Dosage and Administration
The preferred route of administration for Alprostadil (PGE1) is by continuous intravenous infusion into a large vein. Alternately, the drug may be infused through an umbilical artery catheter with its tip positioned at the ductal opening. Increases in blood oxygenation (PO2) are similar by both routes of administration.
The infusion is generally initiated at a rate of 0.05 to 0.1 micrograms Alprostadil (PGE1) per kilogram of body weight per minute. Starting dosages lower than that have been used with apparent good response, but this experience has been largely anecdotal. The most experience has been with 0.1 micrograms/kg/min. After a therapeutic response (an increase in PO2 in neonates with restricted pulmonary blood flow or an increase in systemic blood pressure and blood pH in neonates with restricted systemic blood flow) has been obtained, the infusion rate should be reduced to the lowest possible dosage that will maintain the desired response.
In the event that the initial rate of 0.1 microgram/kg/min. is inadequate, the dosage may be cautiously increased up to 0.4 microgram/kg/min. However, in general, higher infusion rates do not produce greater effects.
Due to its instability, Alprostadil (PGE1) should be stored in a refrigerator at 2 - 8 degrees C (35.6 - 46.4 degrees F). Prepare fresh dilutions of Alprostadil (PGE1) every 24 hours. Discard any dilution more than 24 hours old.
Due to the low concentrations of Alprostadil (PGE1) to be employed, the following guidelines for the dilution of the drug are recommended -
Dilute 1ml (ampoule) of Alprostadil (PGE1) with sterile sodium chloride injection USP or sterile dextrose or glucose injection USP. Dilute to volumes appropriate for the delivery system available.
Alprostadil injection YouTube
penile injection technique by Dr Michael Gillman