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Muse

alprostadil
Used for Erectile Dysfunction
Used for Erectile Dysfunction

Muse (alprostadil) is a prostaglandin E1 agonist. It's a urethral suppository that's inserted into the opening of the penis to treat erectile dysfunction (ED) in adults. It's used as needed before sex, up to 2 times a day. Some of the more common side effects of this medication include pain and burning in the urethra.

Note: Muse (alprostadil) was discontinued in June 2024 and is no longer available in the U.S. Ask your healthcare team about available options for treating ED.

Reviewed by:
reviewer
Ashley Wong, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on September 19, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Muse (alprostadil)?

What is Muse (alprostadil) used for?

How Muse (alprostadil) works

Muse (alprostadil) is a prostaglandin E1 agonist. It's a lab-made version of prostaglandin E1, a chemical that widens your blood vessels and relaxes the muscles around your penis. This allows more blood to flow to the penis to encourage an erection.

Are you looking for information on alprostadil injection (Caverject, Caverject Impulse, or Edex) instead?
When does Muse (alprostadil) start working?
Time passed since treatment started:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Full effect

Drug Facts

Common BrandsMuse (brand no longer available)
Drug ClassProstaglandin
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Muse (alprostadil) essentials

Health: Erectile Dysfunction: man speaking with doctor 1072676164

What’s the Difference Between Caverject and Muse for Erectile Dysfunction?

Written by Kevin Le, PharmD, BCPS, BCPPS
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What are the side effects of Muse (alprostadil)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Pain in the penis (32%)
  • Burning feeling in your urethra (12%)
  • Vaginal burning or itching in the female partner (6%)
  • Pain in the testicles (5%)
  • Minor bleeding or spotting from the urethra (5%)

Other Side Effects

  • Dizziness or fainting
  • Flu symptoms
  • Headache
  • Accidental injury
  • Back pain
  • Pain in the pelvis
  • Runny nose

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Prolonged erection (erection lasting longer than 4 hours)
When do Muse (alprostadil) possible side effects begin and end?
Time passed since treatment started:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Pain in the penis
Burning feeling in your urethra
Pain in the testicles
Prolonged erection
Seek immediate medical care if you experience this side effect.

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Curving of penis with pain during erection

erection continuing for 4 to 6 hours

erection continuing longer than 6 hours with severe and continuing pain of the penis

swelling in or pain of the testes

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Bleeding and pain at the injection site (short-term)

painful erection

Rare

Bruising or clotted blood in the penis at the injection site, usually caused by an incorrect injection

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Muse (alprostadil)

thumbs-up

Pros

Works quickly within 5–10 minutes

Available in different dosage strengths

Effects can last for up to an hour

thumbs-down

Cons

Might be difficult to use; must be inserted into the penis

Can cause pain and burning in the penis

Need to urinate 10 minutes before insertion

pharmacist-tips

Pharmacist tips for Muse (alprostadil)

pharmacist

  • Before using Muse (alprostadil), make sure to review the Instructions for Use and ask your prescriber if you have any questions.

    • Make sure to insert Muse (alprostadil) within 10 minutes of urinating. The urine in the urethra is what helps the medication get absorbed. Wash and dry your hands after urinating.

      • After using Muse (alprostadil), your penis might feel warm and sensitive. This is normal and might last a few hours.

        • Muse (alprostadil) can lower your blood pressure, which can cause dizziness, lightheadedness, blurred vision, or fainting. After using Muse (alprostadil), avoid driving or other tasks where you could get injured if you develop dizziness or fainting.

          • Don't use Muse (alprostadil) more than twice in 24 hours. Taking too much of this medication can raise your risk of low blood pressure, penile pain, and a prolonged erection.

            • Store unopened Muse (alprostadil) pouches in the refrigerator at 36–46°F. If you keep Muse (alprostadil) at room temperature, it's only good for 14 days. Toss any medication that's been kept at room temperature for longer than 14 days.

              • Don't store Muse (alprostadil) at temperatures above 86°F because it won't work as well after being kept at high temperatures.

                • If you're traveling, keep Muse (alprostadil) in a portable ice pack or cooler. Don't store Muse (alprostadil) in the trunk of a car or in baggage storage areas because it can be exposed to really high temperatures.

                  • Muse (alprostadil) doesn't protect you from sexually transmitted infections (STIs), including HIV, and doesn't prevent pregnancy. You should use appropriate measures, such as latex condoms, getting tested for STDs, and limiting sexual partners, to avoid spreading STDs. Couples should use a reliable form of birth control if the female partner is of childbearing age

                    • Muse (alprostadil) shouldn't be used for sexual intercourse with a pregnant woman, unless a condom barrier is used.

                      faqs

                      Frequently asked questions about Muse (alprostadil)

                      Is Muse (alprostadil) still available?
                      No, the makers of Muse (alprostadil) discontinued the medication in June 2024 and it's no longer available in the U.S. Talk to your healthcare professional about alternative treatment options for ED.
                      How do you use Muse (alprostadil)?
                      Use Muse (alprostadil) as directed by your healthcare team. Muse (alprostadil) is a suppository that’s inserted into the urethra with the help of an applicator. When you first start this medication, your prescriber will instruct you on how to insert Muse (alprostadil) safely. To minimize damage to the urethra, it's important to gently stretch the penis outwards to its full length before inserting the medication. After the medication has been inserted, keep the penis gently stretched and roll it for at least 10 seconds to help the medication spread out in the urethra. Your prescriber will give you more details on how to use Muse (alprostadil).
                      How well does Muse (alprostadil) work?
                      In clinical studies, 65% of males taking Muse (alprostadil) had at least one successful sexual intercourse compared to 19% of those taking a placebo (no active medication) during a 3-month period.
                      How long does it take Muse (alprostadil) to work?
                      Muse (alprostadil) can start to work within 5-10 minutes. Let your prescriber know if you don't achieve an erection within this time, because they might need to raise your dose or recommend a different medication.
                      How long does Muse (alprostadil) last?
                      The effects of Muse (alprostadil) last for about 30-60 minutes. If you have a painful erection that lasts more than 4 hours, get medical help because this could cause permanent damage to the penis.
                      What's the difference between Viagra and Muse (alprostadil)?
                      Both sildenafil (Viagra) and Muse (alprostadil) are used to treat ED. One main difference is that sildenafil (Viagra) is a tablet that's taken by mouth, while Muse (alprostadil) is a urethral suppository that's inserted into the penis. Sildenafil (Viagra) can take up to 30 minutes to work, while Muse (alprostadil) starts to work within 5-10 minutes. Because Muse (alprostadil) has been discontinued, your healthcare team will talk with you about other options for treating ED, such as sildenafil (Viagra).
                      Can you mix Viagra and Muse (alprostadil)?
                      Don't take sildenafil (Viagra), a phosphodiesterase 5 (PDE5) inhibitor, with Muse (alprostadil) unless instructed by your healthcare team. Sildenafil (Viagra) and Muse (alprostadil) work in different ways to treat ED. Your care team might consider both medications for you as an option if either one alone doesn't work well to treat ED. But this combination might raise your risk of certain side effects, such as dizziness from low blood pressure. Ask your healthcare team if you've more questions about Muse (alprostadil) and PDE5 inhibitors.
                      What's the difference between Muse (alprostadil) and alprostadil (Caverject, Edex) injection?
                      Both Muse (alprostadil) and alprostadil (Caverject, Edex) injection contain the same active ingredient called alprostadil. Both are used to treat erectile dysfunction, but they're administered differently. Alprostadil injection is injected into the base of the penis, while Muse (alprostadil) comes as a suppository (pellet) that's inserted into the urethra. Because Muse (alprostadil) has been discontinued, your healthcare team will talk with you about other options for treating ED, such as alprostadil injection.
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                      What are the risks and warnings for Muse (alprostadil)?

                      Muse (alprostadil) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                      risk-warning

                      Risk of low blood pressure

                      Muse (alprostadil) might lower your blood pressure. Though not common, this can cause dizziness, lightheadedness, blurred vision, or fainting. This can happen within 1 hour of the dose. If you feel any of these symptoms, sit down right away so you don't fall. To minimize this side effect, your prescriber will prescribe the lowest dose of Muse (alprostadil) that works for you. If you need a higher dose, they'll raise your dose slowly and might monitor you in their office to make sure your blood pressure doesn't drop too low. After using Muse (alprostadil), avoid driving or other tasks where you could get injured if you develop dizziness or fainting.

                      risk-warning

                      Minor bleeding or spotting

                      • Risk factors: Taking blood thinners | Having a condition where you bleed more easily

                        Using Muse (alprostadil) can lead to minor bleeding or spotting because of injury to your urethra. If you're taking blood thinners or have a condition where you bleed more easily, your risk of bleeding after using Muse (alprostadil) might be higher. Talk to your prescriber about the risks and benefits of using Muse (alprostadil) if you're taking blood thinners.

                        risk-warning

                        Prolonged erection

                        Although rare, Muse (alprostadil) can cause a prolonged, painful erection (priapism). Get medical help right away if you develop an erection that lasts more than 4 hours and won't go away with intercourse or masturbation. This can be serious and if it's not treated, it can lead to permanent damage to the penis. Your prescriber will either lower your dose or have you stop taking Muse (alprostadil) if this occurs.

                        risk-warning

                        Interactions with other medications

                        Although rare, using Muse (alprostadil) with blood pressure medications can raise your risk of low blood pressure. This can cause dizziness, lightheadedness, blurred vision, or fainting. Let your prescriber know if you're taking blood pressure medications before you start using Muse (alprostadil) so they can decide if it's safe for you to use.

                        dosage

                        Muse (alprostadil) dosage forms

                        The average cost for 6 suppositories of 1000mcg of Muse (alprostadil) is $478.18 with a free GoodRx coupon. This is 16.09% off the average retail price of $569.84.
                        suppository
                        Suppository
                        DosageQuantityPrice as low asPrice per unit
                        125mcg6 suppositories$468.89$78.15
                        250mcg6 suppositories$414.77$69.13
                        500mcg6 suppositories$443.37$73.89
                        1000mcg6 suppositories$478.18$79.70

                        Typical dosing for Muse (alprostadil)

                        • Adults: The typical starting dose is 250 mcg inserted into the urethra of the penis as needed to achieve an erection. Your prescriber might adjust your dose until you achieve an erection that's appropriate for sexual intercourse. Don't use more than 2 doses in 24 hours.

                        interactions

                        Interactions between Muse (alprostadil) and other drugs

                        Muse (alprostadil) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Muse (alprostadil). Please note that only the generic name of each medication is listed below.

                        Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                        • Heparin
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                        contraindications-icon

                        Muse (alprostadil) contraindications

                        Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Muse (alprostadil) will not be safe for you to take.

                        • Abnormal penile anatomy

                        • Current or frequent urinary tract infections

                        • Conditions that can cause long-lasting erections (e.g., sickle cell anemia, leukemia, multiple myeloma)

                        • Sexual intercourse with a pregnant female (unless a condom is used)

                        • Males for whom sexual activity isn't recommended

                        • Inflammation or infection in the penis

                        alternatives

                        What are alternatives to Muse (alprostadil)?

                        There are a number of medications that your doctor can prescribe in place of Muse (alprostadil). Compare a few possible alternatives below.
                        Muse (alprostadil)
                        Used for:
                        $414.77 Lowest GoodRx priceView Prices
                        Sildenafil (Viagra)
                        Used for:

                        • Erectile dysfunction (ED)

                        $13.87 Lowest GoodRx priceView Prices
                        Tadalafil (Cialis)
                        Used for:

                        • Erectile dysfunction

                        • Benign prostatic hyperplasia (BPH)

                        $18.90 Lowest GoodRx priceView Prices
                        latest news

                        What is the latest news about Muse (alprostadil)?

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                        Muse and Caverject are effective ED treatments with the same active ingredient (alprostadil). Which should you choose? Compare side effects of Muse vs Caverject.

                        What’s the Difference Between Caverject and Muse for Erectile Dysfunction?

                        Muse and Caverject are effective ED treatments with the same active ingredient (alprostadil). Which should you choose? Compare side effects of Muse vs Caverject.

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                        References

                        Best studies we found

                        American Society of Health-System Pharmacists. (2024). Alprostadil urethral suppositories.

                        Meda Pharmaceuticals Inc. (2024). Muse- alprostadil suppository [package insert]. DailyMed.

                        Moncada, I., et al. (2018). Combination therapy for erectile dysfunction involving a PDE5 inhibitor and alprostadil. International Journal of Impotence Research.

                        GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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