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In the Caverject blue box you will find 6 items.
1 One glass vial containing Caverject 40micrograms
The active ingredient in Caverject is 'alprostadil'. Each vial contains 40micrograms of alprostadil. It also contains the inactive ingredients lactose, sodium citrate, hydrochloric acid and sodium hydroxide.
Caverject Powder is made by Pharmacia NV/SA Puurs, Belgium
2 One glass syringe containing 1mL of a clear solution - Bacteriostatic water for injections.
The syringe contains benzyl alcohol and water for injections.
3 One larger 22 gauge needle - 1 inches long with a grey plastic end.
This needle is labelled CE 0086.
4 One small 30 gauge needle - 0.5 inch long with a yellow plastic end.
This needle is labelled CE 0050.
5 Two antiseptic pads (Medi-Swab skin cleansing wipes)
The antiseptic pads are soaked in isopropyl alcohol.
The alprostadil in Caverject is similar to the natural substance in your body called prostaglandin E1. It widens blood vessels so that blood can flow in your penis more easily. This makes it easier for you to have an erection.
Is Caverject suitable for you?
You should not use this injection if you have:
Do not use any Caverject until your doctor says that it is right for you.
Are you taking any other medicines?
Do not use other medicines for erectile dysfunction at the same time as Caverject. Ask your doctor or pharmacist for advice if you are taking 'anticoagulants' to thin your blood. You might bleed abnormally when you do the injection. Make sure that your doctor knows about any other medicines you are taking, including ones you have bought for yourself at the chemist, BEFORE you start using Caverject.
Caverject can be used by couples wishing to conceive and with a partner who is pregnant or breastfeeding. It will not protect your partner from pregnancy, so you should use a reliable contraceptive if appropriate.
Sexually transmitted diseases
Caverject will not protect you or your partner from sexually transmitted diseases like AIDS, herpes and gonorrhoea. Injection of Caverject can start a small amount of bleeding where the needle enters. This could increase the risk of transmission of such diseases. Condoms can protect against sexually transmitted diseases. If you need advice about contraception or 'safe sex' speak to your doctor or contact your local Family Planning Clinic.
A doctor or nurse will show you how to do the injection for AT LEAST the first time. Do not try to do it yourself until you have learnt the correct way or if you can't remember what to do, see your trainer again. These instructions are a reminder only. Keep Medi-Swab away from the eyes.
Different people need different amounts of Caverject to treat erectile dysfunction. The starting dose is 1.25 - 2.5 micrograms. Most men find that a dose of 5 - 20 micrograms is right for them, however, some men may require a higher dose. You should never use more than 60 micrograms in one injection. If Caverject is being used to find the reason for your erectile dysfunction, the dose will be 5 - 20 micrograms.
If the dose that has been prescribed for you does not work well enough, tell your doctor. Do not change your dose unless your doctor tells you to. If you forget how much to use, read the label on the pack or speak to your doctor.
These instructions are intended as a guide only; you should follow your prescriber's advice where it differs from this leaflet.
You and your partner
You may like your partner to be involved in preparing and/or giving the injection. If so, you should speak to your doctor about training for your partner. Wash your hands. Dry them on a clean towel. If your partner wishes to be involved in preparing or giving the injection, they should wash their hands too.
1. Check your pack
Make sure that the vial is the correct strength and the expiry date is still valid. The vial, syringe and needles all have protective covers. The flip-off cap on the vial can rotate; this is normal. Check that all the covers are on firmly and if they are not on properly, do not use them - take the whole pack back to your pharmacist. There are two needles in the pack:
Flip the plastic cap off the vial. Wipe the rubbery top with one of the wet antiseptic pads.
3. Fitting the needle to the syringe
Hold the syringe and twist the white tamper evident cap to break the seal. Take the foil off the larger needle, (22 gauge) with the grey end, keeping the cover on. Join the needle to the syringe by turning the needle clockwise tightly onto the syringe, then remove the needle cover by pushing it away from the syringe with your thumb and forefinger.
4. Mixing the solution with the powder.
Push the needle through the rubbery middle of the vial top. Press the plunger down firmly to squirt all the solution onto the powder. Gently swirl the vial until all the powder has dissolved. If the mixture is cloudy or does not dissolve completely, do not use it. Never use tap water or any liquid other than the one supplied in the syringe. If you do not intend to use your injection immediately, replace the cover on the needle and put the vial and the syringe in the box provided. Store in a safe place at room temperature for up to 6 hours.
5. Filling the syringe
With the needle still inserted, turn the vial upside down. The needle should support the vial unaided. Make sure the needle tip is underneath the level of the liquid. Gently pull the plunger to draw all the mixture into the syringe. Pull the needle out of the vial.
6. Changing to the injecting needle.
Gently twist the larger needle anti-clockwise off the syringe. Put this and the empty vial in the blue box. Remove the smaller injecting needle, (30 gauge) with the yellow end, from its package, keeping the cover on. Twist the needle clockwise tightly onto the syringe, then remove the needle cover by pushing it away from the syringe with your thumb and forefinger.
7. Setting the dose
Tap the syringe gently to send any air bubbles to the top, then push the plunger to squeeze the air bubbles out, ensuring that at least one drop of solution comes out of the needle. Continue pushing until the plunger is exactly at the right mark for your dose. Your doctor will have shown you where this is.
- Take hold of the penis from the front, with the first two fingers underneath close to the testicles and the thumb on top. Gently squeeze the penis between your thumb and finger so that the injection site bulges out. If there is a foreskin on the penis, make sure it is stretched. The injection will go into the part of the penis shown as the shaded area in diagram A.
- If recommended by your prescriber, wipe the skin over this area with the second pad and let it dry.
- Keeping a firm grip on the penis and taking the syringe in your free hand, push the needle straight through the skin all the way into the bulgy part avoiding veins or other obvious blood vessels. The angle is shown in diagrams B and C. Push the plunger firmly and if the Caverject does not come out fairly easily, move the needle slightly and try again. DO NOT force the Caverject liquid from the syringe.
- Pull the needle out. On the needle mark, press gently with the pad or your thumb, as recommended by your prescriber. Massage the penis to help the Caverject spread through it.
- Ensure that the syringe, vial and needles are placed in the blue box. Pull the red plug out of its holder. Close the blue box and push the red plug through the padlock symbol on the box. Make sure it locks in position and the box does not open. Put the box into a carrier bag and tie it up. Dispose of it with your normal household rubbish or as recommended by your prescriber.
It will take a little while for your erection to come on after the injection. With the right dose of Caverject, your erection should be strong enough for you and your partner to enjoy lovemaking. Usually, your erection should not last longer than an hour. If you would like it to last longer, talk to your doctor. If your erection lasts longer than four hours, see the section on side effects.
Tell your doctor straight away if you experience an erection that lasts for longer than four hours, rapid breathing, feeling faint or weak, depression, soft stools or diarrhoea. You may need treatment.
When you first start using Caverject, you may find the injection leaves a small bruise. This should happen less often with practice.
IF ANY OF THE FOLLOWING SIDE EFFECTS BOTHER YOU OR YOU NOTICE ANY OTHER UNPLEASANT EFFECTS, TELL YOUR DOCTOR OR PHARMACIST BEFORE YOU USE CAVERJECT AGAIN.
2-4% of patients have found the following:
1% or less of users have found the following side effects with Caverject:
If your erection goes on for longer than 4 hours, speak to the doctor who prescribed Caverect for you straight away. This may have been a doctor in a clinic or hospital, or your GP. If you cannot contact this doctor, go to a hospital casualty department, and show them the section below 'How to treat prolonged erection or priapism'.
Having been prescribed various erectile dysfunctional medication in the past, I can honestly say that Caverject is the best one Ive tried and although the thought of an injection going in down there would make your toes curl and send shivers down the spine, let me reassure you that the needle itself is so fine and to pardon any unintentional pun being made here, a small prick is all you will feel, but the reward for being so brave guys? Im sure both you and your partner will answer that question easily!
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