The lowest effective dose of prostaglandin E1 as treatment for erectile dysfunction.

The recommended dose of prostaglandin E1 as treatment for erectile dysfunction has been reported to be 10 to 40 micrograms. However, adverse effects probably increase with increasing doses. We conducted a prospective, single-blind, dose-escalating study of prostaglandin E1 on 20 men with erectile dysfunction of various etiologies. The response to prostaglandin E1 was assessed by penile palpation and RigiScan rigidity monitoring. A total of 17 patients completed the study: 1 achieved rigidity with 1 microgram., 2 with 2 micrograms. and 4 with 3 micrograms. prostaglandin E1, while more than 70% achieved rigidity with 5 micrograms. or less and more than 80% had a full erection with 20 micrograms. Of 138 injections there were 2 episodes of pain after injection. We conclude that the often recommended starting dose of 20 micrograms. is too high. A more appropriate starting dose is 2.5 micrograms. with increments of 2.5 micrograms. until the lowest effective dose is achieved. This approach may lessen the major impediments to prostaglandin E1 use, that is burning and pain.