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What should I discuss with my healthcare provider before using alprostadil (Caverject, Caverject Impulse, Edex, Muse, Prostin VR Pediatric)?

Do not use alprostadil if you have:

• sickle cell anemia or the sickle cell anemia trait;
• leukemia;
• a tumor of the bone marrow (multiple myeloma);
• chronic urination problems;
• a history of blood clots;
• a curved or deformed penis;
• penile fibrosis or Peyronie's disease; or
• if you have been told you should not have sexual intercourse for health reasons.

Before using alprostadil, tell your doctor if you have:

• a bleeding or blood-clotting disorder;
• a disease that could be passed in blood (such as hepatitis or HIV);
• heart disease;
• high blood pressure (hypertension); or
• if you have a penile implant.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use this medication.

Use a condom to prevent transfer of this medication to your sexual partner if she is pregnant or could become pregnant.

Alprostadil should not be used by women or by anyone under 18 years old.

How should I use alprostadil (Caverject, Caverject Impulse, Edex, Muse, Prostin VR Pediatric)?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Using too much alprostadil can be very dangerous.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

The injectable form of alprostadil is injected into the side of the penis. The transurethral form is a very small suppository (pellet) that is inserted into the opening of the penis (the urethra).

Your first dose of this medicine will be given in your doctor's office so you can be observed for how well the medication works and if it causes any side effects. You will then be shown how to properly give the medication to yourself.

Do not give yourself an alprostadil injection or pellet if you do not understand the instructions for proper use. Call your doctor, nurse, or pharmacist for help with injection instructions. Using an alprostadil transurethral pellet improperly could cause damage to your urethra.

Alprostadil is used only when needed to get an erection. An erection should occur within 5 to 20 minutes after you use the medication, and should last for 30 to 60 minutes. The length of time your erection lasts may be slightly different from these averages.

To be sure this medication is not causing harmful effects, your penis will need to be examined on a regular basis. It is important that you not miss any scheduled appointments.

Alprostadil injectable is a powder medicine that comes with a sterile liquid for mixing it. Caverject Impulse is a brand of alprostadil injectable supplied as a needle and syringe that contains both the powder medicine and the sterile liquid. The dose is automatically mixed when you turn a dial on the end of the syringe. The Caverject Impulse syringe is designed for only one use. Carefully follow the instructions provided with this product.

Do not mix alprostadil injectable or draw your dose into a syringe until you are ready to give yourself an injection. Do not shake the mixed medication. After mixing, the medication should be clear, without any particles in it.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

The Caverject Impulse device uses a very thin needle, which could break easily. If the needle breaks during injection and you can see and grasp the broken end, remove it and contact your doctor. If you cannot remove the broken end, call your doctor right away.

An alprostadil injection can cause bleeding where the needle is placed. This can make it easier for your sexual partner to be exposed to your blood. Before using this medication, tell your doctor if you have a virus such as hepatitis or HIV, which can be passed to another person who comes into contact with your blood.

Do not use more than 2 alprostadil pellets in one day (24 hours). Do not use more than 3 alprostadil injections per week. Allow at least 24 hours to pass between injections.

Storing this medicine:

• Keep each urethral pellet in its original foil pouch until you are ready to use it. Store the foil pouches in the refrigerator. You may store the pouches at room temperature for up to 14 days.
• Store alprostadil injectable at room temperature. The 40 microgram strength of unmixed alprostadil can be stored at room temperature for up to 3 months, or until the expiration date on the label, whichever happens first.
• Do not expose alprostadil products to freezing or very hot temperatures. Do not store your medication in a closed automobile, or pack it into luggage that will be placed into a cargo area during travel.

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