Muse dosage, forms, and strengths

Muse (alprostadil) is a lesser-known medication used in the treatment of erectile dysfunction (ED). Well-known alternatives for impotence include the phosphodiesterase inhibitors Viagra and Cialis. Muse works via a different mechanism, prostaglandin activity. Prostaglandins are lipid substances in the body that function like hormones, signaling for body changes like increased blood flow. Muse is taken by a different route as well compared to the other alternatives. Muse comes as a pellet that is inserted into the urethral meatus (the opening at the end of the penis). Muse pellets are available in 125 mcg, 250 mcg, 500 mcg, and 1000 mcg strengths.

RELATED: List of PDE5 inhibitors

Muse forms and strengths

• Urethral suppositories: 125 mcg, 250 mcg, 500 mcg, and 1000 mcg

Muse dosage for adults

Muse is FDA-approved for the treatment of erectile dysfunction. Alprostadil is available as a penile injection, under the brand names Caverject and Edex.

Muse dosage for erectile dysfunction

Alprostadil is a naturally occurring prostaglandin called prostaglandin E1 (PGE1). This substance is known to relax smooth muscle in blood vessels, causing vasodilation and allowing more blood flow. When Muse is inserted into the urethra, the increased blood flow can result in an erection sufficient for sexual intercourse.

Muse dosing starts low in order to find the lowest effective dose and attempt to avoid side effects. If a low dose of 125-250 mcg is insufficient, a dose titration can be done to gradually increase the dose in a stepwise fashion on subsequent occasions. Muse cannot be used more than twice in a 24-hour period. The potential adverse reactions that the dosing plan attempts to avoid include priapism (painful prolonged erection), penile pain, urethral pain, urethral burning, testicular pain, minor urethral bleeding, hypotension (low blood pressure), dizziness, syncope (passing out), back pain, and headache.

Muse dosage for children

Muse is not approved for use in children.

Muse dosage restrictions

Muse is intended for use in adult men, including seniors, to improve erectile function. No adjustment in dosing is necessary for renal (kidney) or hepatic (liver) impairment. Women and children should not use Muse.

The use of intraurethral alprostadil is contraindicated or strongly advised against in a few different circumstances. 

• Any history of hypersensitivity or allergy to alprostadil should lead to avoiding Muse. 

• Conditions that increase the risk of priapism (painful and prolonged erection) are contraindications to Muse usage. Such conditions include sickle cell anemia or trait, leukemia, thrombocythemia, and multiple myeloma. 

• Penile deformity, Peyronie disease (curvature of the penis), and penile implants are structural reasons to avoid Muse. 

• Infections of the glans or head of the penis (balanitis) or urethra (chronic urethritis) are other contraindications. 

• In addition, use prior to sexual intercourse with a pregnant woman is advised against unless a condom barrier is utilized.

Muse dosage for pets

Muse is not approved for use in pets.

How to take Muse

Optimizing the effectiveness of Muse requires following a set of instructions on the medication package. Urinating prior to insertion of Muse is often advised. The medication pellet is then placed into the urethra using a single-use applicator and released from the applicator by pressing a button, while the penis is held in an upright position. The following are other helpful tips for Muse administration.

• Your doctor will instruct you on how to use the medicine.

• Sit, stand, or walk for about 10 minutes after you have put in the suppository. This will improve blood circulation, so you have better erectile function. Do not lie down right after you insert the medicine.

• Store unopened foil pouches in the refrigerator. Take the medicine out of the refrigerator about 30 minutes before you use it, and let it warm to room temperature.

• You should have an erection about 15 minutes after using the medicine. The erection should last about one hour.

• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

• Keep the medicine away from heat. It may not work if exposed to temperatures above 86 degrees Fahrenheit.

• Put the cap back on the applicator, and use the foil pouch to throw the applicator away. Only use each applicator once.

Muse dosage FAQs

Muse vs. Caverject: What’s the difference?

Both brand-name medications consist of alprostadil and rely on the ability of PGE1 to increase blood flow to the penis and create an erectile. Caverject is injected in the penile shaft using a thin needle, while Muse is a pellet inserted in the penile urethra.

How long does it take Muse to work?

Muse typically results in an erection within about 15 minutes. Urinating before inserting the pellet; rolling the penis within the hand after inserting the pellet; and sitting, standing, or walking for 10 minutes after insertion may be advised to speed up effectiveness.

How long does Muse stay in your system?

An erection after using Muse can be expected to last about an hour. This relates to its half-life in the body being less than 10 minutes.

How long can you take Muse?

Muse is taken on an as-needed basis to facilitate sexual activity. If effective and tolerated well, it may continue to be used.

What is the maximum dosage for Muse?

The maximum dose of Muse is 1000 mcg. Muse can be up to two times within a 24-hour timeframe.

Can you overdose on Muse?

Using more than the recommended or maximum dose of Muse can lead to serious consequences such as priapism, penile damage, and fainting. Emergency medical attention and a call to the Poison Help line at 1-800-222-1222 is warranted for a Muse overdose.

What interacts with Muse?

Before taking Muse, you should review your medication list (including prescription drugs, over-the-counter medicine, and supplements) with your healthcare provider to look for potential problems with drug interactions. Avoiding concurrent use with blood thinners and other erectile dysfunction medication is typical. 

What happens when you mix Muse and alcohol?

Alcohol and Muse can both cause dizziness and lightheadedness, and when used together, these effects could be worse. Alcohol use may also worsen the chances of successfully achieving an erection.

Can Muse cause any adverse reactions in a female partner?

When a male uses Muse, the female sexual partner could potentially experience vaginal burning, irritation, or itching.

Does Muse help to protect against sexually transmitted diseases?

Muse does not protect against sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). A healthcare professional can provide medical advice on methods to reduce the risk of STDs.

Related resources for Muse dosages:

• Adult dosing, Epocrates

• Contraindications, Epocrates

• Proper use of Muse, Mayo Clinic