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Alprostadil (Injection)

Treats impotence. Also used during tests to find a cause for certain erection problems.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Brand names include
Caverject, Caverject Impulse, Edex
Other forms
Inside the urethra (urine tube), Intracavernosal route, Intravenous
Drug classes About this
Erectile Dysfunction Agent

What works? Research summarized

Evidence reviews

Prostaglandin E1 helps many men suffering from erectile dysfunction to have sexual intercourse

Men who experience erectile dysfunction (ED) are unable to achieve an erection sufficient for satisfactory sexual intercourse. One of the most common treatment is with prostaglandin E1 (PGE1), a naturally occurring PGE used to treat this dysfunction. Men either inject PGE1 into their penis or insert a pellet containing the drug into the end of the penis (into the urethra). The review of trials found that men using PGE1 reported more satisfactory sexual experiences. Higher doses gave greater benefits but also increased the adverse effects. The most common adverse effect is some pain, and men may prefer the urethral medication rather than injections.

Prostanoids for treating people with severe peripheral arterial disease of the legs

People with severely narrowed arteries of the lower limbs may suffer rest pain, ulcers, or gangrene, and this problem is called critical limb ischaemia. There is no option other than amputation for patients who present with critical limb ischaemia and who are unsuitable for rescue or reconstructive intervention of the arteries. The question is whether specific drugs such as prostanoids reduce mortality and progression of the disease, including amputations, more than placebo or other treatments. This review of 20 trials did not find any conclusive evidence that prostanoids provided long‐term benefit. Prostanoids seem to have efficacy regarding rest‐pain relief and ulcer healing. Iloprost may also have favourable results regarding major amputations. The more frequently reported adverse events when using prostanoids were headache, facial flushing, nausea, vomiting and diarrhoea

Prostaglandin E1 for preventing the progression of diabetic kidney disease

Continuous albuminuria (protein in the urine) is the major characteristic of diabetic kidney disease (DKD), which is regarded primary cause of death and poor health in patients with diabetes mellitus, leading to end‐stage‐kidney disease. While blood pressure medication (such as angiotensin‐converting enzyme inhibitors (ACEi), calcium channel blockers and angiotensin‐receptor blockers (ARB)) has been used/recommended for reducing albuminuria and preventing the progression of DKD, the incidence of DKD is still increasing among developed and developing countries. Prostaglandin E1 (PGE1) is a vasodilator agent which is thought to contribute to releasing intraglomerular pressure, increasing kidney blood circulation and reducing albuminuria. This review identified six studies (271 participants) comparing PGE1 with or without ACEi/ARB versus ACEi/ARB, no treatment or Xueshuantong (a Chinese medicinal herb). The results suggest that PGE1 may have a positive effect on DKD by reducing urinary albumin excretion rate (UAER), microalbuminuria and proteinuria. No serious adverse events or allergic responses were reported. All studies were methodologically poor and there is no strong evidence for recommending PGE1 for preventing the progression of DKD as a routine therapeutic measure. More high‐quality research is needed.

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Summaries for consumers

Prostaglandin E1 helps many men suffering from erectile dysfunction to have sexual intercourse

Men who experience erectile dysfunction (ED) are unable to achieve an erection sufficient for satisfactory sexual intercourse. One of the most common treatment is with prostaglandin E1 (PGE1), a naturally occurring PGE used to treat this dysfunction. Men either inject PGE1 into their penis or insert a pellet containing the drug into the end of the penis (into the urethra). The review of trials found that men using PGE1 reported more satisfactory sexual experiences. Higher doses gave greater benefits but also increased the adverse effects. The most common adverse effect is some pain, and men may prefer the urethral medication rather than injections.

Prostanoids for treating people with severe peripheral arterial disease of the legs

People with severely narrowed arteries of the lower limbs may suffer rest pain, ulcers, or gangrene, and this problem is called critical limb ischaemia. There is no option other than amputation for patients who present with critical limb ischaemia and who are unsuitable for rescue or reconstructive intervention of the arteries. The question is whether specific drugs such as prostanoids reduce mortality and progression of the disease, including amputations, more than placebo or other treatments. This review of 20 trials did not find any conclusive evidence that prostanoids provided long‐term benefit. Prostanoids seem to have efficacy regarding rest‐pain relief and ulcer healing. Iloprost may also have favourable results regarding major amputations. The more frequently reported adverse events when using prostanoids were headache, facial flushing, nausea, vomiting and diarrhoea

Prostaglandin E1 for preventing the progression of diabetic kidney disease

Continuous albuminuria (protein in the urine) is the major characteristic of diabetic kidney disease (DKD), which is regarded primary cause of death and poor health in patients with diabetes mellitus, leading to end‐stage‐kidney disease. While blood pressure medication (such as angiotensin‐converting enzyme inhibitors (ACEi), calcium channel blockers and angiotensin‐receptor blockers (ARB)) has been used/recommended for reducing albuminuria and preventing the progression of DKD, the incidence of DKD is still increasing among developed and developing countries. Prostaglandin E1 (PGE1) is a vasodilator agent which is thought to contribute to releasing intraglomerular pressure, increasing kidney blood circulation and reducing albuminuria. This review identified six studies (271 participants) comparing PGE1 with or without ACEi/ARB versus ACEi/ARB, no treatment or Xueshuantong (a Chinese medicinal herb). The results suggest that PGE1 may have a positive effect on DKD by reducing urinary albumin excretion rate (UAER), microalbuminuria and proteinuria. No serious adverse events or allergic responses were reported. All studies were methodologically poor and there is no strong evidence for recommending PGE1 for preventing the progression of DKD as a routine therapeutic measure. More high‐quality research is needed.

See all (9)

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