Priapism Medication

Updated: Nov 28, 2016
  • Author: Hosam S Al-Qudah, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to restore sexual function. Drugs used include adrenergic agonists and antidotes.

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Adrenergic Agonists

Class Summary

These agents have been used successfully in the treatment of priapism, possibly due to their sympathomimetic vasopressor activity.

Terbutaline has been shown to be effective for the treatment and prevention of priapism, although its mechanism of action in these cases is not yet fully elucidated.

Phenylephrine

Phenylephrine is a strong postsynaptic alpha-receptor stimulant with little beta-adrenergic activity that produces vasoconstriction of arterioles in the body. This agent increases peripheral venous return. The drug is best administered in a dilute solution; add 10 mg (usually 1 mL) of phenylephrine to 499 mL of normal saline, yielding a solution with 20 mcg/mL.

Pseudoephedrine (Sudafed, ElixSure, Unifed, Psudatabs)

An oral dose of 60-120 mg may be given in cases of priapism of short duration (2-4 h). Pseudoephedrine promotes vasoconstriction by directly stimulating alpha-adrenergic receptors.

Terbutaline

Terbutaline is a selective beta2-adrenergic agonist used successfully in the treatment of priapism.

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Antidotes

Class Summary

These agents have a second-messenger inhibitory effect, affecting muscle relaxation.

Methylene blue

Methylene blue inhibits smooth muscle relaxation.

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