Alprostadil Injection is a compounded, prescription-only medication prepared by a licensed pharmacy and given as a small injection into the side of the penis (intracavernosal injection), as directed by a prescribing provider. Its active ingredient is alprostadil, also known as prostaglandin E1. Because it is compounded, it is prepared to the strength your provider orders rather than mass-produced.
It is one option a provider may consider as part of care for erectile dysfunction (ED), often when oral medications are not suitable or have not worked well enough for a particular patient.
How does it work?
Alprostadil is a vasodilator that relaxes the smooth muscle and widens the blood vessels inside the penis, helping blood flow in and stay there so an erection can occur:
- Alprostadil (prostaglandin E1): relaxes penile smooth muscle and increases localized blood flow (MedlinePlus monograph).
Given by injection, alprostadil typically produces an erection within about 5 to 20 minutes; your provider will explain what to expect for your dose.
What is it used for?
Providers may prescribe Alprostadil Injection as part of care for erectile dysfunction when they determine it is appropriate for a patient. Injectable therapy is one of several recognized ED treatment options described in the American Urological Association ED guideline. Only a licensed provider can decide whether this formulation is right for an individual; Bayview Pharmacy does not provide consultations or determine appropriateness, and a valid prescription is required.
How does it compare to other ED options?
ED treatments differ mainly in how they are taken and how many ingredients they combine. The table below describes those differences for education only.
| Option | Form / route | How it's used |
|---|---|---|
| Oral PDE5 inhibitors (e.g., sildenafil, tadalafil) | Tablet, by mouth | Taken before sexual activity; depend on nerve signaling and blood flow |
| Alprostadil Injection (alprostadil only) | Intracavernosal injection | Single-ingredient injectable that acts locally on penile blood vessels |
| Bimix Injection (papaverine + phentolamine) | Intracavernosal injection | Two-ingredient injectable; does not contain alprostadil |
| Trimix Injection (adds papaverine + phentolamine) | Intracavernosal injection | Three-ingredient injectable that includes alprostadil |
Differences in form and ingredients are described for education only and are not a statement that any option is better, stronger, or more effective. Your provider determines what is appropriate for you.
How is it used?
Alprostadil Injection is given as a small injection into the side of the penis following the exact technique, instructions, and dose set by your prescriber, who establishes your starting dose and any adjustments. Never change your dose on your own. If you are unsure about the injection technique or dosing, contact your prescriber, and a Bayview pharmacist is available if you have questions about your prescription.
Side effects & safety
As with any medication, side effects are possible. Penile pain or aching after the injection is one of the more commonly reported effects of alprostadil. Other reported effects of penile injection therapy can include bruising or minor bleeding at the injection site, dizziness or flushing, and, with long-term use, scarring or firm areas (fibrosis) in the penile tissue. Report any of these to your provider.
Contact your provider promptly if you have new or worsening penile pain, curvature, or lumps, or any reaction that concerns you.
Who should not use it?
Penile injection therapy is not appropriate for everyone. It is generally avoided in men for whom sexual activity is inadvisable, and extra caution applies to those with conditions that raise the risk of prolonged erections (such as sickle cell disease, leukemia, or multiple myeloma), penile anatomical conditions or implants, or a known sensitivity to the ingredient. Tell your provider about your health conditions and all medications you take so they can determine whether this formulation is appropriate for you.
How should it be stored?
Store exactly as directed on your label, which is often refrigerated and away from heat, light, and moisture. Keep it out of the reach of children. Dispose of needles and syringes in an approved sharps container, and do not reuse needles.
Why is this compounded?
Compounding lets a licensed pharmacy tailor the strength and form to an individual prescription. As a 503A compounding pharmacy, Bayview Pharmacy prepares each order in small batches under USP <795>/<797> standards using quality ingredients.
Clinical details for prescribers
Formulation. Single-agent intracavernosal vasodilator: alprostadil (prostaglandin E1) relaxes cavernosal smooth muscle and increases arterial inflow, producing an erection typically within 5–20 minutes of administration (StatPearls).
Clinical role. May be selected as monotherapy or combined with other agents when a multi-agent approach is preferred (Trimix, Quadmix). Where dose-related penile pain limits use, Bimix offers a prostaglandin-free alternative.
Counseling points:
- Dose-related penile pain is among the most frequently reported adverse effects
- Individualized dose titration set by the prescriber
- Injection technique training before independent use
- Priapism precautions: erection >4 hours is an emergency
Background: intracavernosal injection therapy review (PubMed); This is a prescription-only compounded medication and is not FDA-approved. Your provider determines whether it is appropriate and sets the formulation and dose.
