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Prostaglandin E1

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Prostaglandin E1
Clinical data
Trade namesCaverject, Muse, others
AHFS/Drugs.comMonograph
MedlinePlusa695022
License data
Routes of
administration		Intravenous
ATC code
Legal status
Legal status
Identifiers
  • 7-[(1R,3R)-3-hydroxy-2-[(1E,3S)-3-hydroxyoct-1-en-1-yl]-5-oxocyclopentyl]heptanoic acid
CAS Number
PubChemCID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard(EPA)
ECHA InfoCard100.010.925Edit this at Wikidata
Chemical and physical data
FormulaC20H34O5
Molar mass354.487g·mol−1
3D model (JSmol)
  • CCCCC[C@@H](/C=C/[C@H]1[C@@H](CC(=O)[C@@H]1CCCCCCC(=O)O)O)O
  • InChI=1S/C20H34O5/c1-2-3-6-9-15(21)12-13-17-16(18(22)14-19(17)23)10-7-4-5-8-11-20(24)25/h12-13,15-17,19,21,23H,2-11,14H2,1H3,(H,24,25)/b13-12+/t15-,16+,17+,19+/m0/s1☒N
  • Key:GMVPRGQOIOIIMI-DWKJAMRDSA-N☒N
☒NcheckY(what is this?)(verify)

Prostaglandin E1(PGE1) is a naturally occurringprostaglandinand is also used as a medication (alprostadil).[2]

In infants withcongenital heart defects,it is delivered byslow injection into a veinto open theductus arteriosusuntil surgery can be carried out.[3]By injection into thepenisor placement in theurethra,it is used to treaterectile dysfunction.[4]

Common side effects when given to babies include decreased breathing,fever,andlow blood pressure.[2]When injected into the penis for erectile dysfunction; side effects may includepenile pain,bleeding at the site of injection, andprolonged erection(priapism).[2]Prostaglandin E1is in thevasodilatorfamily of medications.[2]It works by openingblood vesselsand relaxingsmooth muscle.[2]

Prostaglandin E1was isolated in 1957 and approved for medical use in the United States in 1981.[2][5]It is on theWorld Health Organization's List of Essential Medicines.[6]

Biosynthesis[edit]

Prostaglandin E1is biosynthesized on an as-needed basis fromdihomo-γ-linolenic acid(anomega-6 fatty acid) in healthy humans withoutcoronary artery disease[7]and/or agenetic disorder.

Medical uses[edit]

Patent ductus arteriosus[edit]

Alprostadil is also used in maintaining apatent ductus arteriosusinnewborns,primarily for an infant with ductal-dependent congenital heart disease, including cyanotic lesions and acyanotic lesions.

Sexual dysfunction[edit]

Alprostadil is sold in the United States asurethral suppositories(brand nameMuse[8]) and in injectable form (brand names:Edex[9]andCaverject[10]). As a penile suppository, the medication is inserted into the urethra at least ten minutes before the erection is needed. Other forms similarly fast-acting, but instead are injected by the syringe directly into thecorpus cavernosum of the penis.

Alprostadil is also available as a generic. It must be mixed by acompounding pharmacy.The different formulations, including Bimix andTrimix,may includepapaverineand/orphentolamine.A typical mix might be 30 mg of papaverine, 2 mg of phentolamine, and 20 μg alprostadil.

The compound has been made into an applicabletopical creamform known asVitaros,[11]made byTakeda UKLtd., it contains either 200 or 300 μg of alprostadil in 100mg of cream. The tip of the device is placed in theurethral meatus,and the cream is delivered into the urethra.

Off-brand Uses, Interactions[edit]

Clinical trials for the treatment showed positive results in around 3,000 men that it was tested on; it is said to be usable by men with diabetes or heart problems and those who have undergone aprostatectomy.[12]It has no known interactions with food, alcohol or other medications.

Misoprostolis another synthetic prostaglandin E1 analog used to prevent gastric ulcers when taken on a continuous basis,[13]to treat missed miscarriage,[14]to induce labor,[15]and to induce abortion.[16]

Critical limb ischemia[edit]

Prostanoids, including alprostadil, do not reduce the risk of limb amputation but may offer a slight improvement in rest-pain and leg ulcer healing in persons with critical limb ischemia.[17]

Contrast-induced nephropathy[edit]

Preventative administration of alprostadil may reduce the risk of kidney injury (specifically contrast-induced nephropathy) in persons having cardiac angiography or percutaneous coronary intervention.[18][19]

Adverse effects[edit]

References[edit]

  1. ^"FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)".nctr-crs.fda.gov.FDA.Retrieved22 October2023.
  2. ^abcdef"Alprostadil".The American Society of Health-System Pharmacists.Archivedfrom the original on 16 January 2017.Retrieved8 January2017.
  3. ^Northern Neonatal Network (208).Neonatal Formulary: Drug Use in Pregnancy and the First Year of Life(5 ed.). John Wiley & Sons. p. 2010.ISBN9780470750353.Archivedfrom the original on 13 January 2017.
  4. ^British National Formulary (BNF)(69th ed.). British Medical Association. 2015. p. 569.ISBN9780857111562.
  5. ^Sneader W (2005).Drug Discovery: A History.John Wiley & Sons. p. 185.ISBN9780470015520.Archivedfrom the original on 13 January 2017.
  6. ^World Health Organization(2019).World Health Organization model list of essential medicines: 21st list 2019.Geneva: World Health Organization.hdl:10665/325771.WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  7. ^Meller SM, Stilp E, Walker CN, Mena-Hurtado C (2013)."The link between vasculogenic erectile dysfunction, coronary artery disease, and peripheral artery disease: role of metabolic factors and endovascular therapy".J Invasive Cardiol.25(6): 313–9.PMID23735361.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  8. ^"Muse Suppository - Facts and Comparisons".Drugs.com.Archivedfrom the original on 19 January 2013.Retrieved4 January2013.
  9. ^"Edex - Facts and Comparisons".Drugs.com.Archived fromthe originalon 26 October 2012.
  10. ^"Caverject - Facts and Comparisons".Drugs.com.Archived fromthe originalon 26 October 2012.
  11. ^"Vitaros 3 mg/g cream - Summary of Product Characteristics".Medicines.org.uk.Archived fromthe originalon 11 February 2015.
  12. ^"Vitaros- New Erectile Dysfunction Topical Treatment".Meds4All.co.uk.Archived fromthe originalon 11 February 2015.
  13. ^Walt RP (November 1992). "Misoprostol for the treatment of peptic ulcer and antiinflammatory-drug-induced gastroduodenal ulceration".The New England Journal of Medicine.327(22): 1575–1580.doi:10.1056/NEJM199211263272207.PMID1435885.
  14. ^Wu HL, Marwah S, Wang P, Wang QM, Chen XW (May 2017)."Misoprostol for medical treatment of missed abortion: a systematic review and network meta-analysis".Scientific Reports.7(1): 1664.Bibcode:2017NatSR...7.1664W.doi:10.1038/s41598-017-01892-0.PMC5431938.PMID28490770.
  15. ^Chatsis V, Frey N (2018).Misoprostol for Cervical Ripening and Induction of Labour: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines.CADTH Rapid Response Reports. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health.PMID30907996.
  16. ^"Medical abortion".Mayo Clinic.Retrieved28 April2022.
  17. ^Vietto V, Franco JV, Saenz V, Cytryn D, Chas J, Ciapponi A (January 2018)."Prostanoids for critical limb ischaemia".The Cochrane Database of Systematic Reviews.1(1): CD006544.doi:10.1002/14651858.CD006544.pub3.PMC6491321.PMID29318581.
  18. ^Ye Z, Lu H, Guo W, Dai W, Li H, Yang H, et al. (November 2016)."The effect of alprostadil on preventing contrast-induced nephropathy for percutaneous coronary intervention in diabetic patients: A systematic review and meta-analysis".Medicine.95(46): e5306.doi:10.1097/MD.0000000000005306.PMC5120914.PMID27861357.
  19. ^Xie J, Jiang M, Lin Y, Deng H, Li L (August 2019). "Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials".Angiology.70(7): 594–612.doi:10.1177/0003319719825597.PMID30669852.S2CID58950588.
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