[juliofrippo]

Can alprostadil injections be used by myeloma patients?

by juliofrippo on Mon Mar 31, 2014 7:19 pm

I have been in complete remission for over one year following my bone marrow transplant. I read where alprostadil (Caverject, Edex) is not recommended for use by men with multiple myeloma. I would like to renew my sexual life now that I feel well, but would need the alpro­stadil to do so. I have never suffered from priapism when I used this medication prior to being diagnosed with multiple myeloma. In fact, I'm sure that I did use it when I already had myeloma, but before the actual diagnosis was rendered.

Is the risk of using alprostadil worth the benefit of strengthening my marriage? I would really like others' views on this as I suspect I am not the only myeloma male in remission that would benefit from alprostadil.

[Dr. Edward Libby]

Re: Can alprostadil injections be used by myeloma patients?

by Dr. Edward Libby on Sat Apr 05, 2014 12:51 pm

Hello from Seattle Juliofrippo,

This is a very interesting question. I think the contraindication to use of alprostadil (a prosta­glandin) in myeloma is more theoretical than proven.

In some studies, the enzyme Cox-2 has been shown to be upregulated in myeloma. Cox-2 con­verts arachodonic acid to prostaglandins. Increased Cox-2 activity can increase the pro­duction of prostaglandins and may play a role in growth of myeloma cells and resistance to chemo­therapy. Therefore, giving prostaglandins to myeloma patients could theoretically worsen the course of the disease.

There are other treatments that can improve erectile function. You may want to see your urol­ogist to reevaluate possible treatments.

[juliofrippo]

Re: Can alprostadil injections be used by myeloma patients?

by juliofrippo on Mon Apr 07, 2014 11:14 am

Thank you Dr. Libby. Your response was very helpful.