Who is a candidate for MUSE

There are relatively few contraindications to the use of MUSE. Because MUSE is administered intrau-rethrally and not all of the dose may be absorbed at the time of ejaculation, you should not use this therapy if your partner is pregnant.

Men who have undergone prior radical prostatectomy appear to have an increased risk of penile or urethral burning with MUSE, and they should be warned about this possibility. The exact cause of this side effect is not known, but it may be caused by a postsurgical supersensitivity of the corpora or increased retention of the MUSE in the penis because the dorsal vein may have been tied off at the time of radical prostatectomy. In particular, patients who have experienced pain with alprostadil in the past are likely to experience discomfort with MUSE. Hypotension (low blood pressure) and syncope (fainting) have been noted with MUSE as well and can be associated with serious cardiovascular consequences. For this reason, MUSE should be used with caution in men who have significant cardiovascular risks and in older men. In addition, the use of MUSE requires test dosing in the office to ensure that there is no hypotensive or syncopal event with use. Men who are at increased risk for priapism, such as those with sickle cell anemia, leukemia, polycythemia, thrombocythemia, or multiple myeloma, should not use MUSE. Men in whom sexual activity is not advisable, such as those with severe cardiovascular disease, should not use MUSE.

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