> ## Documentation Index
> Fetch the complete documentation index at: https://docs.hi-doctor.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# Vitaros (alprostadil) cream — usage guide

> How to apply the single-use Vitaros alprostadil container, dose timing and frequency limits, storage and prolonged-erection warning signs.

Alprostadil acts locally to increase penile blood flow. Onset and duration vary between individuals, and the prescribed starting dose may need adjustment for tolerability. It does not permanently correct the cause of erectile dysfunction.

## How to use it

Each container is used once, in a fixed order. Read this through before the
first application rather than during it.

<Steps>
  <Step title="Apply one prescribed single-use container">
    Urinate first, wash hands, then place the cream at the opening on the tip of the penis exactly as shown in the leaflet. Hold the penis upright for about 30 seconds so the cream can enter. Do not insert the applicator into the urethra.
  </Step>

  <Step title="Use once and discard">
    Each AccuDose container is for one application. Do not use a second container to replace cream that remains at the opening. Wash hands after use, and do not urinate immediately afterwards.
  </Step>
</Steps>

## Dose schedule

<CardGroup cols={2}>
  <Card title="Five to thirty minutes before sex" icon="clock">
    The effect may begin within 5–30 minutes and can last about 1–2 hours, with individual variation.
  </Card>

  <Card title="Maximum frequency" icon="calendar">
    Do not use more than once in 24 hours, or more than 2–3 times per week. Do not combine with another erectile-dysfunction treatment unless the prescriber has explicitly planned it.
  </Card>
</CardGroup>

## What has been reported

| Effect                                                                | Notes                                                                                                                                          |
| --------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------- |
| Penile burning, pain, redness, tingling, swelling, genital discomfort | Local effects                                                                                                                                  |
| Partner burning or irritation                                         | Can occur after contact                                                                                                                        |
| Dizziness or faintness                                                | Use a condom when the partner is pregnant, could become pregnant, or is breastfeeding, and follow the leaflet's advice for vaginal or anal sex |

## Contact your doctor if

* An erection lasts 4 hours or longer, is very painful, or does not settle — seek emergency care
* Fainting, chest symptoms, heavy urethral bleeding, marked swelling, or a severe allergic reaction
* Local pain or partner irritation is persistent, or the dose needs adjustment

<Warning>
  An erection lasting 4 hours or longer, or one that is very painful or does not settle, needs emergency care.
</Warning>

## Storage

Keep unopened sachets refrigerated at 2–8°C and do not freeze. A sachet may be kept below 25°C for up to 3 days before use — discard it if not used within that time. Protect from light and use immediately after opening.

## What to expect

A licensed EU doctor will review your case in under 24 hours. Because alprostadil does not permanently correct the underlying cause of erectile dysfunction, the doctor may also discuss oral options.

## Common questions

<AccordionGroup>
  <Accordion title="How does alprostadil cream work?">
    Alprostadil is a copy of prostaglandin E1, a substance the body makes naturally that widens blood vessels. Applied to the tip of the penis, it relaxes the smooth muscle of the corpora cavernosa and widens the arteries feeding them, increasing blood flow. Because it acts directly on the blood vessels, it does not depend on sexual arousal in the way PDE5 tablets do.
  </Accordion>

  <Accordion title="How long before sex should I apply it?">
    The effect may begin within 5 to 30 minutes and can last about 1 to 2 hours, with individual variation. Use the prescribed dose as needed, up to once in 24 hours and no more than 2 to 3 times per week.
  </Accordion>

  <Accordion title="Can I combine Vitaros with other erectile dysfunction treatments?">
    Do not combine Vitaros with another erectile-dysfunction treatment unless the prescriber has explicitly planned it. The doctor may discuss oral PDE5 inhibitors such as [vardenafil](/library/medicines/levitra) or [avanafil](/library/medicines/spedra) as alternatives.
  </Accordion>

  <Accordion title="What side effects should I watch for?">
    Penile burning, pain, redness, tingling, swelling or genital discomfort can occur. A partner may also experience burning or irritation after contact. Dizziness or faintness can occur. An erection lasting 4 hours or longer needs emergency care.
  </Accordion>

  <Accordion title="How should Vitaros be stored?">
    Keep unopened sachets refrigerated at 2 to 8°C and do not freeze. A sachet may be kept below 25°C for up to 3 days before use. Discard it if not used within that time. Protect from light and use immediately after opening.
  </Accordion>
</AccordionGroup>

## How Hi-Doctor handles it

Related reading: [vardenafil (Levitra)](/library/medicines/levitra) and [avanafil (Spedra)](/library/medicines/spedra), the oral PDE5-inhibitor alternatives a doctor may consider instead. See also [safety and eligibility checks](/essentials/safety) and [how a Hi-Doctor consultation works](/essentials/how-it-works).

## Start a consultation

<Card title="Sexual health consultation" icon="stethoscope" href="https://hi-doctor.ai/consultation/sexual-health/1">
  Answer the sexual health questionnaire and a registered doctor reviews it.
  They decide whether treatment is appropriate, which one, and at what dose —
  and declining is a normal outcome. See [what it costs](/essentials/pricing)
  and [how the review works](/essentials/how-it-works).
</Card>

<Warning>
  This page is reference information, not medical advice and not a prescription.
  Whether a medicine is appropriate for you is decided by a registered doctor
  after reviewing your consultation.
</Warning>