What are the functions and indications of Alprostadil?

Alprostadil is commonly formulated as an injection. Its therapeutic effects include vasodilation, inhibition of platelet aggregation, improvement of microcirculation, protection of vascular endothelial cells, and promotion of tissue repair. It is mainly indicated for chronic arterial occlusive disease, cardiovascular and cerebrovascular ischemic diseases, diabetic complications, liver disease, and erectile dysfunction. Its use must be conducted under the guidance of a physician. A detailed analysis follows:

I. Therapeutic Effects

1. Vasodilation: Alprostadil acts on vascular smooth muscle by activating adenylate cyclase, increasing intracellular cAMP levels, thereby relaxing blood vessel walls, dilating peripheral and microvessels, reducing vascular resistance, improving vascular spasm, and enhancing blood flow.

2. Inhibition of Platelet Aggregation: By increasing intraplatelet cAMP concentrations, alprostadil inhibits platelet membrane phospholipase A2 and thromboxane A2 synthesis, weakens platelet aggregation, prevents thrombus formation, improves hypercoagulable states, and plays a role in the prevention and treatment of cardiovascular and cerebrovascular embolic diseases.

3. Improvement of Microcirculation: By dilating microvessels, inhibiting platelet aggregation, and enhancing red blood cell deformability, alprostadil improves microcirculatory disorders and increases blood perfusion to tissues and organs. It is particularly effective in improving microcirculatory dysfunction caused by diabetic peripheral neuropathy and chronic arterial occlusive disease.

4. Protection of Vascular Endothelial Cells: Alprostadil enhances the ability of vascular endothelial cells to synthesize prostacyclin, inhibits endothelial cell apoptosis, reduces vascular endothelial injury, maintains the integrity of endothelial function, delays the progression of atherosclerosis, and lowers the risk of cardiovascular and cerebrovascular diseases.

5. Promotion of Tissue Repair: By improving blood supply to ischemic tissues, modulating local inflammatory responses, and activating cell proliferation signaling pathways, alprostadil promotes the repair and regeneration of damaged tissues. It aids in improving tissue metabolism and functional status in the treatment of chronic ulcers and organ dysfunction.

II. Indications

1. Chronic Arterial Occlusive Disease: Used to treat thromboangiitis obliterans and occlusive arteriosclerosis. By dilating peripheral vessels and improving microcirculation, it alleviates symptoms such as pain, coldness, and intermittent claudication caused by limb ischemia, promotes ulcer healing, and prevents disease progression to amputation.

2. Cardiovascular and Cerebrovascular Ischemic Diseases: Used as adjunctive therapy for myocardial infarction, cerebral thrombosis, cerebral arteriosclerosis, etc. By dilating coronary and cerebral arteries, increasing blood flow to ischemic areas, and inhibiting platelet aggregation, it reduces ischemic injury and improves functional status of cardiac and cerebral tissues.

3. Diabetic Complications: Applicable for complications such as diabetic peripheral neuropathy and diabetic nephropathy. By improving microcirculation and protecting vascular endothelial cells, it alleviates nerve damage and renal ischemia-hypoxia, relieves symptoms such as limb numbness, pain, and proteinuria, and delays the progression of complications.

4. Liver Disease: Has an adjunctive therapeutic effect on chronic hepatitis, cirrhosis, and other liver diseases. By improving hepatic microcirculation and promoting hepatocyte repair, it reduces hepatic inflammatory responses, enhances liver function, and improves symptoms such as fatigue and abdominal distension.

5. Erectile Dysfunction: By dilating the penile cavernosal vessels and increasing cavernosal blood flow, it improves erectile function. Following local injection or intraurethral administration, it promotes relaxation of cavernosal smooth muscle, resulting in penile engorgement and erection. It is used in the treatment of vasculogenic erectile dysfunction.

Alprostadil must be used strictly according to medical instructions, with dosage and route of administration adjusted according to the specific condition. During treatment, patients should be monitored for adverse reactions such as headache, dizziness, and hypotension, and any discomfort should be promptly reported to the physician.