alprostadil at a glance
Medicine class
Prostaglandin E1 and vasodilator
Main adult use
Erectile dysfunction; some injections also assist diagnostic assessment
What is alprostadil used for?
Selected products are licensed for:
Erectile dysfunction in adult men, including neurogenic, vascular, psychological or mixed causes.
Diagnostic assessment of erectile dysfunction with selected intracavernosal injections.
Temporary maintenance of ductus arteriosus patency in infants whose congenital heart defect depends on it, pending intervention.
How does alprostadil work?
Alprostadil activates prostaglandin receptors, increasing cyclic AMP and relaxing vascular smooth muscle. In erectile tissue, this increases arterial inflow and traps blood within the penis. In duct-dependent congenital heart disease, vasodilation helps keep the ductus arteriosus open temporarily.
alprostadil preparations and strengths
Cream
Route: Cutaneous
Strengths: 3 mg/g
Solution for infusion
Route: Intravenous
Strengths: 500 micrograms/mL
Injection
Route: Parenteral
Strengths: 10 micrograms, 10 micrograms/mL, 20 micrograms, 20 micrograms/mL, 40 micrograms/mL
How to take alprostadil
Administration depends on the formulation. Follow the product-specific training and instructions from the clinical team.
Cream: urinate first, wash your hands, apply the full single-use container to the urethral opening without inserting its tip, hold the penis upright briefly, then wash your hands again. Do not urinate immediately afterwards.
Intracavernosal injection: use only after supervised training. Use aseptic technique, alternate sites, avoid visible veins and do not use or straighten a bent needle.
Discard single-use containers, needles and unused reconstituted injection solution safely as instructed.
Neonatal concentrate is diluted and given continuously by trained professionals where paediatric intensive-care and ventilation facilities are immediately available.
alprostadil side effects
Common or expected effects
- Penile pain, burning, redness, swelling or discomfort
- Injection-site bruising or haematoma
- Muscle spasms with intracavernosal injection
- Urethral pain or rash with cream
- Vaginal irritation in a partner exposed to cream
- In babies receiving an infusion: temporary fever, breathing pauses, flushing, heart-rate or blood-pressure changes, low potassium, diarrhoea or seizures
Get urgent medical advice
- An erection lasting four hours or longer
- Severe dizziness, fainting or marked hypotension
- Severe allergic reaction
- New penile curvature, hard nodules or other signs of fibrosis requiring prompt clinical review
- In an infant: apnoea, significant bradycardia or seizures
alprostadil in pregnancy
The erectile-dysfunction products are not intended to treat pregnant women, but partner exposure matters. A latex condom should be used with Vitaros when the partner is pregnant or could become pregnant; Viridal also advises condom use if the partner is pregnant. Seek product-specific advice from the prescriber.
alprostadil while breastfeeding
Vitaros should not expose a breastfeeding partner directly; its product information recommends a latex condom because transfer and breast-milk excretion after indirect exposure are uncertain. The other represented uses do not involve treatment of a breastfeeding mother.
alprostadil interactions
Interaction risks differ by formulation and should be checked before treatment.
PDE5 inhibitors and other erection-inducing medicines
Combining them with erectile-dysfunction alprostadil may increase the risk of hypotension or a prolonged erection and is not recommended by selected product information.
Common questions about alprostadil
Answers are fully visible for fast scanning and source review.
Is alprostadil the same as prostaglandin E1?
Yes. Alprostadil is the medicinal form of naturally occurring prostaglandin E1.
Why is alprostadil given to a newborn baby?
It can temporarily keep the ductus arteriosus open when a congenital heart defect depends on that blood-flow pathway until cardiac intervention is possible.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.