Selecting patients for treatment with Vitaros
The pharmacodynamic profile of Vitaros means that it is an appropriate therapeutic choice for a range of patients. [1-3]
Vitaros can provide benefits for men with all severities of erectile dysfunction and benefits may extend to individuals who experience limitations with phosphodiesterase type 5 (PDE5) inhibitors. [1]
Explore the different patient profiles to learn how Vitaros may benefit your patients
Patients who prefer a topical therapy
53% (n=152) of patients expressed a preference for a treatment which is administered topically rather than an oral therapeutic. [1]
Vitaros is the only topical alprostadil cream available for the treatment of erectile dysfunction.
Patients with concerns about therapy systemic effects or food/alcohol interactions
With Vitaros, there is minimal systemic diffusion and drug‒drug interactions are considered unlikely given the drug's metabolism. [1] However it should be noted that no drug-drug interactions studies have been conducted. [1]
Unlike some phosphodiesterase type 5 (PDE5) inhibitors, evidence suggests that Vitaros is not affected by food or alcohol consumption, eliminating this worry and consideration for patients. [1]
Patients taking nitrates or alpha-blockers
PDE5 inhibitors have several contraindications. These include co-administration with nitrates/nitric oxide donors, guanylate cyclase stimulators, and, for some PDE5 inhibitors, ritonavir. Additionally, co-administration with antihypertensive drugs or alpha-blockers is contraindicated as this may result in orthostatic hypotension.[4]
These contraindications limit the treatment options for those with erectile dysfunction, which in particular may impact older patients who are more likely to be in hypertensive medications or have cardiovascular disorders.
Fortunately, Vitaros is not contraindicated in these instances, making it a good alternative therapeutic option for these patients. [4]
Patients for whom PDE5 inhibitors are not appropriate
PDE5 inhibitors are contraindicated in patients with severe cardiovascular disorders, such as recent myocardial infarction, stroke, unstable angina, severe cardiac failure; in patients with hypotension or hypertension; and in patients with known hereditary degenerative retinal disorders or loss of vision because of non-arteritic anterior ischaemic optic neuropathy. [5]
PDE5 inhibitors are also either contraindicated or require dosage adjustments in patients taking CYP3A4 inhibitors and enhancers, as well as in patients with severe renal or hepaticdysfunction, depending on the PDE5 inhibitor. [5]
Vitaros is not contraindicated in these instances given its metabolism and minimal systemic diffusion and can be prescribed to such patients. [4]
References
1.Becher E. Topical alprostadil cream for the treatment of erectile dysfunction. ExpOpin Phamacother. 2004;5(3):623-632
2.Moncada I and Cuzin B. Clinical efficacy and safety of Vitaros©/Virirec©(Alprostadil cream) for the treatment of erectile dysfunction. Urologia 2015;82(2):84-92.
3. Yeager J, Beihn RM. Retention and migration of alprostadil cream applied topically to the glans meatus for erectile dysfunction. Int J Impot Res 2005;17(1):91–5
4. Vitaros Summary of Product Characteristics. Last accessed: May 2022.
5. Hatzimouratidis K, Giuliano F, Moncada I, et al. EAU Guidelines on Erectile Dysfunction, Premature Ejaculation, Penile Curvature and Priapism. European Association of Urology.