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Also known as
MUSE, Alprostadil, Medicated Urethral System for Erection, Intraurethral Alprostadil
Definition
Alprostadil urethral suppository is used to treat men who have erectile dysfunction (also called sexual impotence). It belongs to a group of medicines called vasodilators that can increase blood flow by expanding blood vessels. This medicine causes an erection because it increases the blood flow to the penis.¹
Alprostadil should not be used as a sexual aid by men who do not have erectile dysfunction. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.¹
This medicine is available only with your doctor’s prescription.¹
Clinical Context
Urethral suppositories containing alprostadil (MUSE) are used clinically as a second-line treatment for erectile dysfunction (ED) in men, particularly when oral therapies like PDE5 inhibitors are ineffective or contraindicated.²˒³ This method involves inserting a small medicated pellet into the urethra, which then releases alprostadil, a vasodilator. The alprostadil increases blood flow to the penis, facilitating an erection.²˒⁴
Patient selection criteria often include men who have not responded to oral medications, those who experience side effects from oral treatments, or individuals who prefer a non-oral, on-demand treatment. It can be particularly useful for ED resulting from prostate cancer treatment.⁵
The process involves the patient inserting the suppository into the urethral opening. The medication is absorbed through the urethral mucosa, leading to an erection within 5 to 20 minutes. The erection typically lasts for about 30 to 60 minutes.²
Clinical studies have shown varying success rates, with some reporting efficacy in achieving erections sufficient for intercourse in over 50% of patients.²˒³ The rapid onset of action and good safety profile are notable benefits.⁶ However, proper administration technique is crucial for effectiveness, and some patients may experience local side effects such as penile pain, urethral burning, or minor bleeding.²˒³