Muse (Alprostadil)

Alprostadil is a prostaglandin E1 analog used to manage erectile dysfunction by enhancing penile blood flow.

• Erectile dysfunction: improves the ability to achieve and maintain an erection sufficient for sexual activity.
• Penile arterial insufficiency: increases arterial inflow to the corpora cavernosa in cases of reduced penile blood supply.
• Penile rehabilitation after prostate surgery: may aid recovery of erectile function by promoting regular blood flow during the postoperative period.

• Alprostadil acts as a direct vasodilator by binding to prostaglandin E1 receptors on smooth muscle cells, raising intracellular cyclic adenosine monophosphate (cAMP). Elevated cAMP leads to relaxation of penile smooth muscle, dilation of arterioles, and increased arterial inflow, thereby facilitating erection in response to sexual stimulation.

Alprostadil may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Penile pain or discomfort during or after administration.
• Burning or stinging sensation in the urethra.
• Light‑headedness or dizziness.
• Headache.
• Redness or erythema of the penis.
• Vaginal discharge in female partners.

Serious or Rare Side Effects

• Priapism (prolonged erection lasting more than four hours).
• Severe hypotension leading to fainting.
• Allergic reactions such as rash, itching, or swelling.
• Local infection at the urethral site.
• Penile fibrosis with repeated use.
• Cardiovascular events in patients with underlying heart disease.

Before prescribing Muse, clinicians should evaluate patient suitability and monitor for potential risks.

• Cardiovascular assessment: ensure the patient can tolerate sexual activity and has no uncontrolled heart disease.
• Blood pressure monitoring: watch for hypotensive episodes, especially in patients on antihypertensives.
• Contraindication review: avoid use in patients with known hypersensitivity to alprostadil or prostaglandins.
• Interaction check: assess concurrent use of nitrates or PDE5 inhibitors.
• Patient counseling: advise on proper insertion technique and what to do if an erection persists beyond four hours.
• Store at ambient temperature: keep below 25 °C, protect from moisture and direct sunlight, and retain in the original packaging.

Alprostadil can interact with several medication classes; awareness helps prevent adverse events.

Major Interactions (Avoid)

• Nitrates: combined vasodilation may cause severe hypotension.
• Alpha‑blockers: additive blood‑pressure lowering effect.
• PDE5 inhibitors (e.g., sildenafil): increased risk of priapism.

Moderate Interactions (Monitor Closely)

• Antihypertensive agents: monitor blood pressure for additive effects.
• Warfarin: observe INR for potential changes.
• Alcohol: may enhance hypotensive response.
• Antidepressants (SSRIs): watch for altered sexual function dynamics.