Intraurethral Suppositories

Intraurethral Suppositories

Intraurethral (or transurethral) suppositories are a non-surgical option for men with erectile dysfunction (ED). An applicator is used to place a pellet containing the medication alprostadil into the urethra which then dissolves and increases blood flow to the penis, creating an erection. MUSE® (Medicated Urethral Suppository for Erection) is currently the only intraurethral suppository approved by the FDA. MUSE® is available in 4 dosage strengths: 125 mcg, 250 mcg, 500 mcg, and 1,000 mcg. Together, you and your doctor will determine the dose that is right for you.


Prescription required from your physician.


How it works

Intraurethral suppositories contain alprostadil. The medication works by expanding your blood vessels and increasing blood flow. The increase in blood flow causes an erection. An erection is typically achieved within 5 to 10 minutes of inserting an intraurethral suppository. Patients are recommended to have intercourse 10 to 30 minutes after administrating the medication. Intraurethral suppositories can be used up to twice daily.

What it does

Intraurethral suppositories provide patients with a reliable and relatively quick erection without the need for needles or surgery. Once achieved, erections will last as long as the patient desires.

Reasons for use

Intraurethral suppositories are a good option for men with ED who are unable to take or are unresponsive to oral medications. This therapy is a needle-free alternative to penile injections. Intraurethral suppositories allow for spontaneity and give the patient a say in their erectile function.


Ready to get started?

The current average wholesale price of MUSE® for a 250mcg 6-suppository package is $491. Patients should check with their insurance carrier for full coverage information.

Starting at $491

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Accessory Items

Troubleshooting Guide

Some discomfort from insertion may occur at first but with repeated use, administration will become much easier. Urinating right before administration to moisten the urethra is an important first step to reduce your chances of discomfort.

Sexual activity can begin immediately. However, lying down on your back right after insertion is not recommended. This position reduces blood flow to the penis and can reduce the erection. Sitting, standing or walking for about 10 minutes after insertion will encourage a more successful erection. This time has also been used by patients to include foreplay while assuming a different position.

An erection should be achieved withing 5-10 minutes after insertion and last approximately 30 to 60 minutes. Erection duration varies from patient to patient.

Intraurethral suppositories will produce a reliable erection for intercourse but may not create an erection felt exactly as in your past experiences. Mild pain and aching in the penis or groin area have been reported by some patients. It is normal for your penis to feel full, warm, and slightly sensitive even after the erection is over. These after-effects may last a few hours.

It is possible your erection may continue after orgasm. Applying ice packs alternatively to each inner thigh for at most 10 minutes at a time can shorten the duration of the erection. Call your doctor if you have an erection lasting more than 4 hours.

Most side effects are minor and include burning or aching in the penis and groin. Even rarer side effects include dizziness, light-headedness, fainting, rapid pulse, or swelling of the leg veins. If you feel light-headed or experience a rapid pulse, lie down and raise your legs. If the symptoms do not resolve, call your doctor.

It is recommended to store the intraurethral suppository in a refrigerator, but it can be kept at room temperature for up to 14 days. Do not expose the intraurethral suppository to extremely high temperatures (>86°F) or place in direct sunlight.

Do’s and Don’ts


  • Do store the intraurethral suppository in a refrigerator.
  • Do seek medical attention if your erection lasts more than 4 hours.


  • Don’t use an intraurethral suppository if your partner is pregnant unless a condom is used.
  • Don’t lie down on your back immediately after administering the intraurethral suppository. Sit, stand or walk for about 10 minutes after insertion for better results.
  • Don’t reuse an intraurethral suppository. They are intended for a single application only.
  • Don’t use an intraurethral suppository more than two times per day.

Warnings and Precautions

Intraurethral suppositories are contraindicated in patients with any of the following conditions:


  • Hypersensitivity to the medication alprastodil
  • Sickle cell anemia, thrombocythemia, polycythemia, and multiple myeloma
  • Abnormal penile anatomy including, but not limited to: urethral stricture, balanitis (inflammation of the glans of the penis), severe hypospadias (irregular location of the urethra), severe curvature, and acute or chronic urethritis
  • Hyperviscosity syndrome or susceptibility to developing venous thrombosis

Titration to the lowest effective dose of the intraurethral suppository should be performed under medical supervision.


Incah School of Medicine at Mount Sinai. Intraurethral Agents. Accessed September 2, 2022.


Mayo Foundation for Medical Education and Research. Alprostadil (Urethral Route). Updated February 1, 2022. Accessed September 2, 2022. 


Muse (alprostadil) [drug label]. Somerset, NJ: Meda Pharmaceuticals Inc; April 2018.


MUSE. RED BOOK Online. IBM Micromedex [database online]. Truven Health Analytics/IBM Watson Health; 2021. Accessed September 2, 2022.