Drugs List

Therapeutic Indications

Uses

Treatment of erectile dysfunction

Treatment of symptomatic erectile dysfunction in adult males due to neurogenic, vasculogenic, psychogenic or mixed aetiology.

Administration

To be administered by intracavernosal injection.

The usual site of administration is the dorsolateral aspect of the proximal third of the penis. Visible veins should be avoided. Both the side of the penis and the site of injection must be altered between injections.

Contraindications

Children under 18 years
Anatomical deformation of penis
Cavernosal fibrosis
Leukaemia
Multiple myeloma
Penile implant
Sickle cell disease
Sickle cell trait

Precautions and Warnings

Patients over 75 years
Cerebrovascular disorder
Congestive cardiac failure
Hepatic impairment
History of psychiatric disorder
Ischaemic heart disease
Pulmonary disease
Renal impairment
Severe cardiovascular disorder

Not for use with other agents for erectile dysfunction
Treat medical causes of erectile dysfunction before therapy
Self-admin. - only if adequately trained and have access to expert advice
Treatment for priapism should not be delayed more than 6 hours
Treatment to be initiated by medically trained personnel
Monitor every 3 months especially in initial stages of self injection
Advise patient to report any erection lasting more than 4 hours
Discontinue if cavernal fibrosis develops
Discontinue if penile angulation develops
Discontinue if Peyronie's disease develops
Discontinue treatment if arrhythmias occur

Pregnancy and Lactation

Pregnancy

Not indicated for use in women.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Not indicated for use in women.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Angina pectoris
Bruising at injection site
Dizziness
Fibrotic changes in corpora cavernosa
Fibrotic nodules
Flushing
Haematoma (injection site)
Headache
Local pain (injection site)
Myocardial infarction
Palpitations
Penile angulation
Penile fibrosis
Peyronie's disease
Priapism
Prolonged erection
Tachycardia

Presentation

Injections of aviptadil with phentolamine

Drugs List

Therapeutic Indications

Uses

Treatment of erectile dysfunction

Treatment of symptomatic erectile dysfunction in adult males due to neurogenic, vasculogenic, psychogenic or mixed aetiology.

Dosage

Adults

Elderly

Administration

To be administered by intracavernosal injection.

The usual site of administration is the dorsolateral aspect of the proximal third of the penis. Visible veins should be avoided. Both the side of the penis and the site of injection must be altered between injections.

Contraindications

Children under 18 years
Anatomical deformation of penis
Cavernosal fibrosis
Leukaemia
Multiple myeloma
Penile implant
Sickle cell disease
Sickle cell trait

Precautions and Warnings

Patients over 75 years
Cerebrovascular disorder
Congestive cardiac failure
Hepatic impairment
History of psychiatric disorder
Ischaemic heart disease
Pulmonary disease
Renal impairment
Severe cardiovascular disorder

Not for use with other agents for erectile dysfunction
Treat medical causes of erectile dysfunction before therapy
Self-admin. - only if adequately trained and have access to expert advice
Treatment for priapism should not be delayed more than 6 hours
Treatment to be initiated by medically trained personnel
Monitor every 3 months especially in initial stages of self injection
Advise patient to report any erection lasting more than 4 hours
Discontinue if cavernal fibrosis develops
Discontinue if penile angulation develops
Discontinue if Peyronie's disease develops
Discontinue treatment if arrhythmias occur

Pregnancy and Lactation

Pregnancy

Not indicated for use in women.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Not indicated for use in women.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Angina pectoris
Bruising at injection site
Dizziness
Fibrotic changes in corpora cavernosa
Fibrotic nodules
Flushing
Haematoma (injection site)
Headache
Local pain (injection site)
Myocardial infarction
Palpitations
Penile angulation
Penile fibrosis
Peyronie's disease
Priapism
Prolonged erection
Tachycardia

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: September 2015

Reference Sources

Summary of Product Characteristics: Invicorp 25 micrograms / 2 mg solution for injection. Evolan Pharma AB. Revised July 2015.