Alprostadil

Alprostadil is a vasodilator and platelet aggregation inhibitor, prostaglandin E1 (PGE1). It belongs to group of compounds called autacoids (autacoids function as a local hormone). Chemically Alprostadil is identified as (11a, 13E, 15S)-11, 15-dihydroxy-9-oxoprost-13-en-1-oic acid. Alprostadil is isolated from the seminal vesicle tissues of sheep. Alprostadil is used for temporary maintenance of the patent ductus arteriosus until corrective or palliative surgery can be performed in neonates with congenital heart defects. Administered intravenously or intra-arterially.

Brands
PROSTAVASIN CAVERJECT
Adult Dose
Dose: 50 to 100 ng/ kg/min
Single Dose: 75 (75)
Frequency: As recommended.
Route: IV-inf
Instructions: Initial dose. Advance to 0.2 mcg/kg/min if necessary. USUALLY GIVEN TO NEONATES. For Maintenance dose; When increase in PaO2 is noted, decrease immediately to lowest effective dose.
Neonatal
Dose: 5 to 100 ng/kg/min
Single Dose: 52 (52.5)
Frequency: As recommended.
Route: IV-inf
Instructions: Initially 5 ng/kg/min adjust according to responce in steps of 5ng/kg/min
Paedriatic
Characteristics
Alprostadil also known as PGE 1. . It is of Synthetic origin and belongs to Enoic acid. It belongs to PGE-I-agonist pharmacological group on the basis of mechanism of action and also classified in Antidotes and Prostaglandin pharmacological group.The Molecular Weight of Alprostadil is 354.50. Its pKa is 6.3.
Contraindications
Alprostadil is contraindicated in conditions like Asthma,Bronchospasm.
Effects
Alprostadil produces potentially life-threatening effects which include Apnea, Seizures, Severe Hypotension, Severe hypotension. which are responsible for the discontinuation of Alprostadil therapy.The signs and symptoms that are produced after the acute overdosage of Alprostadil include Bradycardia, Hypotension, Flushing, Apnea, Pyrexia.The symptomatic adverse reactions produced by Alprostadil are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Diarrhea, Abdominal cramps, Flushing, Reaction at injection site, dizziness.
Indications
Alprostadil is primarily indicated in conditions like Patency of ductus arteriosus, and can also be given in adjunctive therapy as an alternative drug of choice in Congestive heart failure, Erectile dysfunction, Ischaemic heart disease, Liver diseases, Pulmonary hypertension, Respiratory distress syndrome.
Interactions
Alprostadil is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCaptoprilEnhanced hypotensive effects when alprostadil given with ACE inhibitors (e.g Captopril)Clonidine (HCl)Enhanced hypotensive effects when alprostadil given with Clonidine.DiazoxideEnhanced hypotensive effects when alprostadil given with Diazoxide.Enalapril (Maleate)Enhanced hypotensive effects when alprostadil given with ACE inhibitors (e.g Enalapril)Glyceryl TrinitrateEnhanced hypotensive effects when alprostadil given with Nitrates (e.g Glyceryl trinitrate).Hydralazine (HCl)Enhanced hypotensive effects when alprostadil given with Hydralazine (HCl).LacosamideLosartan (K)Enhanced hypotensive effects when alprostadil given with Losartan (Angiotensin-II receptor antagonist).MethyldopaEnhanced hypotensive effects when alprostadil given with Methyldopa.MoxonidineEnhanced hypotensive effects when alprostadil given with Moxonidine.PrazosinEnhanced hypotensive effects when alprostadil given with Alpha-blockers (e.g Prazosin)Propranolol (HCl)Enhanced hypotensive effects when alprostadil given with Beta-blockers (e.g propranolol)QuinaprilEnhanced hypotensive effects when alprostadil given with ACE inhibitors (e.g Quinapril)RamiprilEnhanced hypotensive effects when alprostadil given with ACE inhibitors (e.g Ramipril)Verapamil (HCl)Enhanced hypotensive effects when alprostadil given with Calcium-channel blockers (e.g Verapamil) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Paediatrics, Pregnant Mothers, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj Store Below 25°C. Protect from Sunlight. Suppositories Store in refrigerator.
Warnings
Alprostadil should be used with caution in patients with sickle cell anemia, leukemia, multiple myeloma or any allergies. This medication is not to be used by women or children. Should be used with caution in neonates with bleeding tendencies, respiratory distress syndrome.
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