This is often use following failure of oral anti - impotence medications.
- The usual drug use is prostaglandin E1 ( Caverject )
- Best in patients who are motivated, reliable and compliant
- Cautions in patients with drug / alcohol abuse issues, & in those with bleeding disorders
- Not suitable for those with unstable cardiovascular / cerebrovascular disease, or sickle cell anaemia
- Priapism is a major albeit rare side effects of this therapy
Initial injection:
- 10ug initially
- Double test dose up to a maximum of 20ug.
Important Patient Information:
- Storage:
- Caverject should be in the refrigerator within 24 hours of the prescription filled
- Once removed from the refrigerator, Caverject should be used within 24 hours.
- Frequency of use:
- Up to 3x/week
- Ideally with at least 24 hours between each dose
- Dosage:
- First dose should not be given at night
- Patients may increase their dose in order to achieve an erection of 30 - 60 minutes duration or less if desirable.
- Adverse effects:
- Most common are:
- pain
- bruising
- fainting
- scarring / fibrosis
- priapism
- Most avoidable by careful injection technique
- Technique:
- Tap the syringe to expel air bubbles
- Hold the penis stretched across the opposite thigh
- Insert the needle at a 90 degree angle to the shaft of the penis
- Do not move the needle anymore while injecting the solution
- Pull back the foreskin so the solution is not accidentally injected into the glans
- Do not continue pushing the plunger if undue force is required or if the injection is painful
- Apply pressure to injection site for 60 seconds
- Injection sites should be varied, but always inject along the sides of the shaft and avoid superficial veins
- Follow - up:
- Review patients at 1 month initially
- Then every 6 months
