Caverject Impulse (Alprostadil)
Medication information written by Dr. Larisa Roybal, PharmD
Updated - January 15, 2021
Caverject Impulse (Alprostadil) Medication Information
Uses
Caverject Impulse is a prostaglandin E1 agonist indicated for the treatment of erectile dysfunction and as an adjunct to other diagnostic tests in the diagnosis of erectile dysfunction (1.2)
Dosage
The injections are available in two strengths of freeze-dried powder for reconstitution in a dual chamber syringe:
- 10 mcg
- 20 mcg
Side Effects
The most common side effects of Caverject Impulse include:
- Penile pain
- Prolonged erection
- Penile fibrosis
Speak with your doctor or pharmacist for a full list of side effects that applies to you.
Precautions
Prolonged erection and priapism have occurred in patients receiving Caverject. To minimize the chances of this occurring, titrate Caverject Impulse slowly to the lowest effective dose. Advise patients to seek immediate medical assistance for an erection that persists longer than 4 hours
Penile fibrosis has occurred in patients receiving Caverject. Follow patients regularly to detect signs of penile fibrosis. Discontinue in patients who develop penile angulation or cavernosal fibrosis.
Hypotension - injections of Caverject Impulse can lead to increased peripheral blood levels of alprostadil, especially in patients with significant corpora cavernosa venous leakage. Avoid use in patients with known cavernosal venous leakage.
Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. Compress the site of injection with an alcohol swab or sterile gauze for 5 minutes.
Cardiovascular risk related to underlying medical conditions - Underlying treatable medical causes of erectile dysfunction should be diagnosed and treated prior to initiation of therapy.
Risks of use in combination with other vasoactive medications injected intracavernosal - Safety and efficacy of combinations of Caverject and other vasoactive agents have not been systematically studied. Use of such combinations is not recommended
Risk of needle breakage – Caverject Impulse uses a superfine needle and cases of needle breakage have been reported. Careful instruction in proper patient handling and injection techniques may minimize this risk.
Interactions
The potential for pharmacokinetic drug-drug interactions between alprostadil and other agents administered orally or intracavernosal has not been formally studied.
Speak with your doctor or pharmacist for more information.
Storage
Store at controlled room temperature (68º–77ºF).
Pharmacist Tips
- The Caverject Impulse carton contains two (2) sealed plastic trays, with one dose of Caverject in each tray.
- The use of other medical treatments for erectile dysfunction in combination with Caverject is not recommended. Discuss any concerns you may have about combination treatment with your doctor.
Caverject Impulse FAQs
What supplies are needed?
The Caverject Impulse carton contains two (2) sealed plastic trays, with one dose of Caverject in each tray. Each tray contains: (a) a syringe, (b) a separate needle assembly and (c) two alcohol swabs.
Can I take this if I am pregnant?
Caverject Impulse is not indicated for use in females.
Can I take this while breastfeeding?
Caverject Impulse is not indicated for use in females.
Who should not use Caverject?
Do not use Caverject Impulse if you have:
- Certain medical problems that might cause you to have an erection that lasts for more than 4 hours, such as sickle cell anemia, sickle cell trait, multiple myeloma, leukemia.
- A deformed penis shape
- A penile implant
How is the first dose administered?
Administration of the first injections of Caverject Impulse should be done in the physician’s office by medically trained personnel.
Can I reuse any extra solution in the cartridge?
Do not keep any solution in the cartridge to use for a second injection. When you have finished with the syringe, discard it carefully as recommended by your doctor, so no one will use it or stick themselves with it.
Related Drugs
Reference:
Caverject Impulse {package insert}. New York, NY: Pfizer Inc.; 2016.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021212s015s016lbl.pdf
Author: Dr. Larisa Roybal, PharmD
Dr. Roybal is a board-certified pharmacotherapy specialist who has practiced in both ambulatory and acute care settings. Her pharmacy interests include oncology and general inpatient pharmacy.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
