Priapism

In patients with ischaemic priapism being treated with intracavernous sympathomimetic drugs, doctors should observe patients for symptoms and signs consistent with known undesirable effects of these agents. These include acute hypertension, headache, reflex bradycardia, tachycardia, palpitations, and cardiac arrhythmia. Placing all patients receiving sympathomimetics on telemetry monitoring is preferred; however, in patients with high cardiovascular risk, blood pressure and ECG monitoring are strongly recommended.

Ketoconazole (for the prevention of recurrent ischaemic priapism) may cause severe liver injury and adrenal insufficiency.[1]Bivalacqua TJ, Allen BK, Brock GB, et al. The diagnosis and management of recurrent ischemic priapism, priapism in sickle cell patients, and non-ischemic priapism: an AUA/SMSNA guideline. J Urol. 2022 Jul;208(1):43-52. https://www.auajournals.org/doi/10.1097/JU.0000000000002767 http://www.ncbi.nlm.nih.gov/pubmed/35536142?tool=bestpractice.com Liver and adrenal function should be monitored before and during treatment.