What is Alprostadil (Intracavernosal Route): Uses, Dosage, Side Effects and More

Alprostadil intracavernosal injection is a prescription medication used to treat erectile dysfunction (ED) in men. This treatment involves injecting a small amount of medication directly into the penis to help achieve and maintain an erection suitable for sexual activity.

You might be considering this option if oral ED medications haven't worked for you or aren't suitable due to other health conditions. While the idea of an injection might seem intimidating at first, many men find this treatment effective and manageable once they understand how it works.

What is Alprostadil?

Alprostadil is a synthetic version of prostaglandin E1, a natural substance your body produces. When used for erectile dysfunction, it comes as a sterile powder that gets mixed with a liquid right before injection.

The medication works locally in the penis rather than affecting your entire body like oral ED pills do. This targeted approach can be particularly helpful if you have certain heart conditions or take medications that make oral ED treatments unsuitable.

Your doctor will typically prescribe this when other treatments haven't been effective or when you need a more reliable solution for achieving erections.

What is Alprostadil Used For?

Alprostadil intracavernosal injection is primarily used to treat erectile dysfunction in men who cannot achieve or maintain an erection firm enough for sexual intercourse. This treatment can help regardless of what's causing your ED.

Your doctor might recommend this medication if you have ED due to various underlying causes. These can include diabetes, blood vessel problems, nerve damage, or psychological factors that affect your ability to get an erection.

The medication is also sometimes used for diagnostic purposes to help your doctor understand what's causing your erectile dysfunction. During these tests, your response to the injection helps determine whether the problem is physical or has other causes.

How Does Alprostadil Work?

Alprostadil works by relaxing the smooth muscles in your penis and widening the blood vessels. This allows more blood to flow into the penis while reducing the blood flow out, creating an erection.

When you inject the medication into the corpora cavernosa (the spongy tissue in your penis), it starts working within 5 to 20 minutes. The medication acts directly on the tissue where it's injected, which is why it can work even when oral medications don't.

This is considered a moderately strong treatment option. It's more reliable than oral medications for many men, but it requires more preparation and skill to use properly.

How Should I Take Alprostadil?

You'll inject alprostadil directly into the side of your penis using a very fine needle. Your doctor or nurse will teach you the proper technique during your first few visits, and you'll practice until you feel comfortable doing it yourself.

The injection site should be cleaned with an alcohol swab before each use. You'll alternate between the left and right sides of your penis with each injection to prevent tissue damage. The needle goes into the corpus cavernosum, avoiding visible veins and the urethra.

You don't need to take this medication with food or water since it's injected directly into the penis. However, you should avoid alcohol before using it, as alcohol can interfere with your ability to achieve an erection.

Your doctor will start you on a low dose and gradually increase it during office visits until you find the right amount that works for you. Never adjust your dose on your own, as too much medication can cause prolonged, painful erections.

How Long Should I Take Alprostadil For?

You can use alprostadil intracavernosal injection for as long as your doctor recommends and as long as it remains effective for you. Unlike some medications, there's no specific time limit for using this treatment.

Most men use this medication only when they want to have sexual activity, typically no more than once per day and no more than three times per week. Using it more frequently can increase your risk of side effects and tissue damage.

Your doctor will want to see you regularly to monitor how well the treatment is working and to check for any side effects. They may adjust your dose or suggest changes to your treatment plan based on your response and any concerns that arise.

What Are the Side Effects of Alprostadil?

The most common side effects happen right at the injection site and are usually mild to moderate. Understanding what to expect can help you feel more prepared and know when to contact your doctor.

Common side effects you might experience include:

• Pain or aching in your penis after injection
• Slight bleeding or bruising at the injection site
• Burning or stinging sensation during injection
• Swelling at the injection site
• Mild headache or dizziness

These effects are typically temporary and improve as your body adjusts to the medication. The pain usually lasts only a few minutes to an hour.

More serious side effects are less common but require immediate medical attention. These include prolonged erections lasting more than 4 hours (called priapism), severe pain, or signs of infection at the injection site.

Some men may develop fibrous tissue or small lumps at injection sites with long-term use. This is why rotating injection sites and following your doctor's instructions carefully is so important.

Rarely, some men experience low blood pressure, fainting, or irregular heartbeat. These systemic effects are uncommon because the medication works locally, but they can occur, especially with higher doses.

Who Should Not Take Alprostadil?

You shouldn't use alprostadil intracavernosal injection if you have certain medical conditions or take specific medications. Your doctor will review your medical history carefully before prescribing this treatment.

You should avoid this medication if you have conditions that make sexual activity inadvisable, such as severe heart disease or uncontrolled high blood pressure. Men with certain blood disorders, like sickle cell disease or leukemia, also shouldn't use this treatment.

This medication isn't suitable if you have a history of priapism (prolonged erections) or if you're taking blood thinners that significantly increase bleeding risk. Men with severe liver disease or those allergic to alprostadil should also avoid this treatment.

If you have a penile implant, active urinary tract infection, or certain anatomical abnormalities of the penis, your doctor will likely recommend alternative treatments instead.

Alprostadil Brand Names

Alprostadil intracavernosal injection is available under several brand names, with Caverject being the most commonly prescribed. Other brand names include Edex and Prostin VR.

These different brands contain the same active ingredient but may have slightly different formulations or injection systems. Your doctor will choose the brand that's best suited for your needs and comfort level.

Some brands come with auto-injector devices that make the injection process easier and more precise. Your pharmacy can show you how to use whichever system your doctor prescribes.

Alprostadil Alternatives

If alprostadil intracavernosal injection doesn't work for you or causes too many side effects, several other treatment options are available. Your doctor can help you explore these alternatives based on your specific situation.

Oral medications like sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) are often tried first because they're easier to use. These PDE5 inhibitors work differently than alprostadil and might be effective even if injections haven't worked.

Alprostadil urethral suppositories (MUSE) deliver the same medication through the urethra instead of injection. While less invasive, they're generally less effective than injections.

Vacuum erection devices, penile implants, and testosterone replacement therapy (if you have low testosterone) are other options your doctor might discuss with you.

Is Alprostadil Better Than Viagra?

Alprostadil and Viagra work differently and each has advantages depending on your situation. Neither is universally "better" – the best choice depends on your health, preferences, and how you respond to treatment.

Alprostadil injections tend to be more reliable for achieving erections, especially if you have severe erectile dysfunction or haven't responded well to oral medications. The injection works directly on penis tissue, so it can be effective even when blood flow problems or nerve damage make oral drugs less successful.

Viagra is much easier to use since it's just a pill you take by mouth. It also doesn't require the skill and preparation that injections do. However, Viagra doesn't work for everyone and can interact with certain heart medications.

Your doctor will consider factors like your heart health, other medications you take, severity of ED, and your comfort level with injections when helping you choose between these options.