Caverject

Caverject is an injection of a chemical called alprostadil, produced by Upjohn, used to treat Erectile dysfunction (impotence in men).

Caverject Sterile Powder contains alprostadil as the naturally occurring form of prostaglandin E1 (PGE1) and designated chemically as (11alpha, 13E, 15S)-11,15-dihydroxy-9-oxoprost-13-en-1-oic acid. The molecular weight is 354.49. Alprostadil is a white to off-white crystalline powder with a melting point between 115° and 116°C. Its solubility at 35°C is 8000 micrograms (mcg) per 100 milliliter double distilled water.

Usage
Caverject is administered via small-needle injection into an area of the penis known as the corpus cavernosum. It works by relaxing smooth muscle tissue which, in turn, enhances blood flow to the penis, creating an erection. The drug is indicated for the treatment of erectile dysfunction whether the cause is neurological, vascular, psychological or of mixed origin. Patients selected for treatment with Caverject receive initial injections from medically-trained personnel to determine optimum dosing. Usual dosing is from 5 mg to 20 mg. Up to 60 mg can be injected at one time. Caverject can be administered by the patient once he has been trained to self-inject. The syringes are self-contained and easy to use. A kit contains the alcohol wipes used before and after to clean the penis, the needle which is attached to the syringe, and a preloaded syringe.

Penile Injection using Caverject System (note placement of needle) - Immediate Effect (notice swelling) - Resultant Erection (~10 minutes later)

Directions
First the user must remove the wipes and clean the injection site. The site chosen should be free of visible veins and on either side of shaft of penis. After attaching the needle the user must twist the syringe to mix the diluent (sterile, normal saline) and the drug. The syringe is then held upward and the excess air expelled by pushing the syringe as far as it will go. The dosage ring (blue) is turned until the desired dosage (5 mg, 10 mg, 15 mg, or 20 mg) is displayed. The needle is exposed by removing the needle cap and protector. The penis is secured with one hand. (Only one hand is visible in the photo because the other hand was holding the camera.) The other hand is used to insert the needle in the desired location and depress the top of the syringe all the way down. The needle is then withdrawn and the cap and protector replaced. The other wipe is used to clean any blood off the penis. Results usually take 5 to 20 minutes. The duration of the erection is related to the dosage, among other factor, and may last 30 mintutes to over an hour. Because of the very fine needle used the injection is seldom felt and generally not painful.

Side Effects
Caverject may cause mild pain, irritation or slight bleeding at the injection site. There is also a possibility to develop: tenderness or swelling of the penis, redness/lumps/unusual curving of the penis. Caverject can cause priapism and long-term use carries a 3% risk of developing fibrosis of the penis.