Caverject - description of the drug, instructions for use, reviews

Write a review

Reviews: 0

Manufacturers: Pfizer MFG. Belgium NV (Belgium)

Active ingredients

• Alprostadil

Disease class

• Lack of genital response
• Pulmonary valve insufficiency
• Atherosclerosis of the arteries of the extremities
• Raynaud's syndrome
• Thromboangitis obliterans [Berger's disease]
• Other specified peripheral vascular diseases
• Narrowing of the arteries
• Arteritis, unspecified
• Peripheral angiopathy in diseases classified elsewhere
• Tetralogy of Fallot
• Congenital tricuspid valve stenosis
• Congenital mitral stenosis
• Other congenital anomalies [malformations] of the heart
• Cramp and spasm
• Adverse effects of industrial vibration

Clinical and pharmacological group

• Not indicated. See instructions

Pharmacological action

• Potency stimulating
• Vasodilating

Pharmacological group

• Prostaglandins, thromboxanes, leukotrienes and their antagonists

Contraindications

Strict contraindications to the use of Caverject are:

• Anatomical deformations of the penis (Peyronie's disease, angulation or cavernous fibrosis);
• Presence of a penile implant;
• Diseases that can cause the development of priapism (including leukemia, myeloma, sickle cell anemia);
• Stricture of the urethra;
• Hypospadias;
• Venereal diseases;
• Age under 18 and over 75 years.
• Known hypersensitivity to alprostadil;

Also, the drug is not prescribed to men for whom sexual activity is not recommended or contraindicated.

Patients diagnosed with:

• Urethritis;
• Balanitis;
• Venous thrombosis or predisposition to it;
• Increased blood viscosity;
• Polycythemia;
• Thrombocytopenia;
• Cardiac ischemia;
• Chronic heart failure;
• Lung diseases.

Price

The drug is dispensed from pharmacies with a doctor's prescription. The undiluted solution must be stored at temperatures up to 25 °C. Approximate cost of 1 bottle of Caverject 10 mcg in Moscow:

Directions for use and dosage

The first injections are given in the doctor's office. You can administer the drug yourself only after detailed instructions and mastering the self-injection technique.

A solution for intracavernous administration is prepared from the lyophilisate. To do this, use only the included solvent or injection water with 0.9% benzyl alcohol. After dilution, the volume of the resulting solution is 1.13 ml. Depending on the dose of Caverject, 1 ml of solution contains 10.5 or 20.5 mcg of alprostadil, of which 10 or 20 mcg, respectively, enters the body after injection (0.5 mcg is lost due to adsorption on the walls of the bottle and syringe). The solution is injected into the dorsolateral part of the proximal third of the penis with a 27-30 G needle, 13 mm long.

The dose required for each patient is selected by careful titration taking into account the erectile response. The optimal dose is considered to be the one that causes an erection lasting enough for sexual intercourse, but not more than 60 minutes. If there is no reaction to the administered dose, the next one can be administered after about 1 hour, if there is a response - after a day. The patient should be under medical supervision until complete detumescence occurs (cessation of erection and reduction in the size of the penis).

Recommended dosage regimens:

• For erectile dysfunction of neurogenic etiology: initial dose - 1.25 mcg, second injection - 2.5 mcg, third - 5 mcg, then until the optimal dose is reached, the stepwise increase is 5 mcg;
• For erectile dysfunction of psychogenic, vascular or mixed etiology: initial dose - 2.5 mcg, second injection - 5 mcg in case of partial response to the first injection and 7.5 mcg in case of no response, then until the optimal dose is reached, the stepwise increase is 5 -10 mcg.

The maintenance dose is 5-20 mcg. Doses greater than 60 mcg are not recommended.

As an additional tool for diagnosing erectile disorders, Caverject is administered once in a dose that causes a normal erection.

Self-administration of the drug at home should begin with the dose prescribed by the doctor. If you need to change it, you should definitely consult your doctor. The recommended frequency of administration is no more than 3 times a week. Only one dose can be administered per day. An erection usually occurs 5-20 minutes after the injection.

Rules for self-injection:

1. Wash your hands with soap;
2. Remove the protective plastic cap from the bottle;
3. Using one of the napkins included in the kit, wipe the rubber stopper of the bottle;
4. Unpack the large needle marked 22G11/2 (do not remove the protective cap!) and connect it to the syringe;
5. Carefully remove the cap;
6. Holding the syringe with the needle up, move the plunger towards the o to remove excess solvent;
7. Pierce the rubber stopper of the bottle with a needle approximately in the center and inject the solvent into it;
8. Carefully holding the bottle with the syringe as one whole, stir the powder with light circular movements until completely dissolved;
9. Turn the bottle upside down;
10. After making sure that the tip of the needle is located below the liquid level, slowly draw the solution into the syringe to the desired level;
11. Lightly tap the syringe to remove bubbles;
12. Remove the needle from the bottle and put the protective cap on it;
13. Open the package with the second 27G1/2 needle, but do not take it out yet;
14. Remove the needle and protective cap from the large syringe and set aside;
15. Holding a syringe in one hand, take a smaller needle from the opened package and, without removing the cap, connect it to the syringe;
16. Take a comfortable position - sitting, reclining or standing;
17. Use your thumb and index finger to grasp the head of the penis. Pull back the penis and grasp it firmly with your hands so that it does not slip out during the procedure. For men who have not been circumcised, the foreskin should be retracted to accurately locate the injection site;
18. Carefully clean the injection site with a second napkin and set it aside;
19. Take the syringe with your thumb and forefinger, insert the needle with a confident movement at an angle of 90º;
20. Slowly press the plunger with your thumb or index finger until all the solution has been injected;
21. Remove the needle;
22. Holding the penis on both sides, press the napkin to the injection site and hold for about 3 minutes or until the bleeding stops;
23. Collect all used materials and throw them in the trash.

Injections should be given only in places indicated by the doctor, being careful to avoid getting into the veins. Repeated injections of the drug must be carried out alternately on one and the other side of the penis, choosing a new point on the corresponding side.

Drug interactions

Caverject is intended for monotherapy only, and therefore it cannot be mixed in joint therapy with other drugs to improve erectile function.

Drugs used to treat chronic diseases, such as diuretics, antihypertensives or antidiabetics, including insulin, do not affect the effectiveness of Caverject.

The decrease in the degree of binding of the solution to the walls of the bottle is due to the presence of benzyl alcohol in it. In this regard, the solution is more stable, and also ensures a more complete introduction of the drug into the body.

Side effects

The most common local side effect of Caverject, occurring in approximately 37% of patients, is pain in the penis. In 4% of cases, an excessively prolonged erection occurs (up to 4-6 hours), in 3% - hematoma, in 2% - ecchymosis at the injection site. The last two reactions are mainly associated with incorrect administration technique. In 3-4% of patients, fibrous nodules form, penile fibrosis, including angulation, and Peyronie's disease develop.

Very rarely (in less than 1% of cases), the following local reactions are possible: priapism (erection for more than 6 hours), hemorrhages, inflammation, itching and swelling at the injection site, balanitis, feeling of warmth in the penis or numbness, irritation, skin hyperesthesia, bleeding from the urethra, erythema, phimosis, fungal infection, painful erection, impaired ejaculation, venous discharge of blood from the cavernous bodies.

Relatively common systemic reactions: increased blood pressure, headache, dizziness, flu-like syndrome, pain, cough, nasal congestion, upper respiratory tract infections, sinusitis, prostatitis.

Very rarely (less than 1% of cases) the following are observed: thickening and/or swelling of the testicles, swelling or redness of the scrotum, a feeling of warmth in the testicles, pain in the testicles and/or scrotum, spermatocele, hematuria, increased frequency or disturbance of urination, urinary urgency , pelvic pain, vasodilation, tachycardia, peripheral vascular disorders, decreased blood pressure, supraventricular extrasystole, hypoesthesia, vasovagal reactions, muscle weakness, rash, pruritus, hyperhidrosis, dry mouth, nausea, calf muscle cramps, increased serum creatinine levels blood, dilated pupils.

An increase in heart rate and a decrease in blood pressure were observed when Caverject was used in doses of more than 20-30 mcg, so these symptoms are presumably dose-dependent, but have no clinical significance. There is evidence that only three patients were forced to discontinue treatment due to symptomatic hypotension.

Symptoms of overdose: pain in the penis, prolonged erection and/or priapism. Possible irreversible deterioration of erectile function. If the erection lasts less than 6 hours, only medical supervision is necessary, since spontaneous detumescence occurs quite often. If the erection persists for more than 6 hours, an intracavernous injection of an alpha-adrenergic agonist (epinephrine, etilephrine, ephedrine, phenylephrine) is given or blood is aspirated from the corpora cavernosa. In some cases, surgical treatment may be required.

How the drug works

The main active ingredient of Caverject is alprostadil. When administered into the penis, the drug suppresses alpha1-adrenergic receptors, promotes relaxation of the smooth muscle tissue of the corpora cavernosa, and improves blood microcirculation. Alprostadil also inhibits platelet aggregation (synthesis).

The drug has a narrow specialization. The use of Caverject is advisable:

• in the treatment of erectile dysfunction of psychogenic, vascular, neurogenic or mixed origin;
• before conducting diagnostics aimed at identifying the cause of erectile dysfunction.

Duration of action

The onset of action of the drug is observed 5-10 minutes after administration and lasts for 1-1.5 hours. If the duration of an erection exceeds 2 hours, you should consult a doctor to adjust the dosage of injections. To prevent such conditions, self-administration of Caverject should begin with a minimum dose.

special instructions

Before starting to use Caverject, it is necessary to diagnose the causes of erectile dysfunction.

Patients conducting self-treatment should constantly come to see a doctor, especially at the beginning, because Dose adjustment may be required. In the future, it is recommended to visit the doctor every 3 months to assess the safety and effectiveness of therapy, and, if necessary, adjust the dose.

With intracavernous administration, minor bleeding may occur. The risk increases in patients being treated with anticoagulants such as heparin or warfarin.

Prolonged erection in men receiving MAO inhibitors or alpha-agonists can lead to a hypertensive crisis.

Caverject

Active substance:

Alprostadil*

Pharmgroup:

Prostaglandins, thromboxanes, leukotrienes and their antagonists

Average price in pharmacies