How to use MUSE
MUSE uses an applicator for delivery of a medicated pellet containing alprostadil that is gently inserted into the tip of the penis. For your patients' convenience, each MUSE application comes in an individually wrapped foil pouch.
Determine the dose
- Four dosage strengths: 125 mcg, 250 mcg, 500 mcg, and 1,000 mcg1
- Base dosage strength on lowest dose sufficient for sexual intercourse1
- 125 mcg or 250 mcg recommended for initial dosing
- MUSE should not be used more than twice in a 24-hour period1
Have your patients follow these simple instructions to achieve the best results.
Immediately prior to administration, urinate and gently shake the penis several times to remove excess urine. A moist urethra makes administration of MUSE easier. The medicated pellet has been specially developed to dissolve in the small quantity of urine that remains in the urethra after urination.
Open the foil pouch by tearing fully across, beginning from the notched edge. Let the MUSE applicator slide out of the pouch. Save the pouch for discarding the MUSE applicator later.
To remove the protective cover from the applicator stem, hold the body of the applicator with your thumb and forefinger. Twist the body and pull out the applicator from the cover, being careful not to push in or pull out the applicator button. Avoid touching the applicator stem and tip. Save the cover for discarding the MUSE applicator later.
Visually inspect the MUSE applicator. The MUSE system is see-through, and you will be able to see the medicated pellet at the end of the stem. Make sure that the pellet is present before insertion.
Hold the applicator in a way that is the most comfortable for you.
Please review the anatomy of the penis, in the figure at right.
While sitting or standing, whichever is more comfortable for you, take several seconds to gently and slowly stretch the penis upward to its full length, with gentle compression from top to bottom of the glans. This straightens and opens the urethra.
Slowly insert the MUSE applicator stem into the urethra, up to the collar of the applicator. If you feel any discomfort or a pulling sensation, withdraw the applicator slightly and then gently reinsert.
Gently and completely push down the button at the top of the applicator until it stops. It is important to do this to ensure that the medicated pellet is completely released. Hold the applicator in this position for 5 seconds.
Gently rock the applicator from side to side. This will separate the medicated pellet from the applicator tip. If you apply too much pressure you may scratch the lining of the urethra, causing it to bleed.
Remove the applicator while keeping the penis upright.
Visually inspect the applicator tip to see that the medication is no longer in the applicator. Do not touch the stem. If you notice some residual medication in the end of the applicator, gently reinsert into the urethra and repeat steps 7, 8, and 9.
Holding the penis upright and stretched to its full length, roll the penis firmly between your hands for at least 10 seconds. This will ensure that the medication is adequately distributed along the walls of the urethra. If you feel a burning sensation, it may help to continue to roll the penis for an additional 30 to 60 seconds, or until the burning subsides.
Remember, each MUSE applicator is good for a single administration only. Replace the cover on the MUSE applicator, place it in the opened foil pouch, then fold the pouch and discard as normal household waste.
After you have administered MUSE, it is important to sit or, preferably, stand or walk about for 10 minutes while the erection is developing. This increases blood flow to the penis and will enhance your erection.
Reference: 1. MUSE [package insert]. Somerset, NJ: Meda Pharmaceuticals Inc.; 2014.