Alprostadil: What It Is, How It Works, and What Alternatives Exist

When Alprostadil, a synthetic version of a natural prostaglandin that relaxes smooth muscle and increases blood flow. Also known as prostaglandin E1, it is used primarily to treat erectile dysfunction when other treatments fail or aren’t suitable. Unlike pills like Viagra or Cialis, Alprostadil works directly at the site—either injected into the penis or inserted as a small pellet into the urethra. It doesn’t rely on sexual stimulation to trigger a response, making it a go-to for men who don’t respond to oral meds or have nerve damage from diabetes or prostate surgery.

Alprostadil is part of a broader group of treatments for erectile dysfunction, but it’s one of the few that works independently of the body’s nitric oxide pathway. That’s why it’s often used when PDE5 inhibitors like sildenafil or tadalafil don’t cut it. It’s also prescribed after penile implant surgery to help with post-op recovery or as a standalone option for men who can’t take oral meds due to heart conditions or interactions with nitrates. The most common side effects? Mild pain at the injection site, dizziness, or prolonged erections—something you need to watch for closely.

Many men start with pills, then move to Alprostadil when those stop working. But it’s not the only path forward. Some switch to vacuum pumps, others explore newer injectables or even low-intensity shockwave therapy. What’s clear is that Alprostadil isn’t a first-line fix—it’s a targeted tool for specific cases. If you’ve tried everything else and still struggle, it might be worth talking to your doctor about whether Alprostadil fits your situation. Below, you’ll find real comparisons, patient experiences, and practical advice on using it safely, managing side effects, and knowing when to consider other options.