Alprostadil is an FDA-approved prescription medicine. The approach below reflects its approved labeling for erectile dysfunction and is provided for education, not as a personal protocol. The dose is individualized by a prescriber, and the first dose is administered in a clinician's office. Do not self-inject an unsupervised amount.
Overview
Alprostadil is a prostaglandin E1 that widens blood vessels. For erectile dysfunction it is delivered locally — either injected into the side of the penis (intracavernosal, e.g. Caverject, Edex) or as a small urethral pellet (MUSE). Its dosing is fundamentally a clinician-directed titration.
Common dosing pattern
The approved approach is to find the lowest effective dose by starting low and titrating upward under supervision:
- Intracavernosal injection: labeling starts at a low dose (on the order of 2.5 mcg) and steps up under clinician guidance to the lowest amount that works, generally not exceeding 60 mcg.
- Urethral pellet (MUSE): supplied in fixed strengths spanning roughly 125 mcg to 1000 mcg, again titrated to effect.
- Use is limited in frequency (commonly no more than once daily and a few times per week), per the product label.
The exact starting point, step size, and maximum come from the specific product labeling and the prescriber — not from a generic number.
Why the first dose is clinician-supervised
The first dose is given in the office so the clinician can observe the response and rule out a prolonged erection (priapism), which is a medical emergency. Starting low and titrating avoids too strong a response, and the clinician teaches injection technique before any at-home use is considered.
Why oversight matters
Alprostadil can cause priapism, penile pain, and low blood pressure, and it interacts with certain conditions and medicines. A prescriber screens for contraindications, sets the individualized dose, teaches safe technique, and provides the emergency plan if an erection lasts too long. The approach above is the map; the label and a clinician are how it is used safely.
For a broader overview, see the main alprostadil reference page and the safety-focused guide.