Vitaros cream

Vitaros (alprostadil 3mg/g) cream applied to tip of the penis to treat erectile dysfunction.

  • Alternative to tablets
  • 52% of men report improved erections
  • Requires refrigeration

Vitaros cream requires refrigeration and needs to be collected from a local pharmacy. It is currently not available from the manufacturer.

Vitaros cream and erectile dysfunction

About erectile dysfunction

Erectile dysfunction (ED) is common, affecting up to 4 out of 10 men over 40. ED has many causes, including diabetes, high cholesterol and poor circulation. All men with ED need to tell their GP about it. Tests may be needed and treatments of underlying cause(s) may be needed.

ED is often stressful and can lead to depression and relationship problems. GPs can help with these issues and counselling may be needed. There are links at bottom of this page to further information.

About Vitaros Cream

Vitaros cream is an alternative to tablets for erectile dysfunction (impotence). Vitaros is applied to the head of the penis by a dropper 5 to 30 minutes before sexual activity. The active ingredient, alprostadil, is absorbed locally into the skin enhancing erections usually for 1 to 2 hours.

Vitaros is not suitable for all men: Dr Fox consultations check for suitability. Men must read the information on this page and the patient information leaflet supplied with Vitaros, before requesting Vitaros.


In a 12 week study 52% of men report improved erections when using Vitaros, compared with 20% using a placebo (dummy cream).


  • Vitaros cream is not for use with Viagra or sildenafil, Cialis, Levitra, or Spedra tablets. Leave a gap of at least 24 hours (48 hours for Levitra) between cream and tablets. The combination could lead to harmful erections (priapism – see below). The combination could also increase side effects of tablets.
  • If men have intercourse with a fertile woman of childbearing age whilst using Vitaros, they need to use condoms or ensure the woman is on effective contraception. There is a possible risk of abnormal pregnancies using Vitaros. The exact level of risk is not known. Condoms also protect against potential risks to ongoing pregnancies and prevent vaginal irritation and reduce sexually transmitted disease.
  • Men who experience erections for 4 hours or more (priapism) should seek immediate medical attention. Prompt treatment is needed to avoid permanent harm to the penis. In studies of Vitaros priapism occurred in about 1 in 4,000 men.
  • Vitaros should not be kept out of a fridge (2 to 8 celcius) for more than 3 days.

Other cautions

Vitaros is not suitable in men who:

  • have a drop in blood pressure when going from lying/sitting to standing or experience dizziness or fainting
  • are allergic to alprostadil
  • have a condition that might result in a long-lasting erections, such as sickle cell anaemia or trait, thrombocythemia, polycythemia, multiple myeloma, or leukaemia
  • have an abnormally formed penis
  • have an inflammation or infection of the penis
  • are prone to a venous thrombosis (blood clots)
  • have a hyperviscosity syndrome (thickened blood) which could result in a long-lasting erection
  • have been told not to have sex for health reasons such as heart problems or a recent stroke
  • have a partner who is pregnant, breast feeding or of childbearing potential unless a condom is used
  • are taking drugs to prevent blood clots, as there may be an increased risk for bleeding or blood in the urine.

How to use Vitaros

Vitaros cream is applied to the head of the penis using a dropper as described in the manufacturer's patient information leaflet. Correct technique for use is important.

A single dose applicator delivers 300mcg of alprostadil in 100mg (a few drops) of cream. Vitaros is supplied in packs of four.

how to use vitaros cream

Vitaros should NOT be used more than once in 24 hours and NOT more than 2-3 times weekly. More frequent use risks increased side effects, particularly irritation and soreness.

Vitaros and other medicines

Vitaros should also NOT be used with other injectable or locally applied ED treatments such as Caverjet or Muse. They contain the same active ingredient, alprostadil, and there would be an increased risk of priapism.

Vitaros may be less effective when taken in combination with treatments for high blood pressure, decongestants and appetite suppressants. In combination with high blood pressure medication, Vitaros use may increase symptoms of dizziness and fainting, especially in the elderly.

Side effects of Vitaros

Men who experience side effects with the commonly used tablet treatments for erectile dysfunction may find Vitaros an effective alternative.

Very little of the active ingredient (alprostadil) is absorbed into the circulation. The cream works directly by contact with the skin of the penis. There are unlikely to be significant generalised side effects.

Common side effects (affecting more than 1 in 10 patients):

  • mild to moderate local aching, burning or pain and redness of the penis
  • penile skin swelling (oedema)
  • inflammation of the head of the penis (balantitis)
  • penile tingling, throbbing numbness, burning
  • mild vaginal burning or itching and inflammation, in partners

Less common side effects (up to 1 in 100 patients):

  • light-headedness/dizziness
  • prolonged erection for more than 4 hours
  • fainting
  • low blood pressure or rapid pulse
  • pain at the application site or in extremity
  • urethral stenosis (narrowing of urinary outflow)
  • increase in sensitivity
  • penile itching
  • genital rash
  • scrotal pain
  • fullness in genitals
  • lack of sensation to penis
  • urinary tract inflammation

Driving and using machines

Vitaros can increase dizziness or fainting. Do not drive or operate machinery within 1 to 2 hours after administration.

Adverse reactions

Vitaros is newly licensed (02/08/2013). Please message our doctors about adverse events or report them through the MHRA's Yellow Card Scheme.

Further information

Vitaros cream patient information leaflet

Tablets for ED

Tablets for ED are also available from Dr Fox (separate consultation).

Dr Tony Steele

Authored 10 July 2014 by Dr Tony Steele
Last updated 14 October 2021

Reviewed by Dr Tony Steele
Last reviewed 19 June 2019

The order process

Answer short medical questionnaire

Choose medication, register, and pay

Doctor issues prescription online

Pharmacy team post medication direct

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