What special precautions should I follow?

Before using alprostadil: 

• Tell your doctor and pharmacist if you are allergic to alprostadil; other prostaglandin medications such as misoprostol (Cytotec, in Arthrotec), bimatoprost (Lumigan), latanoprost (Xalatan), and travoprost (Travatan);  or any other medications. 
• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products  you are taking or plan to take. Be sure to mention any of the following:  anticoagulants ('blood thinners') such as heparin and  warfarin (Coumadin); appetite suppressants; medications for allergies, colds, high blood pressure, or sinus problems;  and any other treatments for erectile dysfunction. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. 
• Tell your doctor if you have ever been advised by a healthcare professional to avoid sexual activity for medical reasons and if you have or have ever had blood cell problems such as sickle cell anemia (a disease of the red blood cells), leukemia (cancer of the white blood cells), multiple myeloma (cancer of the plasma cells), thrombocythemia (condition in which too many platelets are produced),or polycythemia (condition in which too many red blood cells are produced); conditions affecting the shape of the penis (angulation, cavernosal fibrosis, or Peyronie's disease); a penile implant (device that is surgically placed inside the penis to treat erectile dysfunction); or heart failure. Also tell your doctor if you or any of your family members has ever had a blood clot in the legs or lungs and if you have recently undergone major surgery. Your doctor may tell you not to use alprostadil. 
• If you are using the alprostadil pellet,  tell your doctor if you have or have ever had any narrowing, scarring, or swelling of the urinary opening of the penis or the tip of the penis. Your doctor will probably tell you not to use alprostadil pellets. 
• Tell your doctor if you have or have ever had a  bleeding disorder; a history of fainting;  or kidney, liver,  or lung disease.
• Tell your doctor if your partner is pregnant or plans to become pregnant. Do not use alprostadil pellets before sexual activity with a pregnant woman or a woman who may become pregnant without using a condom barrier. 
• You  should know that alprostadil may cause dizziness, lightheadedness, and fainting. Do  not drive a car or operate machinery after using alprostadil until you know how this medication affects you.
  Talk to your doctor about the use of alcohol during your treatment  with alprostadil. Alcohol may decrease the effectiveness of this medication. 
• You should know that a small amount of bleeding may occur in the area where the medication was given. This can increase the risk of transmitting blood-borne diseases (conditions that are spread through contaminated blood) such as HIV, hepatitis B, and hepatitis C between you and your partner. Tell your doctor if you or your partner has a blood-borne disease.