Caverject/ml (5 injections) Vials

Caverject contains alprostadil (prostaglandin E1), a vasodilator that is injected directly into the corpus cavernosum of the penis to produce an erection. It is used for erectile dysfunction that has not responded to oral treatments such as PDE5 inhibitors, or when oral medicines are contraindicated.

How does Caverject work?

Alprostadil relaxes the smooth muscle in the corpus cavernosum and dilates the penile arteries, increasing blood flow into the erectile tissue. At the same time, the expanding corpora compress the veins, trapping blood and producing a rigid erection. The injection bypasses the need for sexual stimulation to initiate the erection, though stimulation may enhance the response.

Who uses Caverject?

Caverject is typically prescribed for men with severe erectile dysfunction that does not respond to PDE5 inhibitors, men who cannot take oral treatments (for example those on nitrate therapy), men with neurological causes of ED (such as spinal cord injury or post-prostatectomy), and those who prefer the reliability of an injection over oral medication.

How to Use Caverject

The first injection of Caverject (alprostadil) is always given under medical supervision to find the right dose for you and to teach the self-injection technique. Inject into the side of the shaft of the penis, alternating sides with each use, and avoid visible veins. An erection usually develops within 5 to 15 minutes and typically lasts 30 to 60 minutes.

Injection Technique

Clean the injection site with an alcohol swab and allow it to dry. Insert the needle at a 90-degree angle into the corpus cavernosum (the spongy tissue along the side of the shaft). Inject slowly, then withdraw the needle and apply gentle pressure to the injection site for around 2 to 3 minutes to prevent bruising. Do not inject more than once in any 24-hour period, and limit use to a maximum of 3 times per week.

Dose

The starting dose is usually 2.5 to 5 micrograms, adjusted upward by your doctor until an erection suitable for intercourse is achieved without side effects. The maximum dose is 40 micrograms.

Initial dose is determined by the prescriber (usually 2.5 to 5 mcg). Titrate upward in increments of 2.5 to 5 mcg until an erection sufficient for intercourse is achieved, lasting no more than one hour. Maximum dose: 40 mcg. Maximum frequency: once per day and no more than three times per week.

Common Side Effects

• Penile pain during or after injection (common initially, usually settles with continued use)
• Bruising or minor bleeding at the injection site
• Prolonged or painful erection (see below)
• Penile fibrosis or scarring (with long-term repeated use in the same spot)
• Haematoma

Prolonged Erection (Priapism)

An erection lasting more than four hours is a medical emergency and requires immediate attention at a hospital emergency department. Do not wait to see if it resolves on its own. Prolonged erection can permanently damage the erectile tissue if not treated promptly. Caverject should not be used by men who are predisposed to priapism, such as those with sickle cell disease or leukaemia.

Priapism is the most serious risk. Never exceed the prescribed dose or frequency. If an erection lasts more than four hours, attend an emergency department immediately. Regular clinical review (every three months initially) monitors for early signs of penile fibrosis.

Needle safety

Dispose of needles in a sharps container. Never share needles or allow the injection to be given by someone other than the patient or their trained healthcare provider.

Contraindicated in conditions predisposing to priapism (sickle cell disease, multiple myeloma, leukaemia), anatomical penile deformities (Peyronie's disease with severe curvature), penile implants, and known hypersensitivity to alprostadil.