Alprostadil Injections for ED: Is it Safe?

From pills to creams, there are many treatments for erectile dysfunction (ED). So why would someone turn to an alprostadil injection if they can avoid a needle?

It turns out that there are a lot of reasons you might want to treat erectile dysfunction with a needle instead of a pill bottle: injections can be more effective and more convenient for some men and are perfectly safe when taken correctly.

How is alprostadil different from oral medications? How do you inject it — and where? Below, we’ve answered your most pressing questions, including the side effects to watch for and how injection alprostadil works.

An alprostadil injection is a type of intracavernous injection or injection into the erectile tissue of the penis. It’s a treatment for erectile dysfunction, which is the inability to get or keep an erection during sexual activity.

Alprostadil is part of a group of medicines called vasodilators, which 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.

Popular ED medications like Viagra® and Cialis® also increase blood flow, but alprostadil does it through a different mechanism.

Alprostadil, commonly known as prostaglandin E1 (pge1), is an acidic lipid with various effects. It’s sold under several brand names, including Caverject®, Edex® and Prostin VR®.

Doing your own injection of alprostadil can seem intimidating, but it’s a fairly simple process — once you get past any fears of needles.

First things first with injections: make sure you properly prepare to use alprostadil safely.

This means washing your hands and placing the bottles on a clean surface before drawing the medicine into the syringe. You’ll also want to wipe the injection bottle tops with an alcohol swab, but be sure you don’t wipe the needle with the swab.

From there, you’ll want to follow healthcare professional guidance on injection dose, depth and location. Typically, this will mean an injection into the shaftof the penis on either side.

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

As an ED treatment, alprostadil injections should be used as needed before sexual activity. You may get an erection within five minutes to 20 minutes after injection.

ED injections are a viable option for about 70 percent of men experiencing erectile dysfunction, according to data from clinical trials.

Three studies by the New England Journal of Medicine found that alprostadil injections were more effective than a placebo. They also found that men were able to engage in sexual activity 94 percent of the time over six months of intracavernosal injections.

In addition, alprostadil injections have 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)

• Pain at the site of injection

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

• Prolonged erection (priapism)

• Curving of the penis during erection

• A painful erection

• Swelling of the testes

• Dizziness

• Pelvic pain

• Flu-like symptoms

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

You should also let your healthcare provider know if you have penile implants, Peyronie’s disease, hypotension, leukemia, sickle cell anemia, a history of penile pain or painful erections, previous allergic reactions to alprostadil or conditions that cause slower blood flow or low blood pressure.

You can also talk to a urology specialist or healthcare provider for more medical advice about alprostadil injections. If you want more info before then, check out our more in-depth article about intracavernosal injections — or ED injections — and the possible risks.

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

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

• Viagra (sildenafil): 20 mg to 100 mg

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

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

Don’t use more alprostadil or use it more often than your healthcare provider recommends — both could result in permanent damage to the penis. You also shouldn’t use an alprostadil injection more than three times per week.

If you’ve decided injection alprostadil isn’t for you, know that there are plenty of other options for the treatment of erectile dysfunction.

One option is psychotherapy or talk therapy. Many cases of erectile dysfunction are because of psychological reasons rather than physical ones. In therapy, you can reduce anxiety and stress related to sex.

Oral PDE5 inhibitors are another extremely popular treatment for ED. 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.

As of now, the Food and Drug Administration (FDA) has approved four PDE5 inhibitors for ED treatment: Viagra (sildenafil), Stendra (avanafil), Cialis (tadalafil) and Levitra (vardenafil).

Another way to treat erectile dysfunction is through the use of an alprostadil cream or suppository. As an intraurethral suppository, alprostadil can be administered 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 than alprostadil injections.

A final and popularly recommended way to reduce or prevent erectile dysfunction is to make 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.

You’re not alone in dealing with erectile dysfunction — about 30 million men also experience ED. But we know that probably doesn’t lessen your frustration, 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 the possibility of minor side effects.

• However, it does come with risks of injury and medication interactions, which make it a less safe option than oral medications like Viagra.

• 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.