Prostaglandin E1
Pregnancy: C
Alprostadil (PGE1)
Brand names: Caverject, MUSE, Prostin VR, Edex
Adult dose
Dose: Peripheral arterial disease: 20–60 nanograms/kg/min IV; erectile dysfunction: 2.5–40 micrograms intracavernosal
Route: IV infusion (PAD) or intracavernosal (ED) or intraurethral (MUSE)
Frequency: Daily infusion × 2–4 weeks (PAD); as needed (ED)
Max: 60 nanograms/kg/min
PAD: 60 min infusion; vasodilatory and antiplatelet effects; MUSE: 125–1000 mcg intraurethral — less effective than IC
Paediatric dose
Route: IV
Frequency: continuous infusion
Max: 100 nanograms/kg/min
Concentration: 500 micrograms/mL concentrate nanograms/min/ml
Neonates: maintaining ductus arteriosus patency; start 5–10 ng/kg/min, titrate to response; monitor for apnoea (especially <2 kg)
Dose adjustments
Renal
No dose adjustment required
Hepatic
No dose adjustment required
Clinical pearls
- Neonatal use: keeps ductus arteriosus open in duct-dependent congenital heart disease; apnoea risk — have ventilatory support available
- PAD: significant improvement in walking distance and rest pain in critical limb ischaemia
- Priapism from intracavernosal route: medical emergency — phenylephrine injection is antidote
Contraindications
- Severe hypotension
- Acute MI (within 3 months)
- Penile deformity/implant (for IC use)
- Sickle cell disease (priapism risk)
Side effects
- Hypotension
- Pain at injection site
- Priapism (intracavernosal — >4h is emergency)
- Flushing
- Apnoea (neonates)
- Oedema
Interactions
- Antihypertensives (enhanced hypotension)
- Anticoagulants (increased bleeding)
Monitoring
- Blood pressure
- Oxygenation (neonates)
- Signs of hypotension
- Signs of priapism (ED use)
Reference: BNFc; BNF 86; SPC Prostin VR. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators