Alprostadil cream is a topical medication prescribed for the treatment of erectile dysfunction (ED). This medication, often known by brand names such as Vitaros, is applied directly to the penis. It offers an alternative for individuals who may not be able to use oral ED medications due to systemic side effects or drug interactions. This method of administration makes it a non-invasive option in the management of ED.
Understanding How Alprostadil Cream Works
Alprostadil, the active ingredient in the cream, is a synthetic version of prostaglandin E1 (PGE1), a naturally occurring substance in the body. Its mechanism of action involves binding to specific G protein-coupled PGE1 receptors found on the surface of smooth muscle cells within the penis. This binding activates the cyclic adenosine monophosphate (cAMP) pathway, which in turn leads to the relaxation of penile vascular smooth muscle.
The relaxation of these muscles causes the blood vessels in the erectile tissue of the corpora cavernosa to expand. This vasodilation increases blood flow into the penis, facilitating an erection. Unlike some other ED treatments that require an erectogenic stimulus to work, alprostadil acts as a direct agonist, meaning it can produce an erection independently of external stimulation.
Proper Application and Dosage
Before applying, wash your hands thoroughly with soap and warm water. It is also advisable to urinate before application, as the cream is administered into the opening at the tip of the penis, also known as the urethral meatus. The cream typically comes in a single-dose applicator, such as an AccuDose container.
To apply, gently squeeze the tip of the penis to widen the urethral opening. Hold the applicator tip as close as possible to, and directly over, the opening without inserting it into the urethra. Slowly and firmly push down the plunger to expel all the cream into the urethral opening. Any excess cream on the surrounding skin should be gently massaged into the urethral opening with a clean finger.
Alprostadil cream is available in various strengths, such as 200 micrograms or 300 micrograms of alprostadil in 100 mg of cream. Your doctor will recommend the starting dose, and it is important not to adjust it without medical guidance. The cream should be used as needed to achieve an erection, typically 5 to 30 minutes before sexual activity. It should not be used more than once in a 24-hour period and no more than 2 to 3 times per week. Each applicator is for single use only and should be discarded after use. The cream should be stored in a refrigerator and can last up to 3 days at room temperature.
Common Considerations and Side Effects
Common reactions include a mild to moderate aching, burning, or pain sensation in the penis, as well as redness or rash at the application site. Some individuals may also experience penile swelling or inflammation of the glans penis. These effects are usually transient and often resolve within an hour.
A prolonged erection lasting more than four hours, known as priapism, is a serious concern. While rare, occurring in less than 1% of patients in some studies, untreated priapism can lead to penile tissue damage. Other potential side effects include light-headedness, dizziness, or fainting, which can occur due to a temporary drop in blood pressure. Pain in the scrotum or testicles, and urinary tract inflammation, have also been reported.
Alprostadil cream should not be used by individuals with certain underlying health conditions, such as anatomical deformities of the penis like Peyronie’s disease, or conditions that predispose to priapism, like sickle cell anemia. It is also not recommended for use in combination with other erectile dysfunction treatments, especially oral phosphodiesterase type-5 (PDE5) inhibitors, due to a potential increased cardiovascular risk. If your partner is pregnant or of childbearing potential, a condom barrier should be used during sexual activity to prevent exposure to the medication.
When to Seek Medical Advice
If you experience an erection that lasts longer than four hours after using alprostadil cream, seek immediate medical attention to prevent permanent penile tissue damage. Similarly, if you experience severe pain in the penis, or any significant redness, swelling, or unusual curving of the erect penis, contact your doctor without delay.
Consult a healthcare provider for non-emergency concerns, such as persistent mild side effects like burning or discomfort that do not go away, or if you have questions about the cream’s effectiveness. Your doctor can assess your response to the medication, discuss potential dosage adjustments, or explore alternative treatments if needed. Always obtain a prescription for alprostadil cream and ensure ongoing professional medical oversight to ensure its safe and appropriate use.