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Alprostadil Injections for ED: Is it Safe?

Kristin Hall, FNP

Reviewed by Kristin Hall, FNP

Written by Rachel Sacks

Published 12/08/2022

Updated 12/09/2022

Dealing with erectile dysfunction (ED) can be frustrating, to say the least. Naturally, if you’re experiencing it, you want to find a solution as soon as possible. From pills to creams, there are multiple treatments for erectile dysfunction. So what’s the deal with an alprostadil injection? 

Are they good alternatives to medication for erectile dysfunction?

We’ll explore what this particular ED treatment is, including side effects and how injection alprostadil works.

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You may not think that needles and penises go together, but injections to treat erectile dysfunction may be the way to go if other treatments don’t work for you.

ED injections are a viable option for about 70 percent of men experiencing erectile dysfunction.

An alprostadil injection — a type of intracavernous injection or injection into the base of the penis — is a treatment for erectile dysfunction, including the inability to get or keep an erection during sexual activity.

Alprostadil is part of a group of medicines called vasodilators that expand blood vessels to increase blood flow. This treatment can increase blood flow to the penis which, in turn, can help you get an erection.

Alprostadil is more commonly known as prostaglandin E1, a type of acidic lipid with various effects. Some brand names of alprostadil include Caverject®, Edex® and Prostin VR®.

Another way to treat erectile dysfunction is through the use of an alprostadil cream. This medicine can also be administered as an intraurethral suppository (into the urethra) by inserting a pellet into the urethral meatus and allowing the absorption of the drug into the corpora cavernosa. However, this method can be costly and have more side effects.

If you’re using an alprostadil injection, you’ll want to use this ED treatment as needed before sexual activity. You may get an erection within five minutes to 20 minutes after injection.

Different alprostadil medicines can be injected using the same process. How these products are prepared and combined may differ though. Be sure to talk with your healthcare provider about which products you’re using and how to mix the injection properly.

You’ll want to make sure to wash your hands and place the bottles on a clean surface before drawing the medicine into the syringe. You’ll also want to wipe just the injection bottle tops with an alcohol swab. However, don’t wipe the needle with an alcohol swab.

Another thing to be aware of before the injection process is that you shouldn’t take the following medications within 18 hours either before or after an injection:

  • Vardenafil (Levitra®): 10 mg to 20 mg

  • Sildenafil (Viagra®): 20 mg to 100 mg

  • Avanafil (Stendra®): 50 mg to 200 mg

Don’t inject within 72 hours of taking 10mg or 20mg of tadalafil (Cialis®). If you take 5mg daily of tadalafil (Cialis), ask your healthcare provider how you should use this medication along with your injections.

Using larger amounts of alprostadil or using this medication more often than your healthcare provider recommends could result in permanent damage to the penis. You also shouldn’t use an alprostadil injection more than three times per week.

There are few known drug interactions with alprostadil. Before taking alprostadil though, you should let your healthcare provider know about any medicines you’re currently taking, including over-the-counter medicines, herbal supplements or prescription medications.

You should also let your healthcare provider know if you have penile implants, a history of painful erections, you’ve had allergic reactions to alprostadil or conditions that cause slower blood flow or low blood pressure.

You can also talk to a healthcare provider for more medical advice about alprostadil injections. This article also goes more in-depth about intracavernosal injections — or ED injections and the possible risks.

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Intracavernosal injections — like an alprostadil injection — are a viable treatment in men with erectile dysfunction.

Three separate studies by the New England Journal of Medicine found that alprostadil injections were not only more effective than a placebo treatment, but also that men were able to engage in sexual activity 94 percent of the time after six months of intracavernosal injections.

Alprostadil injections have also been found to cause an erection that’s firm enough for sexual activity in 80 percent of men.

As with any medication, an alprostadil injection may cause side effects, although they aren’t common.

You may experience:

  • Bruising or bleeding at the injection site

  • Redness of the penis

  • Skin problems

  • Headache

  • Back pain

  • Burning sensation at the urinary opening

  • Pain in the penis, testicles, legs or perineum (area between the penis and rectum)

If you experience any of the more adverse reactions below, you should seek medical attention immediately:

  • Erection lasting more than 2 hours

  • Curving of the penis during erection

  • A painful erection

  • Swelling of the testes

  • Dizziness

  • Pelvic pain

  • Flu-like symptoms

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If you’ve decided injection alprostadil isn’t for you, you can learn more about other options for the treatment of erectile dysfunction below.

One option is psychotherapy, or talk therapy. Many cases of erectile dysfunction are because of psychological rather than physical reasons.

In therapy, you’ll explore the mental and emotional factors that contribute to your ED and learn to change those negative patterns of thought. You can also work with a mental health professional to reduce anxiety and stress related to sex.

Another popular treatment is oral PDE5 inhibitors. These medications work by blocking the enzyme phosphodiesterase type 5 — or PDE5 — which relaxes smooth muscle tissue and regulates blood flow to certain parts of the body like the erectile tissue of the penis. This makes it easier to get and sustain an erection.

There are currently four PDE5 inhibitors approved by the FDA for ED treatment: sildenafil (Viagra®), avanafil (Stendra®), tadalafil (Cialis®) and vardenafil (Levitra®).

Other ways to reduce or prevent erectile dysfunction are certain lifestyle changes. Limiting or stopping alcohol consumption and drug use, quitting smoking, getting regular exercise and eating a healthy diet are all good places to start.

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You’re not alone in dealing with erectile dysfunction — about 30 million men also experience ED. But that doesn’t mean this condition isn’t frustrating, which may have you considering an alprostadil injection as a way to treat ED.

Alprostadil injections are a relatively safe and effective treatment for erectile dysfunction, with possible minor side effects.

However, if you’re looking for other ways to treat ED, you should consider medication like sildenafil, avanafil, tadalafil and vardenafil — all of which are approved by the FDA and backed by science.

Regardless, your first step toward treating your erectile dysfunction should be scheduling a consultation with a healthcare provider — they’ll be able to help you figure out what the best ED treatment is for your individual needs.

11 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Shindel AW, Lue TF. Medical and Surgical Therapy of Erectile Dysfunction. [Updated 2022 Jul 17]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA):, Inc.; 2000-. Retrieved from
  2. Alprostadil Urogenital. (2018, February 15). MedlinePlus. Retrieved from
  3. Alprostadil, Edex, & Vasodilators Information. (2016, May 9). Cleveland Clinic. Retrieved from
  4. Caverject® alprostadil for injection For Intracavernosal Use DESCRIPTION CAVERJECT Sterile Powder contains alprostadil as t. (n.d.).
  5. MUSE® (alprostadil) urethral suppository. (n.d.). DailyMed. Retrieved from
  6. About Penile Injection Therapy. (2021, May 21). Memorial Sloan Kettering Cancer Center. Retrieved from
  7. Label: CAVERJECT- alprostadil injection, powder, lyophilized, for solution. (n.d.). DailyMed. Retrieved from
  8. Linet, O. I., & Ogrinc, F. G. (1996, April 4). Efficacy and Safety of Intracavernosal Alprostadil in Men with Erectile Dysfunction. The New England Journal of Medicine, (334), 873-877. Retrieved from
  9. Treatment for Erectile Dysfunction NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from
  10. Definition & Facts for Erectile Dysfunction NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from
  11. Jain A, Iqbal OA. Alprostadil. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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