Alprostadil Cream and Injections

Dr Nicholas Antonakopoulos

Medically reviewed by

Dr Nicholas Antonakopoulos

Last reviewed: 12 Mar 2019

Should you consider this medication?

Man looking up Alprostadil

Key takeaways

  • Alprostadil is a medication applied to your penis to improve erectile dysfunction

  • Alprostadil is not a first choice medication. PDE5-inhibitors like Sildenafil are usually tried first

  • You can get Alprostadil from a pharmacy with a prescription and also from some online suppliers

  • There are 3 different kinds of Alprostadil that are all used differently

  • Penis pain is a common side effect of Alprostadil

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If you're looking for treatments for erectile dysfunction then it helps to know what your options are. Erectile dysfunction pills like Viagra are well known but what about medications like Alprostadil?

Alprostadil is an alternative to medications like Viagra but it's not the right choice for everyone looking for treatment. Check to see if Alprostadil is a good fit for you.

What is Alprostadil?

Alprostadil is a medication used in the treatment of erectile dysfunction (ED). It works by improving the blood flow to the penis, which can help get and maintain an erection. It comes in three forms:


  • The medicine is injected into the base of the penis
  • They work for around 80% of men who try them

Urethral sticks:

  • A narrow stick of the medicine is inserted into the urethra (the opening to the penis where urine and semen exits)
  • They work for around 50% of men who try them


  • The medicine is applied around the head of the penis
  • They work for around 40% of men who try them

Alprostadil encourages blood flow – Alprostadil is part of a family of chemicals called prostaglandins. Your body naturally produces these substances to increase blood flow to specific areas in your body. By applying alprostadil to the penis, the body receives signals to increase the blood flow to that area which helps to improve erections.

Should I consider Alprostadil treatment?

Not as a first choice – Alprostadil isn't used first-line for erectile dysfunction treatment. This means that a patient will have tried other medicine beforehand. If that medicine did not work for them, then an option would be to try Alprostadil.

What should you consider first – the first-line treatment for ED are a family of medicines called PDE-5 inhibitors. PDE-5 inhibitors are considered a better first-line treatment because they come in the form of tablets that you can take by mouth. Some patients may find it more comfortable and easier to take a tablet rather than use the methods needed to use Alprostadil. PDE-5 inhibitors include:

Which works best? – both Alprostadil and PDE-5 inhibitors work by improving the blood flow to your penis. The effectiveness of both is roughly equal, with some studies saying that PDE-5 inhibitors are around 80% effective. However, everyone’s body is different and it is very difficult to predict whether Alprostadil will be effective for you.

How can you decide? – to help you make a decision, it may be helpful to make an appointment and talk through your options with a doctor. Your doctor can review the medications you are on, the medical conditions that you have, and your lifestyle to see whether Alprostadil is a suitable option for treatment.

Where can I buy Alprostadil?

You can get Alprostadil from most pharmacies – if you have been prescribed the medicine by a doctor. If the medicine is in stock, you can get it on the same day. If not, you may have to wait until the next day to get your supply of Alprostadil from the pharmacy.

Some availability online – it may also be possible to get Alprostadil from some online doctor services. If you are considering this, it’s important to research the company that you are buying Alprostadil from to make sure they are reputable. Companies that are regulated have to pass certain standards which means that the medicine that you are buying should be safe and effective.

Is it easy to get on the NHS? – you can only get Alprostadil on the NHS if your erectile dysfunction (ED) is caused by a specific set of medical conditions. These conditions are:

  • Diabetes
  • Kidney failure requiring dialysis
  • Kidney transplant
  • Multiple sclerosis
  • Parkinson's disease
  • Polio
  • Prostate cancer
  • Removal of the prostate gland (prostatectomy, including men who have had a transurethral resection of the prostate)
  • 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.

How do you use Alprostadil?

If you have been prescribed the injection – a doctor or a nurse will teach you how to use it. There are some important points to remember:

  • Make sure that you have washed and towel-dried your hands before preparing the injection and before you apply the injection
  • You can prepare the injection up to 24 hours before you use it, so if you prefer not to plan sex in advance you can prepare the injection beforehand
  • Make sure that the needle is not bent. If this is the case, dispose of it safely. Do not attempt to straighten the needle or use this injection because there is an increased risk that the needle will break
  • You can use an alcohol-based swab to clean the area where you will apply the injection
  • Safely dispose of the needle immediately after you’ve applied the injection. Do not keep a portion of the medicine for a second injection as there is an increased risk of needle breakage and infection if you do so
  • Massage your penis gently to help the medicine spread throughout the area

If you have been prescribed the trans-urethral stick – a doctor or nurse will teach you how to use it. There are some important points to remember:

  • Make sure that you have washed and towel-dried your hands
  • Before you apply the medicine, you should urinate as having a moist urethra will make application easier
  • Try not to touch the applicator tip at any point. This is to reduce the chance of getting an infection
  • If you feel any discomfort whilst inserting the applicator, gently withdraw the applicator slightly and re-insert
  • Roll the penis between your hands to help spread the medicine spread throughout the area
  • Throw away the applicator immediately after you use it. Do not keep the applicator for a second use as there is an increased risk of infection if you do so

If you have been prescribed the Alprostadil cream – a doctor or nurse may teach you how to use it. There are some important points to remember:

  • Make sure that you have washed and towel-dried your hands
  • Make sure that you do not insert the applicator inside the penis. Instead, you should squeeze the cream out as close to the opening of the penis as possible to allow the cream to flow into the urethra
  • Do not urinate immediately after you have applied the medicine as there is a risk that it will be washed out before the effects take place
  • Throw away the applicator immediately after you use it. Do not keep the applicator for a second use as there is an increased risk of infection if you do so

Getting your partner to help – you may want your partner to be involved in the preparation and application of the Alprostadil medicine. If this is the case, you can talk to your doctor or nurse about educating your partner as well as yourself.

Can you use it long term? – studies have not found any negative effects that are associated with the long-term use of Alprostadil. Some had even found positive long-term benefits of using Alprostadil. One study found that after 12 months’ use, some men found that they no longer need Alprostadil to achieve a satisfactory erection.

What are the side effects of Alprostadil treatment?

Common side effects – the most common side effect of Alprostadil is pain in the penis. This is most likely caused by the methods needed to use the medicine rather than a side effects of the medicine itself. Other common side effects of Alprostadil include:

  • Dizziness, headache, or flu-like symptoms
  • Swelling, redness, pain, or a rash on the penis
  • Bleeding and burning from the urethra (the opening to the penis)
  • Changes in blood pressure

Are the side effects worth it? – some people find that the benefits of taking Alprostadil outweigh the risks of experiencing some of the symptoms listed above and therefore continue to use it despite the negative effects. You should speak to a doctor or pharmacist if you find that you cannot tolerate these symptoms to see whether there is an alternative option for you.

Signs of an emergency – if you experience swelling of the lips and tongue, difficulty breathing, or a collapse, you may be experiencing a severe allergic reaction. You should call 999 or go to your nearest A&E department.

Medically reviewed by:
Dr Nicholas Antonakopoulos

Dr Nicholas Antonakopoulos graduated from the University of London in 2006. He did his postgraduate training in hospitals in the London area, and he trained for four years in Trauma and Orthopaedic Surgery before completing his training in General practice in 2015.

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Last reviewed: 12 Mar 2019

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