About MUSE

Pills, needles, or pumps may not be preferred by some of your patients.

That’s where MUSE comes in.

MUSE—for the right man, it could be the right option.1

MUSE is different from other ED treatments. It’s a small medicated pellet that works locally to produce an erection.1

Here are some reasons to prescribe MUSE:

  • MUSE is inserted directly into the urethra1
  • In contrast with oral medication1
    • MUSE does not have to be absorbed through the stomach lining and then through the bloodstream 
    • MUSE is not as dependent on blood flow
  • In contrast to treatment with local injection, which can cause penile bruising and scarring, MUSE does not require puncture of the skin1-3
  • MUSE starts working within 5 to 10 minutes and can continue working for approximately 30 to 60 minutes1
  • MUSE is a treatment option for many with ED who want to enjoy sex on a regular basis. Patients are limited to using MUSE only 2 times within a 24-hour period.1

The study

In a study which included patients who found previous intracavernous injection therapy ineffective4:

  • 58% of these patients achieved an erection sufficient for sexual intercourse following treatment with MUSE in a clinic setting
  • 47% of these responsive MUSE patients reported successful sexual intercourse at home

References: 1. Muse [package insert]. Somerset, NJ: Meda Pharmaceuticals Inc.; 2014. 2. WebMD. Erectile dysfunction treatment. www.webmd.com/ erectile-dysfunction/guide/erectile-dysfunction-treatment. Reviewed September 12, 2015. Accessed June 29, 2016. 3. Caverject Impulse [package insert]. New York, NY: Pfizer Inc.; 2016. 4. Engel JD, McVary KT. Transurethral alprostadil as therapy for patients who withdrew from or failed prior intracavernous injection therapy. Urology. 1998;51(5):687-692.

More Important Safety Information

MUSE is contraindicated in men with any of the following:

  • Known hypersensitivity to alprostadil
  • Abnormal penile anatomy: MUSE is contraindicated in patients with urethral stricture, balanitis (inflammation/infection of the glans of the penis), severe hypospadias and curvature, and in patients with acute or chronic urethritis
  • Sickle cell anemia or trait, thrombocythemia, polycythemia, multiple myeloma: MUSE is contraindicated in patients who are prone to venous thrombosis or who have a hyperviscosity syndrome and are therefore at increased risk of priapism (rigid erection lasting 6 or more hours)
  • MUSE should not be used in men for whom sexual activity is inadvisable
  • MUSE should not be used for sexual intercourse with a pregnant woman unless the couple uses a condom barrier

Because of the potential for symptomatic hypotension and syncope, which occurred in 3% and 0.4%, respectively, of patients during in-clinic dosing, MUSE titration should be carried out under medical supervision. During post-marketing surveillance syncope occurring within one hour of administration has been reported. Patients should be cautioned to avoid activities, such as driving or hazardous tasks, where injury could result if hypotension or syncope were to occur after MUSE administration.

A complete medical history and physical examination should be undertaken to exclude reversible causes of erectile dysfunction prior to the initiation of MUSE therapy. In addition, underlying disorders that might preclude the use of MUSE should be sought.

Cardiovascular effects: During in-clinic dosing, patients should be monitored for symptoms of hypotension, and the lowest effective dose of MUSE should be prescribed.

Hematologic effects: Patients administering MUSE improperly may be at risk of urethral abrasion resulting in minor bleeding or spotting. Patients on anticoagulant therapy or with bleeding disorders may be at higher risk of bleeding. Patients on anticoagulant therapy have been safely treated with MUSE; however, the risk/benefit ratio in these patients should be considered prior to prescribing MUSE.

Resumption of sexual activity: Sexual intercourse is considered a vigorous physical activity, and it increases heart rate as well as cardiac work. Physicians may want to examine the cardiac fitness of patients prior to treating erectile dysfunction.

Priapism and prolonged erection: In clinical trials of MUSE, priapism (rigid erection lasting ≥ 6 hours) and prolonged erection (rigid erection lasting 4 hours and < 6 hours) were reported infrequently (< 0.1% and 0.3% of patients, respectively). Nevertheless, these events are a potential risk of pharmacologic therapy and can cause penile injury. Physicians should lower the dose or consider discontinuing MUSE treatment in any patient who develops priapism or prolonged erection.

Drug-Drug Interactions: Because there are low or undetectable (< 2 picograms/mL) amounts of alprostadil found in the peripheral venous circulation following MUSE administration, systemic drug-drug interactions with MUSE are unlikely. Although formal studies have not been conducted, the concomitant use of MUSE and anti-hypertensive medications may increase the risk of hypotension. It is therefore advised that caution be used in the administration of MUSE to individuals on anti-hypertensive medications. In addition, the presence of medications in the circulation that attenuate erectile function may influence the response to MUSE.

Drug-Device Interactions: Use of MUSE in patients with penile implants has not been studied.

Sexual Preference: There is no experience in homosexual men and no experience with other than vaginal intercourse.

In two double-blind, parallel, placebo-controlled trials, 1511 patients received MUSE at least 1 time in the clinic. The most frequently reported (≥ 2%) drug-related side effects during in-clinic titration included pain in the penis (36%), urethra (13%), or testes (5%), dizziness (4%), urethral bleeding/spotting and other minor abrasions to the urethra (3%), hypotension (3%), and syncope (0.4%).

996 patients (66% of those who began titration) were studied during the home treatment portion of the two studies. The most frequently reported (≥ 2%) adverse events with MUSE vs placebo, respectively, were penile pain (32% vs 3%), urethral burning (12% vs 4%), minor urethral bleeding/spotting (5% vs 1%), testicular pain (5% vs 1%), flu symptoms (4% vs 2%), headache (3% vs 2%), pain (3% vs 1%), accidental injury (3% vs 2%), respiratory infection (3% vs 2%), dizziness (2% vs < 1%), back pain (2% vs 1%), pelvic pain (2% vs < 1%) and rhinitis (2% vs < 1%).

The most common drug-related adverse event reported by female partners during placebo-controlled clinical studies was vaginal burning/itching, reported by 5.8% of partners of patients on active vs. 0.8% of partners of patients on placebo. It is unknown whether this adverse event experienced by female partners was a result of the medication or a result of resuming sexual intercourse, which occurred much more frequently in partners of patients on active medication.

Indications

MUSE is indicated for the treatment of erectile dysfunction. Studies that established benefit demonstrated improvements in success rates for sexual intercourse compared with similarly administered placebo.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 855-543-3784.

For additional information, please see the Full Prescribing Information.