Alprostadil cream significantly reduces erectile dysfunction “in a broad range of patients” and is generally well tolerated, with the most frequently reported side effect being burning or redness at the site of application, research indicates.

Two large studies of the cream called Alprox-TD (NexMed) show that the topical agent produces a “small but statistically significant improvement” in erectile function in many patients with mild-to-severe dysfunction, researchers report in the journal Urology.

Injections of alprostadil directly into the penis have been used to treat erectile dysfunction, but administration can be cumbersome or uncomfortable, Dr. Harin Padma-Nathan of the University of Southern California, Beverly Hills and Dr. James L. Yeager of Lake Forest, Illinois note in their report.

In the two studies reported, more than 1700 men with erectile dysfunction were randomized to alprostadil cream, in dosages ranging from 100 to 300 micrograms, or to placebo cream.

Alprostadil topical cream is formulated with enhanced skin-penetrating properties and is applied onto the penis.

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 but significantly.”

Although 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.

It’s worth noting, Padma-Nathan and Yeager say, that 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.

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SOURCE: Urology, August 2006.