Alprostadil (Caverject) is also available in glass vials for reconstitution to provide 1 mL of solution containing either 10 or 20 ug/mL for intercavernosal penile injection to diagnose or correct erectile dysfunction in certain cases of impotence. The availability of orally administered drugs to treat erectile dysfunction has reduced the therapeutic use of this agent.
Prostaglandin E1 Cyclodextrin. This cyclic polysaccharide complex of PGE1 (Vasoprost) is available as an orphan drug for the treatment of severe peripheral arterial occlusive disease when grafts or angioplasty are not indicated. Cyclodextrin complexation is used to enhance water solubility and reduce rapid metabolic inactivation.
Misoprostol. Misoprostol, (16-(^,S)-methyl-16-hydroxy)-PGE1, methyl ester (Cytotec), is a modified prostaglandin analog that shows potent gastric antisecretory and gastro-protective effects when administered orally. Misoprostol is administered orally in tablet form in a dose of 100 to 200 /g 4 times a day to prevent gastric ulceration in susceptible individuals who are taking NSAIDs. Misoprostol is combined with the NSAID diclofenac (Voltaren) in an analgesic product (Arthrotec by Pharmacia), which is potentially safe for long-term antiarthritic therapy. This prostaglandin derivative absolutely should be avoided by pregnant women because of its potential to induce abortion. In fact, the combined use of intramuscular methotrexate and intravaginal misoprostol has been claimed to be a safe and effective, noninvasive method for the termination of early pregnancy.27
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