PROLONGED USE OF MOXISYLYTE CHLORHYDRATE (ICAVEX(R)) FOR INTRA-CAVERNOUS SELF-INJECTIONS FOR IMPOTENCE - EVALUATION OF LONG-TERM TOLERANCE

Moxisylyte chlorhydrate is a selective alpha-blocker of the postsynapt ic alpha 1-adreonoreceptors. It has been used since 1992 for self-inje ctions to induce erection. Tolerance has been studied in open trials i n 143 men using 20 mg per intracavernous injection. Among these subjec ts, 104 were followed for 11 months. Self-administration was performed 7509 times, i.e. 49.1 injections per subject over a mean period of 30 7 days. No severe side effects were observed. A total of 1041 undesira ble effects were reported by 90 subjects (75.1%), including mechanical disorders (28.2%) such as pain and burning sensation at injection, he matomas and ecchymoses. Nodules developed in 0.08% of the cases but al ways regressed. In 71.8% of the cases, the undesirable events was impu table to moxisylyte: dry mouth (2.73%), somnolence (1.9%), sinus conge stion (0.71%). No case of priapism was reported. Long-term evaluation showed a reduction in the main undesirable effects with time. This fal l off in the mechanical events could be explained by the subjects beco me more familiar with the technique. Pharmacological effects remain to be analysed. Treatment efficacy was constant throughout the study per iod. Added to the good tolerance, this result suggests that self-injec tion can be proposed as a first intention treatment for impotency.