Alprostadil: Uses, Side Effects & More – Your Ultimate Guide


Alprostadil is a medicine that uses prostaglandin E1 to cause smooth muscle relaxation and increase blood flow. It has two primary uses: managing erectile dysfunction (ED) and maintaining the patency of the ductus arteriosus in neonates.

Alprostadil works by mimicking the natural impulse of prostaglandin E1, which causes smooth muscle relaxation and increases blood flow. By causing these effects, alprostadil can help manage ED by increasing blood flow to the penis. It can maintain the patency of the ductus arteriosus in neonates by relaxing smooth muscles in this area.

Alprostadil injection is used for both ED management and maintaining ductus arteriosus patency. The label lists a step-by-step use, including a time window and temperature range, and recommends rotating injection sites.

When treating ED with alprostadil injection, it is important to follow the label’s instructions closely. Injection should be performed within a specific time window after preparation, and at a specific temperature range. Injection sites should also be rotated to prevent irritation or damage.

Routes of Administration for Alprostadil

Intracavernosal Injection

One of the most commonly used routes of administration for alprostadil is through intracavernosal injection. This method involves injecting the drug directly into the penis using a syringe and plunger. The medication is typically prescribed to treat erectile dysfunction, and it works by relaxing the smooth muscles in the blood vessels and increasing blood flow to the penis.

While this method may sound intimidating, it is actually a relatively simple process that can be done at home with proper instruction from a healthcare provider. Before administering an injection, patients should clean their hands and genital area thoroughly to minimize the risk of infection. They should also use a new needle and syringe each time they inject alprostadil.

Once ready, patients will inject the medication into one of two areas on either side of the base of their penis using a small needle. Within 5-20 minutes, an erection will occur that can last up to one hour or longer depending on dosage.

Intraurethral Suppository

Another route of administration for alprostadil is through intraurethral suppository. This form of alprostadil comes in pellets or small medicated inserts that are inserted into the urethra using an applicator device provided by the manufacturer.

Once inserted, these pellets dissolve and enter the blood vessels in order to achieve an erection within 10-30 minutes after insertion. Common brands include Caverject and Caverject Impulse.

This method may be preferred over injections due to its ease of use and lower risk of complications such as pain or bleeding at injection site. However, some men may find inserting pellets uncomfortable or experience mild burning sensations during urination after use.

Potential Side Effects of Alprostadil Use

Alprostadil is a medication used to treat erectile dysfunction (ED) in men. While it can be effective in improving sexual function, alprostadil use may also cause side effects. Here are some important things to know about the potential adverse events associated with this medication.

Prolonged Erection

One possible side effect of alprostadil use is a prolonged erection that lasts for more than four hours, also known as priapism. This condition can be painful and potentially damaging to the penis if not treated promptly. If you experience an erection lasting longer than four hours after using alprostadil, seek medical attention immediately.

Correct Use

To avoid side effects from alprostadil use, it’s essential to follow the instructions provided by your healthcare provider carefully. Do not exceed the recommended dose or frequency of use, and do not apply more cream or inject more medication than directed. Using too much alprostadil can increase your risk of adverse events and permanent damage.

Permanent Damage

While rare, permanent damage to the penis can occur if alprostadil is not used correctly or if priapism goes untreated for too long. This damage may include scarring, curvature of the penis, or difficulty achieving erections in the future. To minimize your risk of permanent damage from alprostadil use, always consult with your doctor before starting treatment and report any unusual symptoms right away.

If You Experience Side Effects

If you experience any side effects from alprostadil use, be sure to seek medical attention promptly. Some common symptoms include pain at the injection site (if using an injectable form), itching or burning sensation on the skin (if using a cream), dizziness or lightheadedness, headache, nausea or vomiting, and changes in vision or hearing.

Interactions with Alprostadil

Informing your Health Care Provider of Medications Taken

It is important to inform your health care provider about all the drugs you are taking before using alprostadil. This medication may interact with other medications, causing unwanted side effects or reducing its effectiveness. Your health care provider can help determine if alprostadil is right for you based on your medical information.

Reading Instructions and Contacting a Pharmacist

Before using alprostadil, it is essential to read the instructions carefully and follow them precisely. Patients should contact their pharmacist or health care provider if they have any questions about how to use this medication properly. It is crucial not to exceed the dose recommended by your doctor or pharmacist.

FDA Approval and Use in Adults Only

The FDA has approved alprostadil for use in adults only; therefore, it should not be used in children. If you are an adult who has been prescribed this medication, it is essential to follow the instructions provided by your doctor or pharmacist carefully. Do not share this medication with anyone else, even if they have similar symptoms.

Contacting Your Interprofessional Care Team

If you experience any adverse effects while using alprostadil or notice any changes in activity levels, contact your interprofessional care team immediately. They can help determine whether these changes are related to the medication or something else entirely. You should also reach out to them if you have any questions about how to use this medication correctly.

Precautions to Take

Using alprostadil requires taking certain precautions to ensure safety and effectiveness. Here are some important measures that patients should take before using this medication.

Clean the Injection Site with an Alcohol Swab

Before injecting alprostadil, it is crucial to clean the injection site with an alcohol swab. This helps prevent infection by removing germs from the skin’s surface. Patients should also avoid touching the cleaned area until after they have injected the medication.

Dispose of Sharps Properly

After using alprostadil, patients must dispose of sharps properly to reduce the risk of injury or infection. The needle assembly, protective cap, and blue plunger should be discarded in a sharps disposal container immediately after use. Patients should never reuse needles or share them with others.

Avoid Alcohol and Medicines That Decrease Blood Clotting

Alcohol and medicines that decrease blood clotting can increase the risk of bleeding at the injection site when used with alprostadil. Therefore, patients should avoid consuming alcohol during treatment with this medication. They should also talk to their doctor about any other medications they are taking that may affect blood clotting.

Handle Needles Carefully

Patients who use alprostadil injections must handle needles carefully to prevent injury or infection. They should always follow proper injection techniques and dispose of sharps promptly after use. Patients should never recap needles or break them off in syringes as these actions can lead to accidental needle sticks.

Dosage Guidelines for Alprostadil Use

Correct Dose is Crucial

Alprostadil is a medication used to treat erectile dysfunction (ED) by increasing blood flow to the penis. However, the correct dose of alprostadil is crucial for safe and effective use. The recommended dose of alprostadil varies depending on the dosage form used.

Dosage Forms of Alprostadil

Alprostadil is available in various dosage forms, including injections and pellets. The injection form of alprostadil is administered directly into the penis using a fine needle. On the other hand, pellet form alprostadil comes in small suppository-like shapes that are inserted into the urethra.

Recommended Dose of Alprostadil

The recommended dose of alprostadil ranges from 2.5 mcg to 60 mcg depending on the dosage form used. For example, if you’re using an injection form of alprostadil, your doctor may recommend starting with a low dose like 2.5 mcg and gradually increasing it until you achieve satisfactory results or experience adverse effects.

Partial Dose May Be Necessary

If you experience adverse effects such as pain, bleeding, or prolonged erections after taking alprostadil, your doctor may recommend partial dosing instead of discontinuing its use altogether. Partial dosing involves using smaller doses than what was initially prescribed until your body adjusts to the medication’s effects.

Dose Window and Storage Conditions

It’s important to note that alprostadil should be stored at room temperature and used within the recommended dose window. Using expired or improperly stored medication can cause serious side effects or reduce its effectiveness.

Emergency/Overdose Symptoms of Alprostadil

Emergency Symptoms of Alprostadil Overdose

Alprostadil is a medication used to treat erectile dysfunction and certain heart and lung conditions. However, like any other drug, it can cause adverse effects when taken in excessive amounts. In case of an overdose, immediate medical attention is necessary to prevent serious complications.

Severe Hypotension

One of the emergency symptoms of alprostadil overdose is severe hypotension or low blood pressure. This occurs when the drug dilates the blood vessels, causing a sudden drop in blood pressure. Symptoms may include dizziness, lightheadedness, fainting, and confusion. Severe hypotension can be life-threatening if not treated promptly.

Priapism and Prolonged Erection

Another emergency symptom of alprostadil overdose is priapism or prolonged erection lasting more than four hours. This condition occurs when blood becomes trapped in the penis, leading to tissue damage and permanent impotence if left untreated. Priapism can be painful and may require surgical intervention.

Immediate Medical Attention is Necessary

In case of an alprostadil overdose, seeking immediate medical attention is crucial to prevent serious complications. Patients should call their healthcare provider or go to the nearest emergency room right away. Treatment may involve pumping out the stomach contents or administering medications to increase blood pressure or reverse the effects of alprostadil.

Follow Prescribed Dosage

To avoid an alprostadil overdose, patients should always follow their prescribed dosage and inform their healthcare provider if they experience any adverse effects such as headache, nausea, vomiting, or chest pain. Patients with underlying medical conditions such as heart disease or hypertension should use caution when taking alprostadil.


While alprostadil can be an effective treatment for erectile dysfunction, it’s important to weigh the potential benefits against the risks before deciding whether to use it. By working closely with your healthcare provider and following their instructions carefully, you can minimize your risk of experiencing adverse effects while maximizing the potential benefits of this medication.