Prostaglandin E1 was isolated in 1957 and approved for medical use in the United States in 1981. It is on the World Health Organization’s List of Essential Medicines, the safest and most effective medicines needed in a health system. In the United Kingdom, a dose costs the NHS about 75 pounds. In the United States, it costs $100–200 per dose.In babies, however, prostaglandin E2 works as well as prostaglandin E1 and is much less expensive.
Common side effects when given to babies include decreased breathing, fever, and low blood pressure. When used for erectile dysfunction side effects may include penile pain, bleeding at the site of injection, and prolonged erection (priapism). Prostaglandin E1 is in the vasodilator family of medications. It works by opening blood vessels by relaxing smooth muscle.
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How it works?
Alprostadil is a prostaglandin, specifically prostaglandin E 1, that is produced endogenously to relax vascular smooth muscle and cause vasodilation. The total prostaglandin concentration occurring naturally in human seminal fluid is 100 to 200 mg per mL and includes prostaglandins E 1 and E 2.
Impotence therapy agent—When administered by intracavernosal injection or as an intraurethral suppository, alprostadil acts locally to relax the trabecular smooth muscle of the corpora cavernosa and the cavernosal arteries. Swelling, elongation, and rigidity of the penis result when arterial blood rapidly flows into the corpus cavernosum to expand the lacunar spaces. The entrapped blood reduces the venous blood outflow as sinusoids compress against the tunica albuginea.
Adding papaverine and phentolamine to the alprostadil regimen synergistically increases arterial blood flow via separate mechanisms. Papaverine relaxes the sinusoid and the smooth muscle of the helicine arteries, while phentolamine relaxes arterial smooth muscle and blocks the alpha-adrenergic receptors that inhibit an erection.
Signs of potential side effects, especially hypotension; prolonged erection; priapism; testicular pain or oedema; fibrosis of penis (injection only)
Signs and symptoms of systemic absorption, usually resulting from excessive doses, including dizziness, faintness, reflexive hypertension, prostatic disorders, rapid pulse, or respiratory infection
Alprostadil is also used in maintaining a patent ductus arteriosus in newborns. This is primarily useful when the threat of premature closure of the ductus arteriosus exists in an infant with ductal-dependent congenital heart disease, including cyanotic lesions (e.g., hypoplastic left heart syndrome, pulmonary atresia/stenosis, tricuspid atresia/stenosis, transposition of the great arteries) and cyanotic lesions (e.g., coarctation of the aorta, critical aortic stenosis, and interrupted aortic arch).
Impotence therapy agent
Initial: Intraurethral, 125 or 250 mcg a day, followed by dose adjustments in stepwise fashion on separate occasions as instructed by a physician.
Maintenance: Intraurethral, an individual dose established by a physician is inserted by the patient between ten and thirty minutes before intercourse. Dosage adjustments require physician consultation. No more than two suppositories should be used within twenty-four hours.
Results from the pilot-study suggest that intravenous PGE(1) may be used efficaciously and safely to prevent RCM-induced renal dysfunction in patients with pre-existing impaired renal function.
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Explored the preventative effects afforded by Prostaglandin E1 (PGE1) treatment of rabbits with CCl4-induced liver fibrosis. Found that PGE1 when used in conjunction with olive oil, did prevent the development of liver fibrosis after TACE. -SCBT Publication Review
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