Which medications in the drug class Vasodilators are used in the treatment of Erectile Dysfunction?

Updated: Aug 08, 2018
  • Author: Edward David Kim, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Vasodilators

Some agents injected directly into the penis exert their relaxant effect directly on the smooth muscle of the corpora cavernosa. They can be used alone or in combination with other medications. The most commonly used agents are alprostadil (prostaglandin E1 [PGE1]), papaverine, and phentolamine. The optimal dosages and the most effective combination of these agents must be determined on a case-by-case basis.

These medications can be obtained as commercial preparations or can be formulated according to the physician’s request by compounding pharmacies. Patients can be supplied with vials of a single agent or a combination of agents mixed in a single vial. Patients must be instructed in the proper technique for administration.

A single intraurethral agent, PGE1, which has been formulated into a small suppository, is commercially available as a component of the Medicated Urethral System for Erections (MUSE). This agent was available before the introduction of sildenafil and is still used by a select group of men.

Alprostadil (Caverject, Caverject Impulse, Edex, Muse)

Alprostadil is identical to naturally occurring PGE1 and has various pharmacologic effects, including vasodilation and inhibition of platelet aggregation. When injected into the penile shaft, it relaxes trabecular smooth muscle and dilates cavernosal arteries, thereby, in turn, promoting blood flow and entrapment in the lacunar spaces of the penis, causing penile erection. Various doses have been employed.

Papaverine

Papaverine is a benzylisoquinoline derivative with a direct nonspecific relaxant effect on vascular, cardiac, and other smooth muscles. In the treatment of erectile dysfunction, it is injected intracavernosally into the penis to increase blood flow to the penis and produce an erection.

Phentolamine

Phentolamine is an alpha1- and alpha2-adrenergic blocking agent that blocks circulating epinephrine and norepinephrine, reducing the hypertension that results from catecholamine effects on the alpha-receptors. Injected into the penis, it causes an erection.


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