Alprostadil by Ray Sahelian, M.D. Alprostadil cream

Alprostadil is a hormone like substance that is referred to as prostaglandin E1, a potent vasodilator. Alprostadil is a drug that was marketed for impotence years before Viagra became available. However, alprostadil (product name Muse) did not become very popular since it had to be injected in the penis.

Alprostadil topical cream
Alprostadil cream is generic for Befar or Alprox or Topiglan. Alprostadil is the first topical cream in the world for the treatment of erectile dysfunction. Alprostadil cream has a onset action of 15 minutes and can last several hours, and is nearly as effective as the injectable alprostadil. Alprostadil topical cream is formulated with enhanced skin-penetrating properties and is applied onto the penis. Injections of alprostadil directly into the penis have been used to treat erectile dysfunction, but administration can be painful.

Alprostadil topical cream for erectile dysfunction
Alprostadil cream may slightly improve erectile dysfunction and is generally well tolerated, with the most frequently reported side effect being burning or redness at the site of application. Two large studies of the cream called Alprox-TD (NexMed) show that alprostadil cream produces a "small but statistically significant improvement" in erectile function in many patients with mild-to-severe dysfunction.

Alprostadil topical cream research
Dr. Harin Padma-Nathan of the University of Southern California, Beverly Hills and Dr. James L. Yeager of Lake Forest, Illinois report two studies with than 1700 men with erectile dysfunction. The men were randomized to alprostadil cream, in dosages ranging from 100 to 300 micrograms, or to placebo cream. Erectile function scores rose by a mean of 1.6 to 2.5 points over baseline in the alprostadil groups and fell by 0.7 points in placebo patients. In addition, scores for vaginal penetration and maintenance of erection until ejaculation improved slightly. Overall improvements were modest, the researchers note that 52 percent of patients who used the 300-microgram alprostadil cream reported improved erections versus 20 percent of placebo patients. The study population included men with diabetes, men who had had their prostates removed, and men taking nitrates or alpha-blockers as well as men who had failed Viagra. Their mean age was 60 years. Urology, August 2006.

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