Prostaglandin E1

Prostaglandin E1

File:Alprostadil.svg
File:Alprostadil-BallStick.png
Systematic (IUPAC) name
7-[(1R,3R)-3-hydroxy-2-[(1E,3S)-3-hydroxyoct-1-en-1-yl]-5-oxocyclopentyl]heptanoic acid
Identifiers
CAS Number	745-65-3
ATC code	C01EA01 (WHO) G04BE01
PubChem	CID 149351
DrugBank	APRD00785
Chemical data
Formula	C20H34O5
Molar mass	354.481 g/mol[[]]
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Prostaglandin E₁ (PGE1) is pharmaceutically known as Alprostadil. It is used as a drug in the treatment of erectile dysfunction and has vasodilatory properties.

Sexual dysfunction

Alprostadil is sold in the United States as urethral suppositories, under the brand name MUSE (Medicated Urethral Suppository for Erection) by Vivus. It is also sold in injectable form as Caverject and Edex.

Muse delivers alprostadil as a penile suppository, inserted into the urethra, at least ten minutes before the erection will be needed. Caverject and Edex are similarly fast-acting, but are actually injected directly into the corpus cavernosum of the penis.

NexMed is developing transdermal formulations—Alprox-TD(R) for men with erectile dysfunction and Femprox(R) for female sexual arousal disorder. Alprox-TD(R) has been selling in China and in Hong Kong since October 2001 and April 2002, respectively. Two Phase III studies have been completed for this product, and the Company is seeking regulatory approval in the U.S., Canada and Europe.

It is also available as a generic. The major cost is that it must be mixed by a compounding pharmacy and the alprostadil is sometimes difficult to get. There are different formulations (bi-mix, trimix) which may include papaverine and/or phentolamine. A sample mix might be papaverine 30 mg, phentolamine 2 mg, & alprostadil 20 mcg
As a generic, it is much less expensive than the pre-packaged injectables. For one thing, it is premixed (must be kept refrigerated) so one only loads the syringe with the quantity needed.

Other uses

Alprostadil is also used in maintaining a patent ductus arteriosus in the newborn. This is primarily useful when there is threat of premature closure of the ductus arteriosus in an infant with ductal-dependent congenital heart disease, including cyanotic lesions (e.g., pulmonary atresia/stenosis, tricuspid atresia/stenosis, transposition of the great arteries) and acyanotic lesions (e.g., coarctation of the aorta, hypoplastic left heart syndrome, critical aortic stenosis, interrupted aortic arch).

References

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