PROSTACEL (ALPROSTADIL ) 500MCG ML VIAL (PROSTAL)

WHAT IS THIS MEDICINE AND WHAT IS IT USED FOR?

Prostacel contains alprostadil — a synthetic version of prostaglandin E1 (PGE1), a naturally occurring compound that widens (dilates) blood vessels and prevents platelets from clumping together. At 500 mcg/mL concentration, this is a high-strength preparation used for specialist clinical indications.

Its primary uses are: in neonates (newborn babies) with ductus-dependent congenital heart defects — alprostadil keeps the ductus arteriosus (a blood vessel connecting the pulmonary artery and aorta that normally closes after birth) open until life-saving cardiac surgery can be performed; and in adults for severe peripheral arterial occlusive disease (Stage III and IV Fontaine — critical limb ischaemia), where it dilates narrowed blood vessels in the legs to improve blood flow, reduce rest pain, and help heal ischaemic ulcers.

Lower-strength alprostadil preparations (e.g. 10–40 mcg) are also used for erectile dysfunction, but the 500 mcg/mL vial is a specialist high-concentration preparation not used for that indication.

3. HOW TO TAKE THIS MEDICINE

This preparation is always administered by healthcare professionals in a hospital or specialist clinic — never self-administered at this concentration. For neonatal use (ductus-dependent congenital heart disease): continuous intravenous infusion at 0.05 to 0.1 mcg/kg/minute, titrated carefully in a neonatal intensive care setting.

For peripheral artery disease in adults: intravenous infusion of 20 to 60 mcg alprostadil per day (diluted appropriately), administered over 1 to 2 hours, for a course of several days or weeks depending on response. Preparation and dosing require precise dilution by hospital pharmacy — the concentration must be calculated carefully for each patient and indication.

The 500 mcg/mL concentration requires significant dilution before administration. Exact dilution volumes and infusion rates must be calculated according to the patient's weight, indication, and clinical response. This preparation is used exclusively in specialised clinical settings — neonatal intensive care, cardiology, or vascular medicine. Do not attempt to use this vial outside a clinical environment.

4. POSSIBLE SIDE EFFECTS

5. WHO SHOULD NOT TAKE THIS MEDICINE

In neonates: use is essential for ductus-dependent congenital heart disease — there are no practical contraindications in this life-saving context, but respiratory monitoring for apnoea is mandatory.

In adults: alprostadil should not be given to patients with very low blood pressure (hypotension), significant heart failure, a history of pulmonary oedema (fluid on the lungs) from an earlier alprostadil infusion, or in patients with bleeding disorders.

6. MEDICINES THAT INTERACT WITH THIS TREATMENT

Alprostadil enhances the blood pressure-lowering effect of antihypertensive medicines — blood pressure monitoring is essential during infusion. In adults, concurrent use of anticoagulants or antiplatelet medicines increases bleeding risk.

In neonates, diuretics and other cardiovascular medicines may interact — the neonatal ICU team manages these interactions.

7. HOW TO STORE THIS MEDICINE

Store in a refrigerator at 2–8°C. Do not freeze. Protect from light. Diluted infusion solutions should be prepared fresh and used within the timeframe specified — do not store diluted solutions.

8. PRESCRIPTION REQUIREMENT

9. GUIDANCE FOR PATIENTS & CAREGIVERS

This medicine is administered by your medical team in a hospital — it is not something you manage yourself. For families of babies in NICU: the medicine keeps an important blood vessel open until your baby's heart surgery can take place. The team will monitor your baby's breathing carefully because the medicine can sometimes cause temporary pauses in breathing, which they are trained to manage.

For adults with severe leg circulation problems: the infusion will be given over 1 to 2 hours each day for several days or weeks. Tell the nurse immediately if you feel flushed, dizzy, or unwell during the infusion.

10. PHARMACIST & PRESCRIBER NOTES

11. FREQUENTLY ASKED QUESTIONS

Q: Why does a baby need this medicine?

Some babies are born with heart defects where a specific blood vessel — called the ductus arteriosus — needs to stay open to allow blood to circulate properly until surgery can correct the underlying heart problem. Normally, this vessel closes within the first day of life, but alprostadil keeps it open by preventing the muscle in its wall from contracting. This is a temporary but life-critical measure until cardiac surgery is performed.

Q: What is the ductus arteriosus?

It is a short blood vessel present in all babies before birth, which connects the main artery to the lungs (pulmonary artery) to the main artery to the body (aorta). In babies with certain heart defects, blood flow to either the lungs or the body depends on this vessel remaining open. In healthy babies, it closes within hours to days of birth — but in ductus-dependent heart disease, alprostadil keeps it open.

Q: How is this different from Viagra or alprostadil injections for erectile dysfunction?

Alprostadil is used for erectile dysfunction at much lower doses (typically 2.5 to 40 mcg) given either by injection directly into the penis or as a urethral suppository. The 500 mcg/mL vial discussed here is a completely different, much higher-concentration preparation for intravenous use in critical clinical settings — not for erectile dysfunction.

Q: Is the infusion painful?

In adults, mild discomfort, flushing, or a warm sensation is common during the infusion. Tell the nurse if you feel dizzy, faint, or experience chest pain — these require prompt assessment.