Alprostadil: Uses, Side Effects, Warnings, & More

What Is Alprostadil?

Alprostadil belongs to the prostaglandin analog drug class. Approved by the FDA for the treatment of erectile dysfunction (ED), it facilitates increased blood flow within the penis, aiding in achieving and sustaining an erection. It’s also used to help newborns with congenital heart diseases maintain open blood vessels before surgery.¹ The focus of this article will be its use as a treatment for ED.

How Does Alprostadil Work for Erectile Dysfunction?

Alprostadil is a type of medication known as a vasodilator. These medications widen blood vessels, enhancing blood flow. For people who have ED, the increased blood circulation within the penis may more effectively result in an erection when sexual arousal occurs.

How Effective Is Alprostadil for Erectile Dysfunction?

Research shows that alprostadil is an effective treatment for erectile dysfunction (ED). A study with 979 men showed positive results, with all alprostadil doses outperforming placebo. In a six-month study, 94% of injections allowed sexual activity, rated satisfactory by 87-86% of men and their partners.²

Another study found that alprostadil cream, a simpler option, had an 83% success rate in severe ED, with minimal side effects. This makes alprostadil a useful option for ED treatment, especially for those avoiding systemic treatments.³

How Long Does Alprostadil Last?

The effect of alprostadil typically lasts around 30 to 60 minutes, providing a window for sexual activity. It’s important not to use the injection more than three times a week, allowing at least 24 hours between uses. Following these guidelines reduces the potential risks while facilitating effective treatment.

How Long Does it Take for Alprostadil to Work?

Alprostadil typically starts working within 5 to 10 minutes, allowing for sexual activity within 10 to 30 minutes after use. It’s important to note that an erection may persist after ejaculation, which is a common effect of the medication. This quick onset of action makes alprostadil a convenient option for men seeking prompt results.

How Long Do I Need to Keep Taking Alprostadil?

The duration of alprostadil use varies based on individual needs and preferences. It is typically used on an as-needed basis for managing erectile dysfunction (ED). Users administer the medication shortly before sexual activity.

Follow the prescribed guidelines and consult with a healthcare provider to determine the most suitable and effective usage for your situation. Unlike some daily medications, alprostadil is used on-demand, providing flexibility for those seeking immediate assistance with erectile functioning.

Is Alprostadil More Effective Than Viagra?

In a study comparing alprostadil and Sildenafil citrate (Viagra), both improved penile rigidity. For men with blood vessel-related erectile dysfunction (vasculogenic impotency), alprostadil injection or oral sildenafil are suggested as starting therapies. However, for those with non-blood vessel-related issues, alprostadil may not be the first choice. The study indicates that both treatments are effective, but the choice depends on the specific cause of erectile dysfunction.⁴

Side Effects of Alprostadil for Erectile Dysfunction

Alprostadil for erectile dysfunction may lead to persistent side effects, including prolonged erections, penile pain, swelling, testicular pain, and penile rash. Temporary side effects, often diminishing with continued use, involve dizziness, back pain, bleeding post-injection, urethral discomfort, and stuffy nose. In rare cases, hypotension may occur. Promptly inform a healthcare provider about persistent or serious side effects to ensure proper adjustment or discontinuation of the medication as needed.

Common Side Effects of Alprostadil

Common side effects of alprostadil for erectile dysfunction include several temporary symptoms. Communicate any concerns about side effects promptly with your healthcare provider.

Common side effects of alprostadil include:¹

• Prolonged erection
• Dizziness
• Penile pain
• Back pain
• Pain after injection
• Penile swelling
• Urethral discomfort
• Testicular pain
• Stuffy nose

*All medications, including alprostadil, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Side Effects of Alprostadil

Serious side effects of alprostadil may occur for some patients. If you experience any of the following symptoms or conditions, seek immediate medical help.

Serious side effects of alprostadil include:¹

• Allergic reaction
• Priapism (prolonged erection)
• Penile fibrosis (deformed penis shape)
• Low blood pressure (hypotension)
• Injection site bleeding
• Increased risk of heart problems
• Needle breakage
• Benzyl alcohol toxicity

*All medications, including alprostadil, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.

Alprostadil for Erectile Dysfunction Warnings & Precautions

Important warnings and precautions are issued for alprostadil. Using alprostadil does not come without risk, and it may not be suitable for every patient with ED. Additionally, alprostadil does not prevent sexually transmitted diseases.

Warnings and precautions for taking alprostadil include:¹

• Prolonged erection (priapism): Erections lasting 4 to 6 hours occurred in 4% of users, with a 0.4% risk of priapism. Seek immediate help to prevent potential damage, especially if you have conditions like sickle cell anemia.
• Allergic reactions: Watch for swelling, itching, or rash. If these occur, get medical help right away.
• Penile fibrosis: 3% reported fibrosis. Regular checks are needed, and if you notice signs, stop using them.
• Hypotension: Injections may lower blood pressure. Be cautious if you have known blood vessel issues.
• Injection site bleeding with anticoagulants: If you’re on blood thinners, you may bleed more. Apply pressure after injection.
• Cardiovascular risks: Sexual activity may pose risks if you have heart issues. Consult about your heart health.
• Risks with other vasoactive medications: Combining with other medications is risky. It may cause prolonged erection, priapism, or low blood pressure.
• Needle breakage: Use care with the needle to avoid breakage.
• Counseling on sexually transmitted diseases: Alprostadil doesn’t protect against sexually transmitted diseases. Discuss protective measures with your partner.

Drug Interactions With Alprostadil

It’s essential for individuals using alprostadil to inform their healthcare providers about all medications, including over-the-counter drugs, supplements, and herbs, to ensure a comprehensive understanding of potential risks and benefits. This communication can help avoid unexpected complications and ensure the safest use of alprostadil in each individual’s unique medical context.

4 substances you should avoid while taking Alprostadil include:¹

• Anticoagulant medications (e.g., warfarin, heparin): These medications, which thin the blood, may increase the risk of bleeding at the injection site when used with alprostadil. If taking anticoagulants, consult with your healthcare provider.
• Blood pressure medications: Combining alprostadil with medications for high blood pressure may lead to a greater drop in blood pressure, potentially causing dizziness or fainting. Inform your healthcare provider if you are on blood pressure medications.
• Nitrate medications (e.g., nitroglycerin): Alprostadil may enhance the blood pressure-lowering effects of nitrates, leading to severe hypotension. Avoid using alprostadil with nitrates, commonly used for chest pain.
• Herbal supplements (e.g., ginkgo biloba): Certain herbal supplements, like ginkgo biloba, may increase the risk of bleeding when combined with alprostadil. Discuss the use of herbal supplements with your healthcare provider.

Alprostadil Dosages for FDA-Approved Treatment

Alprostadil dosages for FDA-approved treatment are tailored to individual needs. Available in 20 mcg/vial and 40 mcg/vial lyophilized powder forms, dosages depend on factors like age and the specific condition being addressed. Approved for adults, including geriatric patients, alprostadil should be administered following healthcare provider guidance.¹

Alprostadil Forms & Strengths

Alprostadil is available in various forms and strengths to address individual needs. The medication comes in lyophilized powder forms of 20 mcg/vial and 40 mcg/vial, allowing flexibility in dosing. The choice of the most appropriate form and strength is determined by factors such as the patient’s condition, age, and overall health. Prescribers consider the specific requirements of the individual and may opt for a particular form based on factors like onset time, patient preference, or the desired duration of effect.

Alprostadil is available in the following forms and strengths:¹

• 20 mcg/vial lyophilized powder
• 40 mcg/vial lyophilized powder

How to Take Alprostadil for Erectile Dysfunction

Your prescriber will determine the most suitable Aprostadil dose for your needs. Thorough training in self-injection starts in the clinic setting before starting at-home use. Starting doses vary based on the type of dysfunction, ranging from 1.25 mcg to 2.5 mcg.¹ Your healthcare provider will set up visits every three months to evaluate the effectiveness and safety of your Aprostadil use.

How Often Can You Take Alprostadil?

You can take alprostadil for erectile dysfunction up to three times per week, with at least 24 hours between each dose. The frequency is carefully regulated to balance effectiveness and safety. It’s essential to adhere to the prescribed dosing schedule and avoid exceeding the recommended frequency.

Coping With Injection Site Pain and Discomfort

To minimize discomfort from the alprostadil injection site, follow proper injection techniques as instructed by your healthcare provider. Applying a topical anesthetic cream before the injection can also help numb the area. Additionally, using the medication at room temperature and not using the same injection site each time can reduce localized pain. If persistent or severe pain occurs, do not take any more injections and talk to your provider right away.

How to Get Alprostadil for Erectile Dysfunction

Alprostadil for erectile dysfunction is typically prescribed by healthcare professionals specializing in men’s sexual health, such as urologists or primary care physicians. To initiate the conversation about alprostadil, talk with your healthcare provider about your symptoms and goals for sexual functioning. Your prescriber will evaluate your medical history, assess the nature of your erectile dysfunction, and consider other treatments before potentially deciding on alprostadil.

Can You Buy Alprostadil Over the Counter?

No, alprostadil is not available over the counter. It should only be used under the guidance of a healthcare professional and with a doctor’s prescription. This medication is specifically intended for men with erectile dysfunction, and improper use may lead to permanent damage to the penis and loss of the ability to have erections.

How Much Does Alprostadil Cost?

The cost of Alprostadil can vary based on the specific formulation. For Edex (alprostadil), the GoodRx’s lowest price is approximately $216.70, saving 20.22%, with an average retail price of $271.62.⁵

Muse (alprostadil) has a GoodRx lowest price of around $444.57, saving 23.07%, and an average retail price of $577.88.⁶ Prices may fluctuate based on location, pharmacy, and available discounts. It’s advisable to check reliable sources like GoodRx for the most up-to-date and accurate pricing information.

Alprostadil Vs. Other Erectile Dysfunction Treatments

Alprostadil works differently from more commonly used erectile dysfunction medications, such as Viagra (sildenafil) and Cialis (tadalafil). While Viagra and Cialis focus on boosting blood flow indirectly, Alprostadil takes a direct route by widening blood vessels. This makes it a good pick for those not getting the results they want from pills. Medications like Viagra and Cialis can be more convenient to take, but Alprostadil offers an alternative, especially for those who prefer not to take pills.

Alprostadil in Combination With Lifestyle Changes

Combining Alprostadil with positive lifestyle adjustments may enhance its effectiveness. Adopting a healthy lifestyle, including regular exercise, a balanced diet, and managing stress, can contribute to overall well-being and potentially improve erectile function. Maintaining a healthy weight and avoiding smoking and excessive alcohol consumption may also help.

Despite the potential benefits, lifestyle changes alone might not be sufficient for everyone with ED. Alprostadil, with its vasodilating effects, can complement these efforts by directly promoting increased blood flow within the penis.

Other Treatment Options for ED

There are many treatment options for erectile dysfunction (ED), including non-medication choices. Your healthcare provider can help you understand what may fit best for your situation.

Treatment options for erectile dysfunction include:⁷

• Medication for erectile dysfunction: Medication for erectile dysfunction includes pills or injections that help promote and keep an erection by improving blood flow.
• Natural supplements:* Supplements such as l-arginine and yohimbe may be helpful for treating erectile dysfunction without prescription medication, though more research is needed to back up any claims.
• Sex therapy: Sex therapy can help address feelings, thoughts, and behaviors related to sexual functioning.
• Vacuum erection devices: These are medical devices that help create erections by pulling blood into the penis.
• Penile prosthesis implantation: This is a surgery that implants a device inside the penis, helping restore normal sexual functioning.
• Penile vascular surgery: This surgery helps younger men with ED caused by injury, aiming to restore sexual functioning.

Alprostadil in Combination With Other ED Treatments

Combining Alprostadil with other ED treatments may be an effective strategy for some. Alprostadil can be used alongside oral medications like Viagra or Cialis for a more comprehensive effect. However, there are risks with any medications and your healthcare provider can help determine whether this approach may be appropriate for you.

Questions to Ask Your Healthcare Provider About Alprostadil for Erectile Dysfunction

If you’re considering Alprostadil for erectile dysfunction, sk about the potential benefits, any side effects or risks associated with the medication, and how it aligns with your overall health.

Questions to ask your care team about Alprostadil include:

• How safe is Alprostadil?
• How long will it take for me to adjust to taking Alprostadil?
• Am I at risk for more serious symptoms if I am already taking other medications?
• What are the potential side effects, and how can they be managed?
• Can I take Alprostadil if I have other health conditions?
• Are there any lifestyle changes I should consider while using Alprostadil?
• How often should I follow up with my care team during Alprostadil treatment?
• What should I do if I miss a dose?
• Can I drink alcohol while using Alprostadil?
• How will Alprostadil interact with my current medications?
• Are there any specific warning signs or symptoms that require immediate medical attention?
• What alternative treatment options are available, and how do they compare to Alprostadil?

How to Know If Alprostadil Is Right for You

Determining if Alprostadil is right for you involves a thoughtful discussion with your healthcare provider. Consider factors such as your overall health, existing medical conditions, and the severity of your erectile dysfunction. Discuss any medications you’re currently taking, as well as your lifestyle. Your provider will assess these factors to determine if Alprostadil aligns with your needs and if it’s the most suitable option for your unique situation..