (e.g. spinal cord injury): Initially, 1.25 mcg, followed by 2.5 mcg then 5 mcg, and subsequent increments of 5 mcg until suitable dose at intervals of at least 1 day for responders; for non-responders, a higher dose may be given w/in 1 hr. Max frequency: once daily; 3 times wkly.
Diagnosis of erectile dysfunction
Adult: 5-20 mcg as a single dose.
Urethral
Erectile dysfunction
Adult: Initially, 250 mcg, may be increased in stepwise manner to 1,000 mcg; or reduced to 125 mcg according to response. Max frequency: twice daily; 7 doses wkly.
Diagnosis of erectile dysfunction
Adult: 500 mcg as a single dose.
Topical/Cutaneous
Erectile dysfunction
Adult: As cream: Initially, 300 mcg is applied to the tip of the penis, may be reduced to 200 mcg if patient cannot tolerate AR. Max frequency: once daily; 2-3 times wkly.
Child Dose
Intravenous
Maintenance of patency of ductus arteriosus in neonates with congenital heart disease
Child: Initially, 0.05-0.1 mcg/kg/min via continuous infusion, reduced to the lowest possible dosage that maintains the response. If response is inadequate, may be increased up to 0.4 mcg/kg/min.
Renal Dose
Administration
IV Preparation
IV infusion: Dilute 1 mL (ie, 500 mcg) with sodium chloride for injection or dextrose
Undiluted alprostadil solution may interact with plastic in volumetric infusion chambers resulting in a hazy solution (replace solution and volumetric infusion chamber if this occurs)
Place appropriate amount of intravenous infusion solution (ie, sodium chloride, dextrose) in chamber first, then add undiluted alprostadil solution (avoid direct contact with walls of volumetric infusion chamber)
Dilute to volumes appropriate for the pump delivery system available
Prepare fresh infusion solutions q24hr; discard any solution >24 hr old
IV Administration
Administer via large vein or through umbilical catheter
Administer IV injection via volumetric infusion pump
Contra Indications
History of recurrent priapism, sickle cell anaemia or trait, multiple myeloma, leukaemia, thrombocythaemia, polycythaemia, predisposition to venous thrombosis, anatomical penile deformation (e.g. angulation, cavernosal fibrosis, Peyronie's disease, stenosis of distal urethra, severe hypospadias and curvature, balanitis, acute/chronic urethritis), penile implants. Patient for whom sexual activity is inadvisable (e.g. unstable CV or cerebrovascular conditions). Concomitant use w/ other drugs for erectile dysfunction (e.g. phosphodiesterase type 5 (PDE5) inhibitors, papaverine). Neonates w/ resp distress syndrome. Childn (intracavernosal).
Precautions
Patient w/ bleeding tendencies, blood-borne and pulmonary diseases, transient ischaemic attacks, CHD, CHF, history of psychiatric disorder or addiction. Pregnancy (use condom barrier if female partner is or may be pregnant). Patient Counselling This drug may cause dizziness, syncope, and hypotension, if affected, do not drive or operate machinery. Monitoring Parameters Monitor for BP, resp and heart rates, temp, degree of penile pain, duration of erection, adequate detumescence after dosing, and signs of infection.
Pregnancy-Lactation
Pregnancy Category: X
Lactation: Not indicated for use in women
Interactions
Reduced effect w/ sympathomimetics, decongestants, and appetite suppressants. May enhance the effects of antihypertensives, vasoactive drugs, anticoagulants and platelet aggregation inhibitors.
Potentially Fatal: Enhanced AR, including prolonged erections, w/ PDE5 inhibitors (e.g. sildenafil, tadalafil, vardenafil) and other drugs that induce erection (e.g. papaverine).
Adverse Effects
Side effects of Alprostadil :
>10%
Fever (14%)
Apnea (12%)
Flushing (>10%)
1-10%
Bradycardia (7%)
Hypotension (4%)
Seizures (4%)
Tachycardia (3%)
Diarrhea (2%)
Sepsis (2%)
Cardiac arrest (1%)
Edema (1%)
Intravascular coagulation (1%)
Hypokalemia (1%)
<1%
Cerebral bleeding
Hyperextension of the neck
Hyperirritability
Hypothermia
Jitteriness
Lethargy
Stiffness
Congestive heart failure
Hyperemia
Second degree heart block
Shock
Spasm of the right ventricle infundibulum
Supraventricular tachycardia
Ventricular fibrillation
Bradypnea
Bronchial wheezing
Hypercapnia
Respiratory depression
Respiratory distress
Tachypnea
Gastric regurgitation
Hyperbilirubinemia
Anemia
Bleeding
Thrombocytopenia
Peritonitis
Hypoglycemia
Hyperkalemia
Mechanism of Action
Alprostadil, a naturally occurring prostaglandin E1, is a vasodilating agent and a platelet aggregation inhibitor. It induces erection by relaxation of the trabecular smooth muscles and dilation of cavernosal arteries, allowing blood flow to the lacunar spaces of the penis. It also relaxes the smooth muscles of the ductus arteriosus.
Note
Prostin Vr 0.5mg/ml Injection manufactured by PFIZER MANUFACTURING BELGIUM N.V.. Its generic name is Alprostadil. Prostin Vr is availble in United Arab Emirates.
Farmaco UAE drug index information on Prostin Vr Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.