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Alprostadil vs Mirtazapine: side-by-side comparison

Alprostadil (Prostaglandin E1 (PGE1)) and Mirtazapine (Atypical antidepressant (NaSSA)) belong to different therapeutic classes and are rarely substitutes for each other. The comparison is useful when a single patient is weighing both options for adjacent or overlapping needs.

Property Alprostadil Mirtazapine
Therapeutic class Prostaglandin E1 (PGE1) Atypical antidepressant (NaSSA)
CAS 745-65-3 85650-52-8
ATC G04BE01 N06AX11
Molecular weight 354.49 g/mol 265.36 g/mol
Brands with this active ingredient 1 1

What they share

Alprostadil and Mirtazapine share the common regulatory framework for prescription active ingredients, bioequivalence standards for generics, and pharmacist oversight. Beyond that, points in common are limited.

Key differences

Alprostadil acts by a different mechanism than Mirtazapine, with indications that barely overlap. Comparing the two is useful when a clinician has mentioned both in the same context or the patient wants to understand why one was prescribed instead of the other.

Mechanisms compared

Alprostadil: Alprostadil binds prostaglandin E receptors on smooth muscle of the corpus cavernosum, triggering cAMP-mediated relaxation of cavernosal smooth muscle independent of the nitric oxide pathway used by PDE5 inhibitors. Mirtazapine: Mirtazapine antagonises presynaptic α2-adrenergic autoreceptors and heteroreceptors, increasing noradrenaline and serotonin release.

Indications compared

Alprostadil: Alprostadil is approved for erectile dysfunction of vasculogenic, neurogenic, psychogenic or mixed aetiology in adult men. Mirtazapine: Mirtazapine is approved for major depressive disorder.

Safety profile

Alprostadil: Common adverse effects include penile pain (most common with intracavernosal injection), hypotension, dizziness, urethral burning (with Muse), priapism (rare but serious), penile fibrosis with prolonged use, and small ri… Mirtazapine: Common adverse effects include sedation (highest at low doses 7.5–15mg, paradoxically less at higher doses), increased appetite, weight gain, dry mouth and dizziness.

Frequently asked questions

Is Alprostadil better than Mirtazapine?

Alprostadil and Mirtazapine are not "better or worse" — they treat different things. The sensible question is which fits your specific need.

Can Alprostadil and Mirtazapine be combined?

Whether they can be combined depends on the indications and the interaction profile of each. If both are in a single prescription, the prescriber has weighed it; in self-medication they should never be combined.

Do they have the same side-effect profile?

No — they belong to different classes and have distinct side-effect profiles. Each has its own prescribing information.

Products with Alprostadil

Products with Mirtazapine

The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.