Alprostadil IV

Alprostadil IV is a prescription medication used to treat the symptoms of Erectile Dysfunction (impotence). It is also indicated for palliative therapy to temporarily maintain patency of ductus arteriosus until surgical correction in neonates with congenital heart defects (eg, pulmonary atresia, pulmonary stenosis, tricuspid atresia, tetralogy of Fallot, interruption of the aortic arch, coarctation of the aorta, transposition of the great vessels)

• Alprostadil IV is available under the following different brand names: Prostin VR Pediatric

Pediatric dosage

• IV solution
• 500mcg/mL

Maintain Patency of Ductus Arteriosus

Pediatric dosage

• Neonates less than 28 days: 0.05-0.1 mcg/kg/min IV initially; usual maintenance ranges from 0.01-0.4 mcg/kg/min  
• Reduce infusion rate to provide the lowest possible dosage that maintains response; often effective at 0.01-0.05 mg/kg/min

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Alprostadil IV include:

• injection site reactions (mild/moderate pain, irritation, or slight bleeding),
• unusual discharge from the penis,
• pain in the penis/urethra/testicles,
• headache,
• dizziness,
• back pain,
• a rash on the skin of the penis,
• itching/warmth/numbness of the penis,
• cough,
• stuffy nose,
• cold symptoms, and
• flu symptoms.

Serious side effects of Alprostadil IV include:

• redness/tenderness/swelling of the penis, 
• lumps or unusual curving of the penis.

Rare side effects of Alprostadil IV include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Alprostadil IV has no noted severe interactions with any other drugs.
• Alprostadil IV has no noted serious interactions with any other drugs.
• Alprostadil IV has no noted moderate interactions with any other drugs.
• Alprostadil IV has no noted minor interactions with any other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to drug or components; respiratory distress syndrome; persistent fetal circulation; hyaline membrane disease; the presence of dominant left to right shunt

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Alprostadil IV?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Alprostadil IV?”

Cautions

• Adverse effects and toxicity include apnea, seizures, fever, hypotension, leukocytosis, and pulmonary over circulation
• Neonates usually are intubated prophylactically because of the potential risk of apnea (10-12%)
• Prolonged use occasionally is necessary (in hypoplastic left heart syndrome transplant candidates) and may be associated with the third spacing of fluid
• Monitor blood oxygenation and arterial pressure
• Infuse at the lowest dose for the shortest time possible
• Antral hyperplasia and gastric outlet obstruction have been associated with infusions above 120 hours
• Caution with concurrent use of antiplatelet drugs or anticoagulants

Pregnancy & Lactation

• Do not use it in pregnancy. The risks involved outweigh the potential benefits. Safer alternatives exist.
• Lactation 
  • Not indicated for use in women