Alprostadil Dosing Calculator

Dose

125-1000 mcg

Frequency

As needed (max 2 times per 24 hours)

Duration

Ongoing as needed

Route

Intraurethral

Less invasive than injection; community reports lower efficacy than intracavernosal route

Dose

Variable (alprostadil + papaverine + phentolamine)

Frequency

As needed (max 3 times per week)

Duration

Ongoing as needed

Route

Intracavernosal injection

Combination therapy using lower doses of each component; community frequently discusses Trimix as preferred approach

Dose

2.5-40 mcg per injection

Frequency

Maximum 3 times per week, with at least 24 hours between doses

Duration

Ongoing as needed; periodic physician evaluation recommended

Initial dose titration must be performed in physician office; typical maintenance dose 5-20 mcg

Dose

125-1000 mcg per application

Frequency

Maximum 2 times per 24-hour period

Duration

Ongoing as needed

Initial dose titration in physician office; most patients respond to 250-500 mcg

Dose

0.05-0.1 mcg/kg/min initial; maintenance 0.01-0.4 mcg/kg/min

Frequency

Continuous intravenous infusion

Duration

Until surgical correction; typically hours to days

Administered in NICU with continuous cardiorespiratory monitoring; use lowest effective dose

How much bacteriostatic water should I add to a 5 mg vial of Alprostadil?

The community standard is 1 mL of bacteriostatic water for a 5 mg Alprostadil vial. That gives a concentration of 2.50 mg/mL, so a 3 mcg dose is 0.1 units on a U-100 insulin syringe. Adding 1 mL instead doubles the concentration to 5.00 mg/mL and halves the draw to 0.1 units. Less water = smaller injection volume but harder to measure precisely.

How many syringe units is a 3 mcg dose of Alprostadil?

On a standard U-100 insulin syringe, a 3 mcg dose of Alprostadil is 0.1 units when the 5 mg vial is reconstituted with 1 mL of bacteriostatic water (2.50 mg/mL). If you use 1 mL of bac water instead, draw 0.1 units (5.00 mg/mL).

What is the standard Alprostadil dose?

Community-reported protocols for Alprostadil typically use 3 mcg–60 mcg every other day via Intracavernosal injection. 3 mcg is a common starting dose. FDA-approved protocol; initial titration in office setting with dose adjusted based on response

How long does a vial of Alprostadil last at 3 mcg every other day?

A 5 mg vial of Alprostadil contains roughly 2000 doses at 3 mcg per injection. At every other day dosing, that is approximately 4000 days (about 571 weeks) of supply per vial. Reconstituted Alprostadil should generally be used within 28 days when refrigerated.

Where do you inject Alprostadil?

Alprostadil is typically injected intracavernosal injection. Common sites reported in the literature and by users include: Intracavernosal: dorsolateral aspect of the proximal third of the penis, avoiding visible veins and the urethra, Intraurethral: pellet inserted into the urethral meatus following urination, Intravenous: large peripheral vein or umbilical artery catheter (neonates); central venous access for prolonged infusion. Rotate sites with each injection to reduce localized irritation.

Can I use sterile water instead of bacteriostatic water for Alprostadil?

Bacteriostatic water (containing 0.9% benzyl alcohol as a preservative) is strongly preferred for multi-dose vials like Alprostadil because it inhibits microbial growth and lets a single vial be used over multiple weeks. Sterile water has no preservative and should generally be reserved for single-use preparations only.