Alprostadil medication for erectile function, cream
August 20 2017 by Ray Sahelian, M.D.

Alprostadil is a hormone like substance that is referred to as prostaglandin E1, a potent vasodilator. Alprostadil is a drug that was marketed for impotence years before Viagra became available. However, alprostadil (product name Muse) did not become very popular since it had to be injected in the penis. A natural option for erection improvement is Passion Rx, an herbal aphrodisiac product that works within 2 to 3 days.

Alprostadil topical cream for erectile dysfunction
Alprostadil cream is generic for Befar or Alprox or Topiglan. It is the first topical cream in the world for the treatment of erectile dysfunction. Onset of action is in 15 minutes and can last several hours, and is nearly as effective as the injectable. Alprostadil topical cream is formulated with enhanced skin-penetrating properties and is applied onto the penis. Injections of alprostadil directly into the penis have been used to treat erectile dysfunction, but administration can be painful.

Alprostadil cream may slightly improve erectile dysfunction and is generally well tolerated, with the most frequently reported side effect being burning or redness at the site of application. Two large studies of the cream called Alprox-TD (NexMed) show that alprostadil cream produces a "small but statistically significant improvement" in erectile function in many patients with mild-to-severe dysfunction.

Dr. Harin Padma-Nathan of the University of Southern California, Beverly Hills and Dr. James Yeager of Lake Forest, Illinois report two studies with than 1700 men with erectile dysfunction. The men were randomized to alprostadil cream, in dosages ranging from 100 to 300 micrograms, or to placebo cream. Erectile function scores rose by a mean of 1.6 to 2.5 points over baseline in the alprostadil groups and fell by 0.7 points in placebo patients. In addition, scores for vaginal penetration and maintenance of erection until ejaculation improved slightly. Overall improvements were modest, the researchers note that 52 percent of patients who used the 300-microgram alprostadil cream reported improved erections versus 20 percent of placebo patients. The study population included men with diabetes, men who had had their prostates removed, and men taking nitrates or alpha-blockers as well as men who had failed Viagra. Their mean age was 60 years. Urology, 2006.

Expert Opin Pharmacotherapy. 2014. Alprostadil for the treatment of impotence. Erectile dysfunction (ED) affects over 150 million men worldwide. Oral phosphodiesterase-5 (PDE5) inhibitors are currently used as a first-line therapy and a second-line therapy with either intracavernosal (Caverject) or intraurethral (MUSE) alprostadil is required for a few men who show poor response or intolerance to PDE5 inhibitors. This article reviews the pharmacology, pharmacokinetics, medical applications, efficacy and safety of alprostadil in the treatment of men with ED. The goal of this article is to review the currently published clinical data of alprostadil to establish its potential role in managing men, in particular, those who fail to respond to traditional PDE5 inhibitors. Relevant articles and abstracts were reviewed from PUBMED and conference proceedings. Alprostadil, a synthetic form of prostaglandin E1, is used as second-line therapy in managing men with ED. It has a unique role in men with ED secondary to diabetes and ED secondary to radical pelvic surgery (e.g., radical prostatectomy). In view of these new indications, the role of alprostadil is being redefined. Both intracavernosal and intraurethral alprostadil are approved for use in all countries, and following positive results from recent Phase III trials, topical alprostadil has gained approval in Canada.

Side effects, safety
Pain is the most common side effect from ingestion, and priapism is of concern, so is scarring.

See libido for suggestions on herbs that have an influence on impotence and sexual health.

Is it possible to buy alprostadil cream online without a prescription? What about alprostadil caverject injection?
   This medication is available by prescription from a medical doctor although a person may buy alprostadil from unauthorized pharmaceutical drug selling web sites.

Availability
Q. I enjoy your articles and your web site. I have been reading about Topiglan cream lately and it sounds like a good alternative to the little blue pill. Do you know if it’s been approved for use in the US? I visited my primary care physician several weeks ago but did not ask her about it. Hoping you might know if it’s been approved here in the states.
   A. As of November 2017, I am not aware of it being available to the public, but I am not fully up to date on this drug.