Alprostadil (alprostadil)
Alprostadil Injection Vial (Ml)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Alprostadil, the naturally occurring prostaglandin E1, is a vasodilating agent and a platelet-aggregation inhibitor.
Alprostadil, the naturally occurring prostaglandin E1, is a vasodilating agent and a platelet-aggregation inhibitor and is prepared synthetically for commercial use. Parenteral alprostadil is commercially available as a sterile powder for injection with (Caverject(R) Impulse(R)) or without alfadex (alpha-cyclodextrin) (Caverject(R)), as an alcoholic solution (Prostin VR Pediatric(R)), and as a lyophilized powder with alfadex (Edex(R)). The inclusion complex enhances the water solubility of alprostadil.
Alprostadil also is available as a urethral (micro) suppository, measuring 1.4 mm in diameter and 3 or 6 mm in length (Muse(R)). Prostaglandins of the E series occur naturally in the seminal vesicles and cavernous tissues of males and in the placenta and ductus arteriosus of the fetus. Alprostadil relaxes the smooth muscles of the corpus cavernosum and the ductus arteriosus.
Alprostadil is absorbed through the urethral mucosa and then distributed to corpus spongiosum and corpus cavernosum when administered as a urethral suppository.
Generic name: alprostadil
Drug class: Alprostadil
Therapeutic class: Cardiovascular Therapy Agents
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Alprostadil
Indications
The following indications are listed for Alprostadil:
- Congenital Heart Defect Requiring Patency Of Ductus Arteriosus
Also known as: Congenital Heart Defect Requiring Pre-Surgery Patency Of Pda, Ductal-Dependent Cardiac Lesion.
Dosing
No dosing information is available for this tab.
Alprostadil is administered by intracavernosal injection for the treatment and diagnosis of erectile dysfunction, by urethral suppository for the treatment of erectile dysfunction, or by continuous IV or intra-arterial infusion to maintain the patency of the ductus arteriosus in neonates.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
Alprostadil/Acetaminophen; Nsaids
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Alprostadil is a prostaglandin E1 product used to maintain patency of a patent ductus arteriosus (PDA).(1) Acetaminophen and nonsteroidal anti-inflammatory (NSAID) agents inhibit prostaglandins and may be used for PDA closure in addition to pain/fever management.(2-4)
CLINICAL EFFECTS: Simultaneous administration of acetaminophen or NSAIDs may result in decreased clinical effects from alprostadil, including reduction in PDA.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Avoid concurrent administration of acetaminophen or NSAIDs in patients on alprostadil for maintaining patency of a patent ductus arteriosus (PDA).(1)
DISCUSSION: NSAIDs and acetaminophen are used as management for patent ductus arteriosus (PDA) closure.(2-4) Alprostadil is used to maintain patency of a PDA.(1) In a case report, a 37-week gestational age neonate with cardiac defects required alprostadil therapy for PDA patency. After multiple doses of acetaminophen for pain, an echocardiogram showed reduction of the PDA requiring increased doses of alprostadil. Additional acetaminophen was discontinued. Follow up echocardiogram showed successful reversal of PDA reduction and alprostadil dose was reduced.(5)
There are no moderate interactions for this drug.
Contraindications
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- Pregnancy
- Apnea
- Pyloroduodenal obstruction
- Respiratory distress syndrome in the newborn
- Hypotension
- Increased risk of bleeding
Adverse reactions
There is no enhanced messaging for this drug.
More Frequent
- Apnea
Less Frequent
- Bradycardia
- Hypotension
- Seizure disorder
- Sepsis
- Tachycardia
Rare or Very Rare
- Anemia
- Anuria
- Bradypnea
- Cardiac arrest
- Chronic heart failure
- Disseminated intravascular coagulation
- Edema
- Erythema
- Hematuria
- Hemorrhage
- Hypercapnia
- Hyperkalemia
- Hypoglycemic disorder
- Hypokalemia
- Hypothermia
- Infantile cortical hyperostosis
- Intracerebral hemorrhage
- Lethargy
- Neck hyperextension
- Paroxysmal supraventricular tachycardia
- Peritonitis
- Respiratory depression
- Respiratory distress syndrome in the newborn
- Second degree atrioventricular heart block
- Shock
- Tachypnea
- Thrombocytopenic disorder
- Ventricular fibrillation
- Wheezing
More Frequent
- Fever
- Flushing
Less Frequent
- Diarrhea
Rare or Very Rare
- Drowsy
- Irritability
- Muscle rigidity
- Vomiting
Precautions
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
ICD codes
| Code | Type | Description |
|---|---|---|
| Congenital heart defect requiring patency of ductus arteriosus | ||
| Q20.3 | ICD10CM | Discordant ventriculoarterial connection |
| Q21.3 | ICD10CM | Tetralogy of fallot |
| Q22.0 | ICD10CM | Pulmonary valve atresia |
| Q22.1 | ICD10CM | Congenital pulmonary valve stenosis |
| Q22.4 | ICD10CM | Congenital tricuspid stenosis |
| Q22.9 | ICD10CM | Congenital malformation of tricuspid valve, unspecified |
| Q25.1 | ICD10CM | Coarctation of aorta |
| Q25.4 | ICD10CM | Other congenital malformations of aorta |
| Q25.5 | ICD10CM | Atresia of pulmonary artery |
ICD code information from First Databank (FDB).
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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