Alprostadil (Urethral)

Alprostadil is a vasodilator, it works by expanding blood vessels, allowing blood flow which causes an erection.


30 million men in the United States alone suffer from erectile dysfunction. Approximately 52% overall develop the condition over their lifetime according to the Cleveland Clinic. Age, underlying medical conditions, and certain types of medication increase the risk for the erectile dysfunction to develop. Alprostadil is recommended in the cases that can't or couldn't be treated by other drugs.

What does it treat

  • Erectile Dysfunction
  • Heart Condition in babies

Type of medicine

  • Injection
  • Urethra Suppository Pellet

Side effects

Patients experience some sort of side effects with all medications. Some side effects are more serious than others. While taking this medication you and your doctor will have to determine whether or not the benefits outweigh the disadvantages.

  • headache
  • backpain
  • blurry vision
  • aches and pains in penis
  • swollen legs
  • urethra pain
  • hot burning in urethra
  • lightheadedness resulting in fainting
  • long lasting erection over 4 hours long
  • swollen veins in legs and thighs
  • runny nose
  • throwing up
  • insomnia
  • fever
  • chills
  • fatigue
  • excessive sweating
  • sneezing
  • cough
  • joint pain
  • sore throat
  • ¬†feeling of Discomfort
  • feeling of illness
  • stuffy nose
  • achy muscles
  • confusion
  • bleeding in testicles
  • pain in testicles
  • dizziness
  • loss of appetite



  • Urine dissolves the suppository, go to the bathroom and urinate before insertion.
  • Take the pellet out of the package and take the applicator cap off
  • Extend your penis length by stretching it up and out. Apply pressure to the top and bottom of the penis.
  • Gently insert the delivery stem up to its collar and ease the stem into the urethra. Slowly remove the applicator if there's any pain or a pulled feeling in the penis. Gently try again.
  • Release the suppository into the urethra by pressing the bottom until it can't go down anymore. Wait 5 seconds and move the applicator slowly back and forth to gently remove it.
  • Check device for any excess suppository.
  • If any portion of the suppository remains, repeat.
  • To dissolve the suppository, roll penis back and forth in your hands for a minimum of 10 seconds.
  • Continue until any throbbing or stinging stops.
  • For the best results walk or stand around for at least 10 minutes.
  • Put the cap back on, return it to the foil and dispose of it in the garbage.

Inject the penis 15-30 minutes before having sexual intercourse. Do not take more than 2 doses within a day. A full day or 24 hours must pass before each dose. Your doctor will review the urethral suppository process at length and in detail at your consultation. Do not double dose. Only take the exact amount stated by your doctor and in the directions given by the pharmacist.

It's best to insert the pellet 15-30 minutes before sexual intercourse. You'll need the extra time to walk around and get the medicine working, and the erection in full effect. Do not insert more than pellet one at a time. The initial dose should always be at the lowest strength to avoid overdose. Consult with your doctor before attempting to increase your dosage. If the directions state you may increase the dosage until you achieve an erection, slowly increase the dose in the increments indicated in the insert and consult with your doctor.

Do not skip any steps for insertion of the suppository. Inserting the urethral suppository should not cause unbearable pain. If you experience any pain outside of what the doctor or pharmacist prepared you to experience, call in to be seen and stop the process immediately. Write down all the steps you took and what you did. The doctor will identify what you did wrong and advise you on what steps to take.

Always use the dose that is the lowest that achieves your erection.


Consult with your doctor if you have allergies before trying to get the prescription. Inform your healthcare professional of any allergic reactions while using Alprostadil. They will review your medical history to determine an alternative treatment or solution. If you do have an allergic reaction that is serious or painful you may not be a candidate for this drug.

Medication used to treat allergies may cause drowsiness, lightheadedness, or dizzy spells. The two medications may not be able to be mixed, or cause a bad reaction. Your doctor may prescribe new allergy medicine or they may determine you cannot receive this medication while on your current prescription.

Allergic reactions to any medications you currently take or have taken in the past should be reported to the doctor as soon as possible, at the first consultation.

Any medicine used to treat prostaglandin that causes an allergic reaction should be immediately reported. This includes Travatan, Cytotec, Lumigan, Cytotec, Xalatan.

When you go for the initial appointment create a list of medicine you're taking now, have taken in the past for other conditions and any medicine or treatment for erectile dysfunction. Depending on what's on your list the doctor will determine if you are still a candidate for this erectile dysfunction treatment. Share information about all prescription medication, nonprescription medicine, any vitamins, all nutritional supplements and every herbal supplement. Nothing is to be left off the list. You never know what may have a bad interaction with Alprostadil. The doctor will determine what you can still take and what you cannot take while on this medicine. Some medication may cause an adverse reaction resulting in an unwanted extended erection that lasts over 4-6 hours. This can cause throbbing, swelling, redness, and sensitivity in the penis. If you experience ant of these symptoms contact your doctor and arrange to be seen.

Other medications taken to thin the blood may affect your reaction and the dosage the doctor decides to prescribe. Warfarin Heparin, anything taken for allergies, anything prescribed for high blood pressure, medication prescribed for sinus and weight loss or appetite suppression pills. The type of medication you take or any underlying condition you currently suffer from can have an effect on your dosage and affect the results of the drug. The doctor may increase or decrease dosage during the course of your treatment in order for you to maximize your sexual experience.

Those advised to avoid sexual activity for any reason, especially medical reasons, must report the information to their doctor. This is a sexual enhancemnet drug, the point of this medicine is to enable you to have an erection to have intercourse. If you are advised not to have sex, the doctor may determine you are not a candidate for this treatment.


Overdosing on Alprostadil is not common, but it is possible. Patients that suspect signs of any of the following symptoms should seek medical attention because these could be a sign of overdose.

  • feeling sick to the stomach
  • extended erection 6 hours or longer
  • consistent penis pain
  • blurred vision
  • lighthededness that causes fainting

Talk with your doctor. Share all information regarding your health history. Be open and honest about any current or past medical conditions, medication, treatments, procedures etc. You may not be a candidate for this medication while being treated for certain diseases. Patients who have conditions that affect the blood cells like leaukemia, sickle cell anemia, thrombocythemia, multiple myeloma, or polycythemia must report that to the doctor. Any non-blood related diseases and conditions should also be reported to your doctor at the initial consultation.

Patients who have had a penile implant, heart failure, or any medical condition that has an impact on the shape of your penis must share the information with their doctor. You may not be a candidate for Alprostadil. If you have a curved or bent penis the suppository method is hard to execute. You doctor will review all your information, and determine whether your penis can easily take the injection. If they determine it may be painful or the suppository will have a hard time to dissolve the doctor will go over any other alternatives.

Share your family medical history. Discuss whether or not clots in the legs and lungs run in your family.

Report major surgeries and procedures to your doctor. Depending on the type of surgery and when you had it you may not be a candidate for this medication.

  • Swollen penis, swollen urinary opening, and scarring may occur while taking Alprostadil pellets. If they do, you may not be a candidate for this medication.
  • Fainting spells, a disease of the kidney, a disease of the liver and any condition that affects bleeding should be reported to the doctor at the first consultation.
  • Always practice safe sex at all times while taking Alprostadil. Discontinue and avoid sexual activity with pregnant women. Inform your doctor if there is a possibility your partner may be pregnant or plans on trying to get pregnant anytime soon before you take this medication.
  • Take your first dose when you don't have to go anywhere or do a lot of moving around. Figure out the effects this medicine will have on you. This medication is not to be taken if you have to drive or operate heavy machinery. Alprostadil may cause you to faint, become light-headed, or get dizzy.
  • Drugs and alcohol cause this medication to become less effective. Drugs and alcohol can cause side effects like fainting, lightheadedness,and dizziness to amplify, don't mix them together. Avoid all drugs and alcohol to receive the full benefits of your dose.
  • Contact your doctor immediately if you erection lasts too long. Permanent damage can occur if you don't seek medical treatment.
  • Follow explicit instructions that come with the medication and whatever instructions your doctor has given you word.
  • Wash your hands before and after each use
  • Prepare any additional questions for the doctor

Initiate any lifestyle changes advised by your doctor to combat your erectile dysfunction or improve the experience with the medication. To receive the full benefits it's important that you follow all the doctor's instructions and any additional instructions outlined by the pharmacist. Eat healthily, change your diet and exercise lightly to improve your overall quality of life but also to receive the maximum benefit from any medication you may be taking.

Development of new medical problems while on Alprostadil is not normal. If you see signs of any new medical condition while on this medication immediately make an appointment to see your doctor. Create a list of the new symptoms, or anything you experience that's out of the ordinary while on this medicine and share the information with the doctor. The doctor will decide if you can continue the treatment with this medication or if you have to try something else.


All medications should be kept in a safe place out of reach of children. Also keep your medication out of the reach of other people. Alprostadil comes in a container that can be kept tightly closed. For safety, keep this medication in the original storage container.

Where and how to store this drug is clearly stated in the insert of this medication. The doctor will explain in detail how and where to store this medication. Once the medicine is mixed together, the doctor will inform you of how long you have to receive the full benefit, before it loses its potency. The safest way to store Alprostadil pellets is in the original package. Up to 14 days before use you can store the medicine at room temperature or in the refrigerator. Your doctor will tell you how to safely dispose of any unused medicine. Do not use or give this medication to anyone. Nobody, including you, should take this medicine after the expiration date.

Keep all medications out of sight. Many medicine storage containers are not child resistant. The worst culprits are nonprescription items like eye drops, face creams, asthma inhalers, and smoker's patches. Utilize all safety features and double check to make sure the caps to your meds are locked, or the drawer or cabinet you store them in is locked to protect children from poisoning.


Erectile dysfunction is common among men, but it does not have to be the end of a man's sex life. There is no one solution to this problem. Patients who had a condition that wasn't improved by their first treatment deserve the chance for alternative methods. Talk with your doctor and evaluate your case in depth to determine whether or not this drug is a fit for you. Reveal all medical information for the best results.

Last Reviewed:
December 10, 2017
Last Updated:
April 04, 2018
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