Ancillary / PDE5 / Vascular

Alprostadil (PGE1)

Prostaglandin E1. FDA-approved for erectile dysfunction (intracavernosal or intraurethral). Potent vasodilator — directly relaxes smooth muscle independent of testosterone or NO pathways. Works where PDE5 inhibitors fail. Also used for peripheral vascular disease and critical limb ischaemia.

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Educational reference only. This page does not diagnose, prescribe, or replace care from a licensed professional. Laws, availability, and clinical appropriateness vary by location.

Reference doseED: 5–20 mcg intracavernosal injection (start at 5 mcg). Urethral: 125–500 mcg MUSE.

Half-life0.1 hours

Risk flagmoderate

Regulatory noteFDA-approved context noted

Side effects and watch-outs

⚠️ Priapism (erection lasting >4h) — seek emergency care if occurs
Penile pain (most common side effect — 30% of users)
Haematoma at injection site
Penile fibrosis with frequent long-term use
Hypotension
Dizziness
⚠️ Never use with PDE5 inhibitors (additive priapism risk)
Urethral burning (MUSE form)