Alprostadil (urethral route)


    Brand Name

    US Brand Name

    Muse

    Canadian Brand Name

    Muse Micro


    Description

    Alprostadil urethral suppository is used to treat men who have erectile dysfunction (also called sexual impotence). It belongs to a group of medicines called vasodilators that can increase blood flow by expanding blood vessels. This medicine causes an erection because it increases the blood flow to the penis.

    Alprostadil should not be used as a sexual aid by men who do not have erectile dysfunction. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.

    This medicine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Suppository

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Alprostadil urethral suppository is not indicated for use in children.

    Geriatric

    No information is available on the relationship of age to the effects of alprostadil urethral suppository in geriatric patients.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Heparin

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Abnormal penis, including curved penis and birth defects of the penis or
    • Heart or blood vessel disease or
    • Hyperviscosity syndrome or
    • Leukemia (blood related cancer) or
    • Multiple myeloma (blood related cancer) or
    • Polycythemia or
    • Priapism (prolonged erection) or
    • Sickle cell anemia (blood disorder) or
    • Sickle cell trait or
    • Thrombocythemia or
    • Trouble urinating—Chance of problems occurring may be increased and this medicine should be used with caution in these patients.
    • Bleeding problems—Chance of bleeding in the urethra may be increased.
    • Hypotension (low blood pressure) or
    • Syncope (fainting)—Use with caution. May make these conditions worse.

    Proper Use

    Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often or longer than your doctor ordered.

    This medicine comes with patient directions. Read and follow the instructions carefully. Ask your doctor if you have any questions.

    This medicine usually begins to work in about 5 to 10 minutes. You should attempt intercourse within 10 to 30 minutes after using the medicine. An erection may continue after ejaculation.

    To use:

    • Before inserting a suppository, you should urinate. The small amount of urine normally left in your urethra will help dissolve the suppository after it is inserted.
    • Remove the delivery device containing the suppository from the foil. Remove the cap from the applicator stem.
    • Stretch your penis upward to extend its length, pressing your penis top and bottom. Gently insert the delivery stem up to its collar into your urethra (located at the top of the penis). If you have pain or a pulling feeling in the penis, withdraw the device and start again.
    • Press the button down slowly as far as it will go. This releases the suppository into the urethra. After holding the delivery device within your penis still for 5 seconds, carefully rock the penis and delivery device as a unit from side to side. This helps remove the suppository from the device.
    • Remove the delivery device while your penis is upright. Look at the device to make sure that the suppository was completely released.
    • Repeat the process if a part of the suppository remains in the device.
    • After the suppository is completely released, roll your penis between your hands for 10 seconds. This helps to dissolve the suppository. If you feel any stinging, continue this motion to help stop it.
    • Sitting, standing, or walking for 10 minutes while an erection is developing helps increase the blood flow to your penis to gain a proper erection.
    • Replace the cap on the delivery device. After storing it in the foil, fold and throw away.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For urethral dosage form (suppositories):
      • For erectile dysfunction:
        • Adults—One suppository inserted into the urethra once a day, 10 to 30 minutes before sexual intercourse. Do not use more than 2 suppositories each day.
        • Children—Use is not recommended.

    Missed Dose

    If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

    Storage

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.

    Store unopened foil pouches in the refrigerator. Keep the medicine away from heat. It may not work if exposed to temperatures above 30 degrees C. You may also store the suppositories at room temperature for up to 14 days before each use.


    Precautions

    Do not use alprostadil suppositories if you have a penile implant unless advised by doctor.

    Use a condom when having sexual intercourse with a pregnant female while using this medicine. Although harm to the fetus is unlikely, using a condom will protect the fetus from exposure to this medicine. If a woman can become pregnant, use of contraceptive methods is recommended because the effects of this medicine on early pregnancy are not known.

    This medicine may make you dizzy or lightheaded. Do not drive or do anything that could be dangerous until you know how this medicine affects you.

    If too much is used, the erection lasts too long and does not reverse when it should. This condition is called priapism. If the erection is not reversed, the blood supply to the penis may be cut off and permanent damage may occur.

    Contact your doctor immediately if the erection lasts longer than 4 hours or if it becomes painful. This may be a sign of priapism and must be treated right away to prevent permanent damage.

    This medicine will not prevent pregnancy or protect you or your partner from diseases such as syphilis, herpes, or HIV. Use a latex condom during sex for protection.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    More common

    • Burning sensation in the urethra
    • pain in the penis or urethra

    Less common

    • Bleeding and pain in the testes
    • blurred vision
    • confusion
    • dizziness
    • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
    • pain in the testes
    • sweating
    • unusual tiredness or weakness

    Rare

    • Fainting

    Get emergency help immediately if any of the following symptoms of overdose occur:

    Symptoms of overdose

    • Painful or prolonged erection of the penis

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Back pain
    • chills
    • cough
    • diarrhea
    • fever
    • general feeling of discomfort or illness
    • headache
    • joint pain
    • loss of appetite
    • muscle aches and pains
    • nausea
    • runny nose
    • shivering
    • sneezing
    • sore throat
    • stuffy nose
    • sweating
    • swelling of the legs
    • trouble sleeping
    • vomiting

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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