What is Alprostadil?

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 07 Jun 2022

Alprostadil is a medication for the treatment of erectile dysfunction (ED). This is when you have difficulty getting or maintaining an erection.

Man looking up Alprostadil

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

Alprostadil comes in many different forms. The 3 most common are:

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, such as Muse:

  • 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

How does Alprostadil work?

Alprostadil works by making the blood vessels expand which causes more blood flow to the penis. This is known as a vasodilator, and it helps 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.

Alprostadil does not help with premature ejaculation, but there are other treatments that can help with that such as EMLA cream or Priligy tablets.

How effective is Alprostadil?

Alprostadil can be very effective. However, it’s important to remember that everyone’s body is different and results will vary from person to person.

The different forms of Alprostadil, such as a cream, injection or urethral stick, also have different success rates.

The injection is generally the most effective form of Alprostadil and works for around 80% of men who use it.

How do you use Alprostadil?

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

Alprostadil injection

If you’ve been prescribed the Alprostadil injection, a doctor or a nurse will teach you how to use it. Here are some important points to remember:

  • wash and dry your hands first
  • use a fresh needle each time
  • use an alcohol swab to clean the site of the injection
  • safely dispose of the needle after one use to avoid penile infection
  • massage your penis gently to help the medicine spread

It’s worth pointing out that you can prepare an Alprostadil injection up to 24 hours before you use it. This is a good idea if you want to avoid disruption to sex.

Alprostadil trans-urethral stick

With the Alprostadil trans-urethral stick, a doctor can help teach you how to use it. Here are some tips on how to use it best:

  • wash and dry your hands first
  • go to the toilet beforehand to make the application easier
  • try not to touch the applicator tip to avoid infection
  • if you feel any discomfort then gently withdraw the applicator and reinsert
  • roll the penis between your hands to help the medicine spread
  • throw away the applicator immediately after you use it to avoid penile infection

Alprostadil cream

Or if you’ve been prescribed the Alprostadil cream, you should:

  • wash and dry your hands first
  • squeeze the cream out as close to the opening of the penis as possible
  • after you have applied the cream, wait for up to an hour before going to the toilet
  • throw away the applicator immediately after you use it to avoid penile 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. One clinical trial found that after 12 months’ use, some men found that they no longer need Alprostadil to achieve a satisfactory erection.

Where can I buy Alprostadil?

You can buy Alprostadil from most pharmacies if you have been prescribed the medicine by a doctor. If the medicine 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.

Why is Alprostadil not used as a first choice for erectile dysfunction treatment?

Alprostadil cream or injections tend not to be used as the first choice for treating erectile dysfunction.

You will need to have tried phosphodiesterase-5 (PDE-5) inhibitors beforehand as they are less invasive. Most patients also find it more comfortable and easier to take a tablet, such as:

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

What are the side effects of Alprostadil?

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 medicine itself.

Other side effects include:

  • dizziness
  • headaches
  • 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 weigh this up so you can make an informed decision about your medication.

If you experience swelling of the lips and tongue, difficulty breathing, or a collapse you should call 999. You may be experiencing an allergic reaction.

If you experience a prolonged or painful erection lasting for more than 4 hours, then you should speak to a doctor or call 111 for advice.

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.

Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion
Accreditations: BSc, MBBS, MRCGP (2008)

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 07 Jun 2022

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