Alprostadil vs Tadalafil: side-by-side comparison
Alprostadil (Prostaglandin E1 (PGE1)) and Tadalafil (PDE5 inhibitor) 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 | Tadalafil |
|---|---|---|
| Therapeutic class | Prostaglandin E1 (PGE1) | PDE5 inhibitor |
| CAS | 745-65-3 | 171596-29-5 |
| ATC | G04BE01 | G04BE08 |
| Molecular weight | 354.49 g/mol | 389.4 g/mol |
| Brands with this active ingredient | 1 | 7 |
What they share
Alprostadil and Tadalafil 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 Tadalafil, 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. Tadalafil: Tadalafil selectively inhibits PDE5, the enzyme responsible for breaking down cyclic guanosine monophosphate in the corpus cavernosum and other vascular smooth muscle.
Indications compared
Alprostadil: Alprostadil is approved for erectile dysfunction of vasculogenic, neurogenic, psychogenic or mixed aetiology in adult men. Tadalafil: Tadalafil is approved for three indications: erectile dysfunction in adult men, lower urinary tract symptoms associated with benign prostatic hyperplasia, and pulmonary arterial hypertension.
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… Tadalafil: Common adverse effects in clinical trials include headache, dyspepsia, back pain, myalgia, nasal congestion and facial flushing.
Frequently asked questions
Is Alprostadil better than Tadalafil? ▾
Alprostadil and Tadalafil are not "better or worse" — they treat different things. The sensible question is which fits your specific need.
Can Alprostadil and Tadalafil 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 Tadalafil
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.