A to Z of MS
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A to Z of MS Alprostadil (Caverject, MUSE, Viridal)
Product name
Caverject, MUSE, Viridal
Alprostadil is a vasodilator for the treatment of erectile dysfunction, which can affect men with multiple sclerosis . The NICE Guideline states that treatment with alprostadil may be considered where general and specific factors that cause or worsen erectile dysfunction have been assessed and there has been no response to sildenafil (Viagra).
How alprostadil works
Alprostadil is a synthetic form of prostaglandin, a naturally occurring chemical in the body. It works by causing blood vessels to expand, increasing blood flow. When this is administered to the penis the increased blood flow results in an erection.
How alprostadil is given
Alprostadil is applied directly to the penis by injection (under the trade names Caverject or Viridal Duo). Alternatively, a pellet can be inserted with an applicator into the tip of the penis (known as MUSE - Medicated Urethral System for Erections).
Side effects and contraindications
Side effects of Caverject and Viridal Duo can include pain in the penis or groin and bleeding in the tissue around the injection site. Less frequently, the erection may not subside for several hours, known as priapism. This can be uncomfortable and without medical attention may result in tissue damage in the penis.
A side effect with MUSE is a burning feeling or irritation at the end of the penis. The partner may also experience similar pain after penetrative sex and oral sex should be avoided with a man using MUSE. MUSE shouldn't be used if the partner is pregnant.
Reference
Landtblom AM.
Treatment of erectile dysfunction in multiple sclerosis.
Expert Review Of Neurotherapeutics 2006;6(6):931-935.
abstract