Alprostadil is also known as prostaglandin E1 which is a naturally occurring prostaglandin that is used as medication. It is a vasodilator that works to relax the smooth muscle of blood vessels which allows more blood to flow through them.
It can be used to help babies with heart defects; it is used as a slow injection into the ductus arteriosus which in turn dilates the vessel and so improves the blood supply to the lungs. This treatment is vital until surgery can be carried out.
Alprostadil also has another medicinal use as a natural vasodilator; it has become very valuable in the treatment of erectile dysfunction.
How does alprostadil work?
As a vasodilator, alprostadil works to open blood vessels; it affects the muscles of the walls of the arteries and veins and so prevents them from constricting. The result is that blood will flow more easily through the vessels and in the case of erectile dysfunction, if there are any blockages or restrictions that are causing the failure of the blood to engorge the penis, those blockages will be opened up.
Different ways alprostadil can be administered
There are three different ways that alprostadil can be administered for the treatment of erectile dysfunction:
By injection – the injection is administered at the base of the penis. Your doctor will teach you how to perform this task and eventually you will be able to self inject at home
By urethral suppository – it is likely that your first dose will be administered by a health professional; the pellet is placed in the urethra using a special applicator. Firstly it is important to urinate as the small amount of urine that will be left in the urethra will help to dissolve the suppository.
The suppository is about the size of a grain of rice and it is inserted into the urethra (the opening at the end of the penis) using the applicator. It may be necessary to use a form of lubricant so that the applicator can be inserted more easily into the urethra.
Once the suppository has been successfully inserted, roll your penis between your hands for ten seconds; this will help the suppository to dissolve. If any stinging occurs, continue with the rolling of the penis until the sensation passes. Finally, sit, stand or walk for ten minutes in order to encourage the blood flow and so aid the erection
Urethral cream – the cream is supplied in a container that looks like a syringe although IT IS NOT A SYRINGE and should not be inserted in the penis or injected in any way. The containers are single-use only. Again, your first dose will most likely be given by a healthcare professional so that you are clear about how to follow the instructions you are given with the cream.
It is the case when using alprostadil in all forms that if your partner is pregnant, or likely to become pregnant, that a barrier method of contraception is also used as alprostadil may cause harm to an unborn baby; in addition, it will prevent any irritation from being caused in your partner's vagina
Who should avoid alprostadil
If you have any medical problem that may cause you to have an erection that lasts more than four hours such as sickle cell anaemia, sickle cell trait, multiple myeloma, leukaemia, have a penile implant, or have a deformed penis.
Side effects of alprostadil
- injection site reactions (mild/moderate pain, irritation, or slight bleeding),
- unusual discharge from your penis,
- pain in your penis/urethra/testicles,
- back pain,
- a rash on the skin of your penis,
- itching/warmth/numbness of your penis,
- stuffy nose,
- cold symptoms, and flu symptoms.
It may be that you experience less common side effects such as redness and swelling of the penis or lumps or unusual curves in the penis. If this happens then consult your doctor
Alprostadil is often used when systemic drugs such as Viagra and Cialis have been tried but the user has, for whatever reason, not tolerated the drug very well in that they have suffered debilitating side effects or if the user suffers from a condition that precludes their use.
A final thought is that now that alprostadil has been introduced in cream for it may be adopted by more men as the form of administration is likely to be considered to be far less invasive than the injection or the suppository.