Viridal injection (Alprostadil)

Do not use Viridal

• if you are allergic to alprostadil or any of the other ingredients of this medicine (listed in section 6). 
• if you have a deformity or disease of your penis 
• if you have sickle-cell disease (abnormal red blood cells) 
• if you have leukaemia (cancer of blood cells)
• if you have multiple myeloma (tumour of the bone marrow) 
• if you have an implant in your penis 
• if you have been told not to have sex for health reasons such as heart problems or a recent stroke
• if you have Peyronie’s disease or any scarring or deformity of the penis or foreskin. If any of the above applies to you talk to your doctor or pharmacist

Talk to your doctor or pharmacist before using Viridal

• if you have one or more cardiovascular risk factors (these might include high blood
pressure, tobacco use, raised blood glucose, raised blood cholesterol, overweight and
obesity)
• if you have or have ever had any heart problems
• if you have or have ever experienced fainting and blackouts
• if you have had short-term changes to your speech, hearing or vision
• if you suffer from lung problems
• if you have one or more risk factors for stroke (these might include high blood
pressure, raised blood cholesterol, coronary artery disease, heart arrhythmia, diabetes)
• if you suffer from blood clotting disease
• if you have or have ever had stomach bleeding or bleeding from the intestines.
You may need to have further tests before your doctor can give you this treatment (for
example, a stress resistance test and tests to check for other treatable underlying causes of
impotence).

Erection lasting over four hours can be dangerous therefore you should report immediately to
your doctor, or, if unavailable, seek immediate medical assistance for any erection that
persists for longer than four hours.
Edex will not protect you or your partner from sexually transmitted diseases like
chlamydia, gonorrhoea, herpes simplex virus, viral hepatitis, HIV, genital warts or syphilis.

As you may get a small amount of bleeding at the injection site, it is especially important that
you use a condom to avoid sexually transmitted diseases.

Viridal Duo should not be used by patients with drug addiction, mental illness or intellectual
disability.

You may need to have regular follow up examinations by your doctor to check for the
formation of scar tissue on the penis.

Your dose, form, and how often you take it will depend on age, condition being treated, severity of condition and other medical conditions you have.

The typical dosage is 2.5 to 5 mg taken two times per day dependent on condition being treated.

You may take apixaban with or without food.

If you cannot swallow a tablet whole, crush and mix it with water, apple juice, or a spoonful of applesauce. Swallow the mixture right away without chewing. Do not save it for later use.

A crushed tablet mixture may also be given through a nasogastric (NG) feeding tube.

Do not stop taking apixaban unless your doctor tells you to. Stopping suddenly can increase your risk of blood clot or stroke.

If you stop taking apixaban for any reason, your doctor may prescribe another medication to prevent blood clots until you start taking apixaban again.

Store at room temperature away from moisture and heat.

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other
medicines.
Tell your doctor if you are taking any of the following medicines:

• Drugs to treat depression known as MAOIs such as phenelzine. When taken with
Edex, these can cause very high blood pressure
• Other drugs injected into the penis for the treatment of erection difficulties such as
papaverine or phentolamine. Taking Edex as well could cause a dangerously
prolonged erection
• Any other medicines used to treat erection difficulties including sildenafil. When used
in combination with Edex, they could induce prolonged erection
• Medicines to thin your blood such as warfarin. These can cause bleeding at the site of
injection of Edex
• Drugs to lower your blood pressure and change the diameter of your blood vessels.
Edex may increase their effects and cause very low blood pressure.
• Any other medicine, including medicines obtained without a prescription.
• Other medicines to treat blood clotting as you may need special attention

You should wear a condom if your partner is, may be or could become pregnant. This is to
avoid causing irritation of her vagina or possibly damaging the unborn baby.

If you have any questions on this or if your partner is breast-feeding, please ask your doctor
or pharmacist for advice.

Viridal does not interfere with ejaculation and fertility

If you feel dizzy or faint after using Viridal you should not drive or use machinery or tools.

Always use this medicine exactly as your doctor has told you. Check with your doctor if you are not sure.

Click here to read all the instructions of how to use Viridal

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Seek immediate medical help if you have any of the following symptoms:
• An erection that lasts for more than 4 hours
• Serious allergic reactions which causes difficulty in breathing or dizziness
• Skin reactions such as rashes and blistering.
Very common: may affect more than 1 in 10 people
• Pain in the penis
Common: may affect up to 1 in 10 people
• Burning sensation during injection which quickly gets better
• Pain at the site of injection
• Lumps at the site of injection or in your penis after long-term use.
• Spot-like bruising (blood spots under the skin) at the site of injection
• Fluttering or vibrating feeling sensation due to uncontrollable muscle movement
• Erections might occur more often and longer in duration
• Bend or kink in the penis, especially after long-term use

Uncommon: may affect up to 1 in 100 people
• Reddening, itching, swelling, blistering, numbness, tenderness or a feeling of warmth
at the site of injection
• Bleeding at the site of injection
• Headache
• Priapism (prolonged erection of more than 4 hours)
• Fungal infection
• Common cold
• Reduced sense of touch or sensation
• Heightened sense of touch or sensation
• Dilation of the pupils
• Changes to heart rhythm or increased heart rate
• Low blood pressure
• Raised creatinine
• Decreased or altered blood flow to the arms or legs
• Feeling sick
• Dry mouth
• Skin rash
• Excessive sweating
• Pain when urinating, urinating more frequently or a sudden need to urinate
• Bleeding in the urethra, which can cause there to be blood in your urine
• A general increase in iron stores in the body
• Problems attaining or maintaining an erection
• Problems with ejaculation
• Painful or swollen testicles
• Lumps on the testicles
• Pain in the pelvis
• Pain, swelling or reddening of the scrotum
• Pain, swelling or reddening at the tip of the penis
Rare: may affect up to 1 in 1,000 people
• Serious allergic reactions which causes difficulty in breathing or dizziness
• Skin reactions such as rashes and blistering
• Drop in blood pressure, which may cause dizziness or fainting
• Scarring of the inside of the penis after long-term use.
• Rare nervous system disorders like vertigo (disorientation with spinning sensation),
dizziness

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.

Very rare: may affect up to 1 in 10,000 people
• Isolated cases of thrombocytopenia (abnormal drop in the number of platelets)
Not known: frequency cannot be estimated from the available data
• Loss of memory
• Stroke
• Insufficient blood flow to the heart muscle via the coronary arteries, often resulting in
chest pain (angina pectoris); heart attack
• Bleeding of the stomach and intestines

Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side
effects not listed in this leaflet. You can also report side effects directly via:
Yellow Card Scheme

Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or
Apple App Store

By reporting side effects, you can help provide more information on the safety of this
medicine.

Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on the label and carton
after EXP. The expiry date refers to the last day of that month.
• Do not store above 25°C. Store in the original package in order to protect from light.
• Do not use this medicine if you notice some moisture in the powder.
• When you have mixed the powder with the liquid in the injector, use immediately.
This cannot be stored.
• Do not throw away any medicines via wastewater or household waste. Ask your
pharmacist how to throw away medicines you no longer use. These measures will
help protect the environment.