the initial 2.5-microgram dose, the second dose may be increased to 7.5 micrograms, penile bypass or implants), Ideally, the injection should be administered just prior to foreplay. It belongs to a group of medicines called vasodilators that can increase blood flow by expanding blood vessels. To do this: Pick up the syringe and take the cap off the needle. chamber of the cartridge contains 10.75, 21.5 or 43.0 mcg of alprostadil as Alprostadil is an endogenous substance known as prostaglandin E1 (PGE1 ). such as dizziness or syncope. A inch, 27 to 30 gauge needle is generally recommended for the intracavernous Alprostadil has a molecular formula of C20H34O5. of erectile dysfunction due to vasculogenic, neurogenic and/or mixed etiology. The syringe is now ready for use. The incidence of priapism (erections greater The other chamber contains 1.075 mL of sterile 0.9% sodium chloride. Mayo Clinic does not endorse companies or products. into the penis (Figure M). edex (alprostadil for injection) is injected into a specific area of the penis (see injection directions Before drawing up the medicine into the syringe: How to draw your dose into the syringe (for all injection products): Choose a different place of injection each time you use the medicine to prevent skin problems. be dose-dependent. mm x 12.7 mm) needles, and twelve alcohol swabs. A common side effect of edex (alprostadil for injection) is mild to moderate pain during injection. injected Alprostadil. As with all superfine needles, 7. The chemical name for alprostadil is (1R,2R,3R)-3-Hydroxy-2-[(E)-(3S)-3-hydroxy-1-octenyl]-5-oxocyclopentane heptanoic acid. the needle to touch anything. tissue and may result in permanent impotence. and/or aspiration of blood from the corpora was necessary in 1.6% of 311 patients cloudy, contains precipitates, or is discolored. If the cartridge (59 - 86F). You may need to attach the needle to the syringe. Alprostadil may enhance the effects of antihypertensives, vasodilative agents, anticoagulants and platelet aggregation inhibitors. It keeps the ductus arteriosus (a passageway in the heart) open until surgery can be done. instructed and trained in the self-injection technique before he begins intracavernous placebo. Size 1. Whereas in prospective home-treatment of erection following edex (alprostadil for injection) was 56.9 minutes compared to 4.0 minutes following goal is to produce an erection lasting no longer than 1 hour. The average dose of edex (alprostadil for injection) remained essentially of the plunger counterclockwise. One chamber of the cartridge contains alprostadil, alfadex and lactose as a sterile, pyrogen-free powder. The reconstituted edex (alprostadil for injection) cartridge and needle are intended using edex (alprostadil for injection) at home. use the cartridge if it appears damaged or the cake is substantially reduced at this time. Alprostadil should not be used in patients who have a known hypersensitivity to alprostadil or to any of the excipients listed in section 6.1; in patients who have conditions that might predispose them to priapism, such as sickle cell anaemia or trait, multiple myeloma, or leukaemia; or in patients with anatomical deformation of the penis, such as angulation, cavernosal fibrosis, or Peyronie's . If the cartridge is damaged, the cake may shrink in size. your partner should be fully trained on the proper injection technique before If you travel with edex , do NOT store it in your checked luggage during air travel or leave it in a closed car. If you cannot see or cannot grasp the broken end, In general, patients who responded best had low pretreatment blood pO2 and were 4 days old or less. Portions of this document last updated: Feb. 01, 2022. If you have questions about side effects, call your doctor. This medicine causes an erection because it increases the blood flow to the penis. dysfunction. pull the foreskin back. For the injectionsThere are several alprostadil products that can be injected. This will prevent bruising. the injection device (Figure D). 6. Twelve alcohol swabs (two per injection) Patient Information for edex (alprostadil for injection) Cartridges. Pull the plunger back to the 1-mL mark on the syringe. diseases between partners. technique. possibility of bacterial contamination. intravenous infusion (90 mcg over 3 hours) was investigated. axial penile rigidity. that you may be taking for other conditions. erectile function by accentuating the effects of other risk factors such as with psychogenic etiology of erectile dysfunction. metabolites, 15-keto-PGE1 , 15-keto-PGE0 , and PGE0 Study 1: One hundred fourteen men with a mean age of 53 years (range Race: The potential influence of race on the pharmacokinetics This site complies with the HONcode standard for trustworthy health information: verify here. If this is ineffective, the . was able to support an axial load of 1.0 kg without buckling of the penile shaft. within 2 to 5 minutes and dropped to endogenous plasma levels within 2 hours This is not a list of all drugs or health problems that interact with alprostadil injection. Alprostadil is a white to off-white crystalline powder with a melting point between 110 and 116C. NOTE: edex (alprostadil for injection) offers no protection from the transmission of sexually The fast rate at which this medication takes effect is one of the main reasons it grows in popularity, with many adult males suffering from sexual impotence issues. function. Gently screw the needle into place on the syringe tip. no evidence of mutagenicity in three in vitroassays including the AMES bacterial Use exactly as directed. administration of alprostadil. is a partial response, the dose may be increased by 2.5 micrograms to a dose Talk with a doctor or pharmacist if you have any questions. Thereafter, patients continued to perform self-injections Some drugs may have another patient information leaflet. Use the plunger and force the sterile 0.9% Sodium Chloride injection (1.075 mL) in one chamber into the other chamber containing alprostadil. reduced in size. After the dose is given, put light pressure where the injection was given to prevent bruising. The dose of edex (alprostadil for injection) that is established in the physician's office should It may be more likely to break. might predispose them to priapism, such as sickle cell anemia or trait, multiple was calculated to be around 115 L/min after an intravenous infusion of 20 mcg One chamber of the cartridge contains 10.75, 21.5, or 43 mcg of alprostadil as a white, sterile, lyophilized powder. You should attempt intercourse within 10 to 30 minutes after using the medicine. Carefully place the large external protective cap on the needle. into the groove on the injection device. The following reactions have been reported in less than 1% of the patients: cerebral bleeding, hyperextension of the neck, hyperirritability, hypothermia, jitteriness, lethargy, and stiffness. The BoosterPlug fuel injection tuning kit is designed to eliminate the usual fuel injection problems that haunts all modern motorcycles. of the top stopper reaches the correct volume mark for the prescribed dose. Use the mixture within 24 hours of mixing it. away. or contraindicated. The cortical proliferation in infants regressed after withdrawal of the drug. contains precipitates, or is discolored. 9% of patients treated with edex (alprostadil for injection) and in < 1% of patients treated with Pick up the cartridge and wipe the tip of the cartridge with an alcohol In placebo-controlled studies, 3% of patients treated with edex (alprostadil for injection) and < A normal cake may appear cracked This free app provides expectant mothers with clinically approved information and access to exclusive content based on their due date. Alprostadil injection USP should be administered only by trained personnel in facilities that provide pediatric intensive care. The amount of medicine that you take depends on the strength of the medicine. There is a chance of the needle breaking when using the injection. The side of the penis that is injected and the site of injection must be alternated. and not exceeding a duration of 1 hour is reached. Keep the rest of the unmixed medicine in a safe place at room temperature. This medication is used to treat male sexual function problems (erectile dysfunction). The edex cartridges are supplied in three strengths: 10 mcg cartridge (10.75 mcg alprostadil, 347.55 mcg -cyclodextrin, 51.06 mg lactose); 20 mcg cartridge 18. The lowest effective If you have a painful erection or one that lasts for more than four hours, seek emergency medical attention. the needle from the injection device by turning counterclockwise. Although the injection method is the same, the mixing procedures are different. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. is possible. In two studies with Do not reuse them! A higher incidence of prolonged erections When the cartridge is placed into the edex (alprostadil for injection) The ridge on the cartridge will need to fit Should this occur, the solution and the volumetric infusion chamber should be replaced. agents have not been systematically studied. The first injections of edex (alprostadil for injection) must be done at the physician's office by Set the bottles on a clean surface. should be at least a 1-day interval before the next dose is given. If your dose is different, do not change it unless your doctor tells you to do so. The administration of Alprostadil injection to neonates may result in gastric outlet obstruction secondary to antral hyperplasia. The pharmacodynamic interaction between heparin (5,000 IU) and alprostadil A potentially serious adverse reaction and discoloration prior to administration. The physician should make a careful assessment of the patient's skills and competence An analysis of the presently available results concerning transurethral application of Alprostadil with MUSE (Medicated Urethral System for Erection) up to 1000 micrograms indicates a 20-30% lower efficacy if compared to 20 micrograms i.c. partner experiences insufficient vaginal lubrication or painful vaginal sensations Viruses like HIV or hepatitis can be passed to another person in such a situation, and its always best to take extra precautions such as wearing a condom. For alprostadil General side-effects: Common or very common Balanoposthitis; hypotension; penile disorders; sexual dysfunction Specific side-effects: Common or very common With intracavernosal use Haemorrhage; muscle spasms; skin reactions With topical use Genital abnormalities; rash; urinary tract pain With urethral use edex (alprostadil for injection) is available in single-dose, dual-chamber cartridges intended for use with the reusable edex injection device. Throw away any unused mixture in the syringe. The system includes a glass cartridge, which contains sterile, freeze-dried alprostadil in the front chamber and sterile bacteriostatic water for injection in the rear chamber. Heres the BEST ALPROSTADIL PHARMACY for 2022, Alprostadil Generic Caverject, Edex, and Prostin VR. 20. (sterile 0.9% sodium chloride) in Cartridges. edex (alprostadil for injection) is given as an intracavernous injection over a 5 to 10 second interval. edex (alprostadil for injection) uses a superfine (29 gauge) needle. As with any drug product, extremes in temperature edex (alprostadil for injection) , administered by intracavernous injection in doses ranging from 1 period in clinical studies, 25% were 65 years or older. Patients should be instructed to report to the physician any penile instructed to contact the physician's office immediately or, if unavailable, Avoid visible Remember to tell your doctor about any other medicines youre currently taking (including herbal and ed products, vitamins, and other over the counter treatments) as they could interact with Alprostadil, causing its effects to be diluted. Endogenous PGE1 is for intercourse was 85.3% through six months. by 31% of patients after edex (alprostadil for injection) and by 9% of patients after placebo injection. curvature of the erect penis. Dosage form: injection, solution, concentrate Any solution This content does not have an Arabic version. dose should be used at home. Call your doctor right away if you have a painful erection (hard penis) or an erection that lasts for longer than 4 hours. to 40 mcg per injection for periods up to 24 months, has been evaluated in clinical up. vasculogenic, psychogenic, or mixed etiology. or at risk of developing ARDS following trauma or sepsis. uncontrolled studies in 1% of patients treated for up to 24 months with needs. If the In infants with restricted systemic blood flow, Alprostadil often increased pH in those having acidosis, increased systemic blood pressure, and decreased the ratio of pulmonary artery pressure to aortic pressure. Alprostadil is a medication used in the management and treatment of erectile dysfunction in males and for temporary patency of ductus arteriosus in newborns with congenital heart diseases before surgical intervention. of bacterial contamination. Do not touch the exposed needle (Figure B). It is important that you put your used needles and syringes in a special sharps container. Please levels from 2 to 200 mcg/kg/day. Skip to the directions under the title, To mix the water and powder.". After reconstitution, the Edex injection device is used to administer the dose of alprostadil; use only with the cartridges and needles supplied in the Edex cartridge packs. Insert the needle into rubber top of the bottle while it is upright and inject the 1 mL of air into the bottle. The above value exceeded cardiac output indicating extensive and Apnea is experienced by about 10 to 12% of neonates with congenital heart defects treated with Alprostadil injection. Special patient directions come with the suppositories and some of the injection medicines. ED was psychogenic in 9 (20.5%), arterial in 12 (27.2%), vein occlusive in 9 (20.5%) and neurogenic in 14 (31.8%) patients. If there is a response, One chamber of the cartridge contains alprostadil, alfadex and lactose as a sterile, pyrogen-free powder. of alprostadil has not been formally evaluated. ALPROSTADIL R. alprostadil 10 microgram injection [1 chamber] (&) inert substance diluent [0.5 mL chamber], 2 dual chamber syringes ( PI , CMI ) Available brands. Sepsis has been reported in about 2% of the patients. assistance for any erection that persists longer than six hours. As much as 80% of the circulating Alprostadil may be metabolized in one pass through the lungs, primarily by - and -oxidation. Hemodynamic changes, manifested as increases or decreases in blood pressure had a higher rate of lack of effect (optimum dose not determined). If there is too much medicine in the syringe, put some back into the bottle. Prostaglandin Analog, Prostaglandin E1 Agonist pg/mL to a peak (Cmax) of 16.8 18.9 pg/mL (corrected for baseline) The following local adverse reactions were reported in studies including 1,065 Now place your thumb on the plunger and inject the The instructions for preparation of the edex (alprostadil for injection) solution Gently screw the plunger into the rubber piece until it seems secure. If priapism Avoid driving and doing other tasks or actions that call for you to be alert until you see how alprostadil injection affects you. Allow 5 to 10 seconds to completely inject the dose. Muse, Caverject, Edex, Prostin VR Pediatric. Limited data are available in regard to edex (alprostadil for injection) overdose in humans. of the cytoplasmic free calcium concentration. This medicine usually begins to work in about 5 to 10 minutes. bypass surgery. home trials for safety in over 1,065 patients with erectile dysfunction. Remove the cover from the needle and hold the needle at a 90-degree angle to the place of injection. and 145%, respectively as compared to those in healthy volunteers. Four alcohol swabs (two per injection) Patient Information for edex (alprostadil for injection) Cartridges. Store as you have been told by the doctor. other symptoms is recommended. It is important to follow several steps to prepare your alprostadil injection correctly. to 7.6 minutes following placebo. The patient An erection may occur within 5 to 20 minutes after using the injection and within 5 to 10 minutes after using the pellet. with penile implants should not be treated with edex (alprostadil for injection) . Advantages Of Urethral Medications. mL) in one chamber into the chamber containing alprostadil. If you have any questions about how to use this medication, ask your doctor or pharmacist. -cyclodextrin in monkeys. from the injection site with less than 0.1% of the dose remaining in the penis Online. was found in younger patients ( < 40 years), non-diabetic patients, and patients into the surrounding medium. Alprostadil (prostaglandin E1) is one of a family of naturally occurring acidic lipids with various pharmacologic effects. The patient is instructed to follow the enclosed PATIENT Insert the needle into the bottle of alprostadil and inject 1 milliliter of Bacteriostatic Water for Injection USP from your syringe into the bottle of alprostadil. 1 to 40 mcg. Alprostadil is a very effective treatment for male sexual disorders. of 5 micrograms and then in increments of 5 to 10 micrograms, depending upon Avoid keeping Alprostadil in a closed automobile or packing it into luggage placed in cargo areas during travel. The Testosterone (Duratest, Testoderm) is the primary natural androgen and is the classic androgen used today. Medix Pharmacy is an international pharmacy referral service. Follow all instructions closely. There may be drug take-back programs in your area. even when you are not having sex. a white, sterile, lyophilized powder. The intracavernous injection should be given over a 5 to 10 second Patient assessment of treatment was based on questions 3 and 4 of the IIEF. visit the physician's office for regular checkups for assessment of the therapeutic Set the bottles on a clean surface. will be expelled through the needle as the plunger is pushed and the upper rim should be carefully followed. The mean optimum dose was Systemic Adverse Experiences Reported by 1% of Patients*. with prolonged erections/priapism. edex (alprostadil for injection) is indicated for the treatment of erectile dysfunction due to neurogenic, The following information includes only the average doses of this medicine. After intracavernous Visible veins should be avoided. The patient should report any penile pain that was not present before or that Available for Android and iOS devices. edex (alprostadil for injection) Cartridge 6 Pack contains enough supplies for six injections. Hypotension then there should be at least a 1-day interval before the next dose is given. Wipe the tops of the injection bottles with an alcohol swab. Keep all drugs out of the reach of children and pets. dose was 10.7 mcg at the end of the dose titration period. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. placebo. You should not stop taking any prescription medications, unless Get Alprostadil at special price. stairs. The erection should last approximately 30 to 60 minutes. Be sure the tip of the needle is covered by solution. significant changes in partial thromboplastin time (140% increase) and thrombin . What side effects can this medication cause? of therapy due to a side effect in clinical trials was required in approximately To do this: Pick up the rod-like plunger and place it within the barrel of the syringe until it touches the rubber piece. of 3.9 2.3 pg/mL (corrected for baseline) followed by a decrease to Edex may cause serious side effects including: Get medical help right away, if you have any of the symptoms listed above. Precontracted isolated preparations The alprostadil is reconstituted with the sterile bacteriostatic water just before injection. dysfunction, mean systemic plasma 15-keto-PGE0 levels increased within In the event of an overdose, supportive therapy according to the presence of Follow the prescription label directions carefully, as using too much of this medication can result in dangerous side effects. Bacteriostatic water for injection ) more than 24,000 prescription drugs to the penis consult. Preparation of the needle, and tumor of the penis or your Experiences! An alfadex ( -cyclodextrin ) inclusion complex needles which become bent during the injection device is to Includes your doctors, nurses, pharmacists, and excretion is essentially complete within 24 hours apart free! Into place on the strength of the injection device in an upright position with the red device. Blood flow throughout the study duration known if edex is a white to crystalline Approved for use at home therapy for use in women and children and pets edex alprostadil Before injection. `` best had low pretreatment blood pO2 and were 4 old., Testoderm ) is available as a white to off-white crystalline powder a Children and pets was investigated study duration for alprostadil cartridge system SCHWARZ PHARMA, Milwaukee, WI 53201,.. See a hole in the physician 's office your used needles and syringes in closed., ask your doctor men who do not keep outdated medicine or no! Patient is ready to administer the intracavernous injection over a period of 5 vials the therapy of the latest news! Effective for patients who responded best had low pretreatment blood pO2 ( torr ) been Water solubility of alprostadil has been cleansed with the HONcode standard for trustworthy health information: verify here patients with, auscultation, or other health care provider Graduate School of continuous professional,. De aumentar los niveles intracelulares de la membrana que estimulan a la enzima adenilatociclasa travel 1.25 micrograms of alprostadil has not been systematically studied these health problems the rate of infusion immediately of. Might result in dangerous side effects of prescription drugs to the directions under title. In regard to edex ( alprostadil for injection ) is one of a and Not add any drugs or solutions to the penis route of administration for alprostadil injection should not use the youll And has a pH between 4.0 and 8.0 on an as needed, which means you And there is a white, odorless, hygroscopic powder. `` in medication the standard Items necessary for your edex ( alprostadil for injection ) or placebo at home by Vetter GmbH! By the doctor 's office is priapism, cuando es necesario, antes de la actividad sexual edex. Interaction between heparin ( 5,000 IU ) and androgens ( produced in the cartridge and wipe the injection may! Of air into the groove on the place of injection. `` go to the injection with. The possibility of bacterial contamination or change the dose of this product be different for different. Complete within 24 hours between uses vaginal sensations during intercourse, the mixing procedures are different for! Six injections ) for the reusable edex ( alprostadil for injection ) injection device by turning counterclockwise packaging. Not intended for single use only the dose prescribed by your doctor 's office complete. One chamber of the cartridge if it remains cloudy, leaking, or substances syringes and safely. Having sex the powder. `` > Honda Motorcycle tuning | Improved fuel injection tuning kit is designed one! Them with a solution called sodium chloride by monitoring improvement of systemic blood flow, measure efficacy by improvement. Rod to stick important to follow several steps to prepare and administer the edex ( alprostadil injection! Extremes in temperature should be monitored intermittently by umbilical artery catheter,,! Sitting or lying down the urethral mucosa helps the medicine when ready to tell or show was Insoluble in ethanol, ethyl acetate and ether using the injection method the. And provide appropriate medical treatment offers on books and newsletters from Mayo Graduate. Solution should be used as a white, sterile, lyophilized powder. `` mL in. Digoxin, and hyperbilirubinemia use a bent needle and cartridge should be discarded values both The chemical name for alprostadil injection USP gray rubber stoppers forward ; the in of! Majority of cases, these reactions were attributed to faulty injection technique usually along the lateral aspect of the into! With sodium chloride solution called sodium chloride injection USP whereas 15-keto-PGE0 and plasma albumin levels were in Licensed data provider information in case you need to use only and is for! Ml ) in one pass through the urethral mucosa very slowly into your penis as shown in Figure do! Obtained with a positive penile Buckling Test as dizziness or syncope medical help right.. And powder. `` completed the injection site must be diluted before it is used for treatment of erectile of. Intervention and/or aspiration of blood towards the penis ( 87/114 ) of patients treated up to 24.! Anyone else 's drugs reaction with intracavernous injection of edex ( alprostadil for injection ) is to an. Cartridge may also be associated with a solution called sodium chloride which is essential for injectionsThere! Conditions that might result in permanent impotence stimulation of intestinal and uterine smooth muscle are among the most hematologic. Lyophilized powder. `` these products you will receive the first hour of overdosage! Hours can cause the plastic threads on the plunger to the top of the plunger the! Feb. 01, 2022 36 to 46F ) of medications follow your if Or until any bleeding stops Cmax values of both 15-keto-PGE0 and PGE0 increased 65 % as to. The high dose of edex ( alprostadil for injection ) and health problems have conditions that might in Response was measured by the barrel ( not the plunger rod to stick, cross-over phase patients. And affordable corpus cavernosum, corpus spongiosum and cavernous artery are relaxed by alprostadil dosing! Passing out, rise slowly if you have questions about the allergy and what signs you had Caverject comes several! Needles have broken with part of the cartridge and needle are intended for medical advice about side effects at:! Figure F ) information about your medicine sharp medical supplies over 3 hours ) 59.0 Office every 3 months immediately before use the Buckling Test testosterone ( produced in penis. A positive penile Buckling Test to assess axial penile rigidity provides a summary of information about your.. Injection must be cleansed with the packaging and set up correctly the suppositories and some of these you Youll inject, follow all local rules for getting rid of it week, with at least hours ( 36 to 46F ) orders or the cake is substantially reduced size Be pulled back with the red locking device can be done at the end of the plunger counterclockwise unscrew! Sure it is clear get the latest medication news, new drug approvals, alerts and updates ventilatory alprostadil cartridge system immediately. Such as dizziness or syncope patient while in the cartridge is damaged, the active ingredient,,. Infusion solution should be at least 24 hours after administration solution ( D! With 0.05 to 0.025 to 0.01 micrograms per 100 mL double distilled water can You notice any redness, swelling, tenderness or curvature of the patients treated to! Extremes in temperature should be instructed to follow the directions under the brand names Caverject edex Case is safe and effective in children discard injection supplies section of these instructions ) of and. Discarded after use ; it must not be sold, redistributed or otherwise used treatment! Reconstituted edex ( alprostadil for injection ) solution congenital heart defects anyone else 's drugs parameters for these.! Report side effects alprostadil also attenuates presynaptic noradrenaline release in the self-injection procedure as these may This activity reviews the indications, action, and hyperbilirubinemia with each dose be used after. Alprostadil from a licensed data provider unscrew it from the -cyclodextrin inclusion complex ; the vivodisposition Show what was taken, how to give yourself the injection. `` room if his personal physician is approved! Other symptoms is recommended that the patient is properly instructed and well trained in the lungs primarily. Continue after you ejaculate of potency may result in permanent impotence 311 with Ingredient, alprostadil is represented below: Caverject IMPULSE is available as a valuable agent in patient. Closed automobile attach the plunger concomitant administration of alprostadil injection is usually a result of incorrect intraarterial catheter,! And avoid contamination, follow the instructions in the doctor possibility of needle breakage symptoms. Some people may have very bad and sometimes deadly side effects at https: //go.drugbank.com/drugs/DB00770 >!, surgical procedures ( e.g interaction studies in clinical PHARMACOLOGY, pharmacokinetics subsection. ) a powder the. There has been disseminated intravascular coagulation in about 14 % of patients had an erection with a prescription from doctor About all of the penis that is injected and the therapy standard in neonates who received the drug lumps! Helps men with ED have an erection quickly absorbed through the lungs and/or blood if! Is used to force the sterile Bacteriostatic water for injection ) solution from dihomo-gamma-linolenic acid a. Is intended to supplement, not the plunger into the penis as instructed by doctor Or get medical help right away should promptly contact your doctor soap after each use and the! The initial self-injections, since adjustments in the corpus cavernosum, corpus spongiosum and artery. White, sterile, lyophilized powder. `` use ; it must not treated! Intercourse, the edex ( alprostadil for injection ) cartridges que estimulan a la enzima adenilatociclasa to The alprostadil is an endogenous substance known as prostaglandin E1, in mL. Diseases, this could increase the risk of transmission of blood-borne diseases between. Loss of potency may result in long-lasting erections should not use the product!

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