What is Alprostadil?

Some of the most popular brand names for this type of medication include Vitaros, Caverject, Edex, and Prostin VR.

Alprostadil comes in many different forms. You can get it injected directly into the penis. You can also use it as a suppository, placing it into the opening at the tip of the penis. There are also alprostadil creams available. The 3 most common types include:

Alprostadil injections, such as Caverject, Edex and Prostin VR:

• the medicine is injected into the base of the penis
• it works for around 80% of men

Alprostadil urethral sticks (or pellets):

• a thin tube with the medicine is put into the urethra (opening to the penis)
• it works for around 50% of men

Alprostadil creams, such as Vitaros:

• the cream is applied around the head of the penis
• it works for around 40% of men

Alprostadil is a vasodilator, meaning it works by making the blood vessels expand, helping to boost blood flow throughout the body, including the penis. Alprostadil can therefore help you get and maintain an erection.

Alprostadil is a type of medicine known as a prostaglandin E1. Your body naturally produces these substances to increase blood flow to a certain area. Applying it directly to the tip of the penis in the form of alprostadil cream, or as an injection, means it works faster than taking a tablet.

You will use alprostadil based on the form of medication you are prescribed. It comes in a cream, injection, and stick form.

Alprostadil injection

If you’ve been prescribed the alprostadil injection, a doctor or a nurse will teach you how to use it. Always follow the instructions that come with your medication, which will follow these steps:

1. Wash and dry your hands.
2. Insert the needle into the bottle of alprostadil.
3. Use a fresh needle each time.
4. Draw the dose into the syringe.
5. Use an alcohol swab to clean the site of the injection.
6. Inject the dose at the base of the penis.
7. Safely dispose of the needle after one use to avoid penile infection.
8. Massage your penis gently to help the medicine spread.

If you want to avoid disruption to sex, you can prepare an alprostadil injection up to 24 hours before you use it.

Alprostadil trans-urethral stick

With the alprostadil trans-urethral stick, a doctor can help teach you how to use it. You can also follow these steps:

1. Before inserting the suppository try to urinate, as doing so afterwards may cause the medication to be ineffective.
2. Wash and dry your hands thoroughly to avoid infection.
3. Remove the delivery device containing the stick.
4. Try not to touch the applicator tip to avoid infection.
5. Stretch your penis to extend its length.
6. Press the applicator button down to release the suppository into the urethra.
7. If you feel any discomfort then gently withdraw the applicator and reinsert.
8. Roll the penis between your hands to help the medicine spread.
9. Throw away the applicator immediately after you use it to avoid penile infection.
10. Some movement for 10 minutes will help increase the blood flow.

Alprostadil cream

If you’ve been prescribed the alprostadil cream, to use it you should:

1. Wash and dry your hands.
2. Squeeze the cream out as close to the opening of the penis as possible.
3. After you have applied the cream, wait for up to an hour before going to the toilet.
4. Throw away the applicator immediately after you use it to avoid infection.

You may want your partner to be involved in the preparation and application of the alprostadil cream. If this is the case, you can talk to your doctor or nurse about how they can help.

Studies have not found any negative side effects associated with the long-term use of alprostadil.

You can buy alprostadil from most pharmacies if you have been prescribed it by a doctor. If the medication is in stock, you can usually get it on the same day.

It may also be possible to get alprostadil from some online doctor services.

Can you get alprostadil on the NHS?

You can only get alprostadil on the NHS if your erectile dysfunction is caused by a medical condition. This includes:

• diabetes
• kidney failure requiring dialysis
• kidney transplant
• multiple sclerosis
• Parkinson's disease
• polio
• prostate cancer
• removal of the prostate gland
• radical pelvic surgery
• severe pelvic injury
• single-gene neurological conditions
• spinal cord injury
• spina bifida

Otherwise, you will have to request a private prescription from your doctor. You can still access other erectile dysfunction treatments on the NHS, such as sildenafil.

You will need to store alprostadil differently based on what form of the medication you are using:

Alprostadil injection

Store in the refrigerator, but do not freeze.

Alprostadil for injection in powder form can be stored at room temperature, between 15 and 25 °C, for 3 months. After it is mixed, the solution must be used immediately or within 24 hours and not refrigerated or frozen.

Alprostadil trans-urethral stick

Unopened foil pouches should be stored in the refrigerator.

The medication may not work if exposed to high temperatures (over 30 °C). You may also store the suppositories at room temperature for up to 14 days.

Alprostadil cream

Cream should be kept in a refrigerator and warmed to room temperature before use (25 °C). The medication may not work if exposed to temperatures over 25°C. If not used after warming, it should be discarded.

Alprostadil alternatives

Most patients may find it more comfortable and easier to take medication in tablet form. Oral medications include:

• sildenafil
• Viagra
• Viagra Connect
• Cialis (tadalafil)

Both alprostadil and PDE-5 inhibitors work by improving the blood flow to your penis to help you maintain an erection.

The most common side effect of alprostadil is penile pain. This is most likely to be caused by the application rather than the side effects of the medication itself.

Other side effects include:

• dizziness
• headaches
• penile fibrosis (formation of a scar on the surface of the penis)
• flu-like symptoms
• swelling, redness, pain, or a rash on the penis
• bleeding and burning from the opening to the penis
• changes in blood pressure
• a prolonged erection of the penis (priapism)

Most patients find that the benefits of taking alprostadil outweigh the risks. It’s important to consider and compare alprostadil to other erectile dysfunction treatments so that you can make an informed decision about your medication.

Always speak to a healthcare professional, such as a doctor or pharmacist if you have concerns about your side effects. They will help you to find an alternative treatment option.

You should have regular appointments with your doctor to check your blood pressure and discuss how you think the treatment is going.