Caverdzhekt

Kaverdzhekt is a representative of a group of drugs that have the ability to affect the genitourinary system and the hormones of the reproductive system.

The drug is widely used in urology to restore erectile function. The pharmacological group, which includes Kaverdzhekt, consists of drugs that are analogues of prostaglandin E1.

The beginning of the drug begins after 5-10 minutes after injection. The duration of activity of the drug is from 1 to 3 hours, depending on the severity of the pathological process, the presence of concomitant pathology and the patient's age.

The dosage should be selected by the doctor for each patient individually. The first administration of the drug should be carried out in a hospital environment, after which it is possible to independently inject the patient, provided it is well prepared and skillful.

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Indications Caverdzhekt

The drug is used in urology with a therapeutic and diagnostic purpose. Thus, the indications for the use of Kaverdzhekt include the treatment of erectile dysfunction, the cause of which can be a psychogenic and neurogenic disorder. These include the pathology of the nervous system, psycho-emotional lability, constant stressful situations, experiences, a high workload at work and an insufficient amount of time allocated for sleep.

In addition, the cause of dysfunction of erectile function may be vascular pathology. As a result of spasm of blood vessels, there is an inadequate delivery of oxygen and nutrients to the genitals, which has a direct effect on erection.

It is worth noting that not always one factor affects sexual function, but a combination of several, which leads to erectile dysfunction of mixed origin.

Indications for use Kaverdzhekt also suggest the use of a medication to diagnose erectile disorders as an auxiliary component.

For the full-value treatment of erectile function, it is required not only to correctly diagnose, but also to identify the cause of the pathology. In addition, direct treatment of erectile function should eliminate the causative factor, otherwise the therapeutic effect may not be long-term.

Release form

The drug is used for intracavernous administration, so its release form is represented by a lyophilizate for the preparation of an injection solution.

Important physicochemical features of the drug are lyophilized powder with a white or beige shade. In addition, the kit includes a special solvent, which is a liquid without color, suspensions, with the smell of benzyl alcohol.

The main active component of the drug is alprostadil. It is contained in the amount of 10 μg in the vial. In addition, it is necessary to indicate the auxiliary components in the form of lactose monohydrate and sodium citrate. The form of the solvent is represented by water for injection with alcohol benzyl concentration of 9 mg / ml.

The package contains a filled syringe with a solvent of 1 ml, an injection needle in a plastic case, and a bottle of powder (lyophilizate).

This form of release makes it possible to prepare the drug directly before administration. Remains of medication after a single use are forbidden to use, since in a diluted form the drug can not remain for a long time.

Pharmacodynamics

The main active substance of the drug is contained in the tissues and fluids of animals. Alprostadil has various therapeutic effects, among which the most pronounced are vasodilator action, inhibition of platelet aggregation and protection of blood vessels.

Pharmacodynamics Kaverdzhekt is caused by alprostadil - an analogue of prostaglandin E1. Thanks to him, after intracavernous administration, alpha1-adrenergic receptors are blocked in tissues, muscle fibers of cavernous bodies relax, and local blood circulation activates, including microcirculation.

 Due to the removal of spasm and dilatation of arteries of cavernous bodies and trabecular muscles of a smooth type, a powerful blood supply and expansion of lacunae of cavernous bodies is provided.

Pharmacodynamics Kaverdzhekt provides an enhanced blood supply, while the corporal veno-occlusive mechanism is activated, as a result of which the outflow of blood through the veins localized under the belly membrane decreases. Thus, the onset of an erection is stimulated.

From the time of the administration of the drug to the development of an erection can pass from 5 to 10 minutes. The therapeutic effect of the drug is noted for 1-3 hours. The duration of an erection depends on the age of the patient, the severity of the pathology, which provoked erectile dysfunction, as well as the presence of concomitant diseases.

[2], [3]

Pharmacokinetics

The medication is intended for intracavernous administration and is characterized by rapid metabolism. After intravenous administration, about 80% of alprostadil circulating through the bloodstream is metabolized during passage through the respiratory system (lungs) with the help of omega and beta oxidation.

Due to enzymatic oxidation, several metabolites are obtained, including keto groups. Keto metabolites have less therapeutic activity than the main active substance of the drug.

Pharmacokinetics Kaverdzhekt provides removal of 90% metabolites of alprostadil by urinary organs throughout the day. The remaining 10% is excreted by the intestine. The entire administered dose is metabolized, so the drug is not unchanged in its unmodified form. In addition, there is no accumulation of alprostadil in tissues.

After intracavernous injection of 20 μg of alprostadol at 30 and 60 minutes, no significant increase in the concentration of the active component in the blood was detected. However, the amount of metabolites of the drug increased and reached a maximum in half an hour after the administration of Kaverdzhekt. An hour after the use of the drug, the level of metabolites returned to its previous values.

Alprostadil circulates along the bloodstream in a bound state with proteins, in particular albumins and to a lesser extent globulins. The association of the drug with erythrocytes and leukocytes has not been proved. After intracavernous administration, the drug is rapidly metabolized and exerts its therapeutic effect.

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Dosing and administration

The drug is intended for intracavernous administration. To do this, use a size needle of size 27-30. The way of application and dose should be selected by the doctor individually.

Intracavernous administration should be performed under sterile conditions. Localization of the injection is a site on the dorsolateral surface of the upper third of the penis (closer to the testicles). To avoid the development of local adverse reactions, you need to change the injection site each time, handle it with a swab with alcohol and avoid getting the needle into the visible veins.

For the preparation of the drug before administration, it is necessary to remove the plastic cap from the vial and wipe the rubber cap with an alcohol swab. Then you need to inject 1 ml of the solution from the syringe with the needle into the powder dilution bottle. To accelerate the process of dissolution, you can several times wipe the bottle.

Now you need to get the drug into the syringe (a little more than the intended dose), change the needle and remove the air from the syringe (this will result in a little drug).

After processing the place of administration of the drug, you need to make an injection. The remaining volume of the drug should not be used anymore, since the drug is not stored in a dissolved state.

With the diagnostic purpose, Kaverdzhekt is used in a dose of 20 mcg (for men without neurological pathology) and not more than 10 mkg (with neurological pathology), after which it is necessary to spread the massage movements along the penis. The therapeutic effect is assessed by establishing the time of the onset of erection and its duration. If the erection persists for more than an hour, it is necessary to take measures to accelerate the excretion of the drug. To avoid the development of priapism by the time the patient leaves the clinic, he should be rid of the erection and completely relax member.

The method of administration and dose are established, based on the severity of the pathology, the age of the patient and the presence of concomitant diseases. The initial dose for men with a lesion of the spinal cord is 1.25 μg, the subsequent two times more. The fourth dose should be 10 μg and then increase by 5 μg until an effective dose is obtained for the desired effect.

In the case of vascular, mixed or psychogenic reasons for the development of erectile dysfunction, it is recommended to start with 2.5 μg, then increase by 5 μg until the necessary therapeutic effect is obtained.

When the result is achieved, the dose should not be used more often than 1 time per day and more often 3 times a week. At the beginning of the treatment, intracavernosal injections with the drug should be performed by a medical professional, after which, having mastered the principles of administration, the patient can independently perform manipulation at home.

The optimal dose is the amount of medicine used, which provides an erection during the first hour. Do not exceed the maximum dosage (60 mcg) to prolong the erection for more than an hour. In most cases, 5-20 μg of alprostadol is sufficient.

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Use Caverdzhekt during pregnancy

During pregnancy, special control is needed over the medicines that the woman takes. In the first three months, the process of laying the bodies is carried out, interference in which can later manifest themselves in their inadequate development and inadequate functionality of the systems. 

However, this does not mean at all that the remaining 6 months of pregnancy do not require attention, since the fetus grows and develops at a given time, which is also important for its life.

The last trimester of pregnancy is important because the mammary glands of a woman are most intensively prepared for feeding a baby. With the use of medicines in recent terms, the probability of penetration of its metabolites into breast milk increases, which threatens the health and life of the baby.

The use of Kaverdzhekt during pregnancy is absolutely contraindicated in view of the fact that the drug is not intended for use by women. In addition, it is prohibited for admission during the period of feeding, as well as in childhood.

Contraindications

Before using any medication, you must first familiarize yourself with its contraindications to avoid the development of adverse reactions and worsening of the condition.

Contraindications to the use of Kaverdzhekt include the presence of an individual intolerance of alprostadol or excipients that are part of the drug.

In addition, it is forbidden to use the drug in diseases that contribute to the development of priapism. These include sickle cell anemia, erythrocyte anomaly, myeloma or leukemia. It is also necessary to take into account anatomical abnormalities of the structure of the penis, such as Peyronie's disease, angulation and cavernous fibrosis, urethral stricture and hypospadias.

Contraindications to the use of Kaverdzhekt include a ban on the use of the drug for men with penile implants. In addition, men who are contraindicated in sexual activity for various reasons, also it is not recommended to use Kaverdzhekt. The drug is prohibited before the age of 18 and after 75 years, as there is no data on the therapeutic effects of the drug in this group of patients.

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Side effects Caverdzhekt

Due to clinical studies, the side effects of Kaverdzhekt were detected, which were observed with its single or prolonged use.

In some cases, infection of the upper respiratory tract, including fungal pathogens, is observed. From the nervous system, there is dizziness, headache, loss of consciousness and changes in the sensitivity of the skin.

In addition, sometimes there is the appearance of mydriasis, hematomas at the injection site, ecchymoses and influenza-like syndrome. The cardiovascular system can respond to the administration of Kaverdzhekt by a violation of rhythm and conduction in the form of supraventricular ectrasystoles, damage to the veins, a decrease in blood pressure and excessive expansion of blood vessels.

Side effects of Kaverdzhekt also include nausea, dryness in the oral cavity, the appearance of rash, hyperhidrosis, redness, nasal congestion and cough.

The musculoskeletal system can respond to the use of the drug with muscle spasms, pain syndrome in the buttocks, lower extremities and lower back.

From the side of the urinary and reproductive system it is necessary to distinguish dysuric symptoms, the appearance of blood in the urine, frequent urge to urinate, urinary incontinence, as well as swelling of the testicles, pain in the penis, increased erectile function, damage to the penis and dysfunction of the prostate.

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Overdose

After intracavernous administration of the drug, it is possible to develop a prolonged erection or priapism. A man should notify a doctor about an erection lasting more than 4 hours. If priapism (long erections) persists for more than 6 hours, then it is necessary to take therapeutic actions. Such a condition is observed with an overdose of Kaverdzhekt.

The initial therapy is aspiration of the penis. For this, it is necessary to insert a butterfly needle into the cavernous spaces and aspirate 20-50 ml of blood. If necessary, the manipulation must be repeated on the other side of the penis and continue until 100 ml is collected.

If an overdose has occurred as a result of using an excessively large dose and aspiration has proved ineffective, then it is recommended that an alpha-adreno-ergic drug is intracavernosed. It is necessary to control the pressure and pulse of the patient with the use of vasoconstrictive drugs.

Overdose especially affects the health of patients with ischemic damage to blood vessels that feed the myocardium, brain ischemia, hypertension, as well as using monoamine oxidase inhibitors.

 With prolonged erection, it is necessary to prepare 200 μg / ml concentration of phenylephrine solution and inject 0.5-1 ml every 5-10 minutes. In the absence of this drug, the use of epinephrine with a concentration of 20 μg / ml is allowed.

After the introduction of these drugs and the insufficient effect, you should continue to bleed the blood from the penis. The maximum dose of phenylephrine is 1 mg, and for adrenaline, 100 μg (5 ml). In the absence of the effect of drugs and aspiration, surgical treatment - shunting - should be used.

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Interactions with other drugs

Studies on the simultaneous use of Caverectekt with other drugs for the treatment of erectile dysfunction, for example, sildenafil were not performed in order to avoid the development of a prolonged erection.

In addition, you should not use Coverage with drugs that can prolong the erection, such as papaverine. Interaction Kaverdzhekt  with other preparations influencing an erection, it is counter-indicative, as too long erection can threaten with the general health.

The use of Cavageject with drugs - sympathomimetics can reduce the activity of alprostadol, which can not provide the desired result with regard to erectile function.

Interaction Kaverdzhekt  with other preparations with antihypertensive action is shown by increase of effect of the last that threatens excessive depression by pressure and a collapse. Alprostadol activates the pharmacodynamics of vasodilators, anticoagulants and antiplatelet agents.

As a result of the combined use of Kaverdzhekt and drugs that affect the blood coagulation system, bleeding may develop.

At the same time intracavernous injection of alprostadol with the intake of diuretics, insulin, NSAIDs and oral hypoglycemic drugs does not cause adverse reactions.

Storage conditions

In order to maintain the medicinal properties of the drug for a certain period of time, it is necessary to take into account the recommendations for its storage.

So, it is necessary to maintain the optimum level of temperature, humidity and illumination in order to avoid premature loss of medicinal properties of the medication.

Storage conditions Kaverdzhekt means control over the temperature of the room where the drug is located. It should not exceed 25 degrees. In addition, it should be taken into account that direct sunlight adversely affects the structure of the drug, which can change its pharmacokinetics and pharmacodynamics.

A prerequisite is the lack of access of children to the drug. Children can be injured by a bottle or a needle, and also when ingesting powder, cause the development of adverse reactions and poisoning. To avoid this, it is necessary to store the Coverage in places that are inaccessible to children.

Special instructions

Kaverdzhekt is an effective remedy for the treatment of erectile dysfunction, but it requires special attention when used. So, applying a large dosage, the erection can observe up to 4-6 hours and even more that threatens the general condition of the man. To avoid surgical treatment of drug overdose, it is necessary to strictly follow the doctor's recommendations and do not exceed the dosage in order to prolong the erection for more than an hour.

Shelf life

Provided that the rules for the storage of the medicinal product are observed, the drug has its therapeutic potential for the whole shelf life.

In the manufacture of medicines, the expiry date must be indicated, which has a date of manufacture and last use. At the end of the expiry date, Kaverdzhekt, which is 2 years, is prohibited to use and the drug should be disposed of.

If during the expiration date the medicinal product is exposed to sunlight, excessive moisture, or the bottle has lost its tightness, then alprostadol can change its structure and the corresponding effects on the human body.