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Myron I. Murdock, M.D., F.A.C.S.
Intraurethral Drugs Intraurethral pellets of Prostaglandin E1, (PGE1 0r Muse) was the second medication approved by the Food and Drug Administration for the treatment of male erectile dysfunction. It is effective in approximately 40% of males with erectile dysfunction. It is best used in those patients with mild to moderate symptoms. Its major side effect is irritation of the urethra and penile discomfort which occurs in only 3% of patients. When used in conjunction with Viagra oral medication the two drugs are synergistic in their effect and make for an excellent combination therapy in those patients in which the Viagra is sub optimal and/or Muse sub optimal. There have been no studies on the combination of Viagra and Muse and therefore the Viagra package insert states that they are not indicated together. On the other hand, among urologists who treat impotence, the combination has excellent results and may be tried under physician management. Muse therapy comes in the dosages of 125, 250, 500, and 1,000 mcg. A small toothpick-like applicator holds the tiny pellet which is placed into the urethra quite easily and painlessly. Massage of the penis within five to ten minutes causes an erectile effect. Relatively large doses are needed because 90% of the drug is destroyed in the urethra, and only approximately 10% get absorbed into the erectile bodies of the penis as active prostaglandin E1.
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