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Sexual health · Gijón

MUSE in Gijón, online

An EU-licensed doctor reviews your case and, if eligible, issues an electronic prescription you can collect at a pharmacy in Gijón.

€35once

Consultation price. The medicine is paid at your pharmacy.

  • Prescription only, if a doctor approves
  • Collect at any EU pharmacy
  • Full refund if not approved
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MUSE

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Every case read by a registered doctor.

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Valid across the EU

E-prescription accepted at EU pharmacies.

Local facts

MUSE consultations in Gijón

Available toResidents of Spain
LanguagesSpanish and English
Doctor replyUnder 2 hours on average
Collected atPharmacies in Spain · QR e-prescription
About the medicine

What it is and how it works

Alprostadil is a prostaglandin E1 that directly dilates the blood vessels of the penis. It's considered when oral PDE5 inhibitors are ineffective or contraindicated.

It's administered as a urethral cream or an intracavernous injection, under medical instruction. Each route has its own efficacy and tolerability profile. Correct technique matters, and the doctor explains the protocol and the warning signs.

Who it is for

  • Adult men whose erectile dysfunction is unsuited to, or not helped by, oral tablets
  • Given as a cream at the tip of the penis, a urethral pellet, or an injection

Safety summary

An erection lasting 4 hours or more is priapism, and it is a medical emergency

Read the safety summary
Pricing

One consultation, one clear price

You pay for the doctor's consultation. If a prescription is issued, the medicine is paid at your own pharmacy.

  • Consultation reviewed by an EU-licensed doctor
  • Private follow-up in the in-app chat
  • Full refund if the doctor does not approve
One-off

Sexual health

One-offNo subscription€35once
  • Consultation reviewed by an EU-licensed doctor
  • Electronic prescription if approved
  • Private follow-up chat
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Full refund if a review is not approved

FAQs

Your questions answered

MUSE16 questions
What is alprostadil and when is it used?
It is a prostaglandin E1 that directly dilates the penile vessels. It is considered when oral PDE5s are ineffective or contraindicated.
As a urethral cream (applied into the urethra) or an intracavernous injection, under medical instruction. Each route has its own efficacy and tolerability profile.
More questions
Correct administration technique, risk of local pain, priapism (prolonged erection) and, rarely, fibrosis. The doctor explains the protocol and warning signs.
Combination with PDE5 is considered only under medical supervision. It is never paired without explicit indication due to priapism risk.
Yes, and that is the main way it differs from the tablets. Alprostadil is a copy of prostaglandin E1 and relaxes the smooth muscle of the erectile tissue directly, so it does not wait for the nitric oxide signal that sexual stimulation produces. In the registration programme, in-clinic test doses produced erections firm enough for intercourse in 65.9% of 1,511 men without any sexual activity taking place. The urethral pellet typically produces an erection 5 to 10 minutes after it is inserted, lasting roughly 30 to 60 minutes. That independence is also why the erection can outlast the encounter.
No, not the injection or the urethral pellet. The product information for the injection states that the first injections must be given by medically trained personnel, and the dose has to be titrated under a physician's supervision until the lowest effective dose is found. The pellet is titrated the same way. Hi-Doctor is a remote doctor consultation service, so it cannot supervise an in-clinic first dose; a doctor here can review your history, discuss whether this class of treatment fits and refer the in-person step, but the titration itself has to happen face to face with a clinician.
Seek medical help straight away if an erection lasts 4 hours or more. That is priapism, and the product information is explicit that treatment should not be delayed beyond 6 hours, because untreated priapism can damage penile tissue and cause permanent loss of erectile function. While arranging help you can lie on your side and apply an ice pack alternately to each upper inner thigh for two minutes at a time. Beyond that the treatment is a clinical procedure, drainage of the erectile tissue and sometimes an injected medicine, done by a doctor, not something to attempt yourself.
Write to your doctor in the private chat in your account: describe what you notice and when it started. The doctor can adjust the plan, pause it or suggest another option. If you have severe symptoms such as difficulty breathing, swelling of the face or chest pain, call 112 or go to an emergency department straight away.
It depends on what you take. List every medicine, supplement and herbal product in the questionnaire, including ones you use only occasionally. The doctor checks for interactions before prescribing, and your pharmacist checks again when you collect MUSE.
Depending on your case, the doctor can consider a different medicine or dosing pattern, or recommend an in-person urologist, a sexual health clinic or psychosexual therapy. If a heart condition or another health issue needs checking first, the doctor tells you before prescribing anything.
If the medicine does not work as expected or causes side effects, write to your doctor in the private chat. The doctor can review the dose or the option chosen. Tell the doctor about any new health condition or new medicine before you use it again.
Yes. Hi-Doctor runs 100 % online across the EU, so if you live in Gijón you can fill in the questionnaire and receive the medical review without travelling. The electronic prescription issued by the licensed doctor is valid in any EU pharmacy under Directive 2011/24/EU; in Spain it is dispensed directly from the prescription QR.
Yes. All communication happens in the private chat of your account, GDPR-compliant. The doctor treats discretion as a core of the service and there is no history visible outside your consultation.
The private electronic prescription (Receta Médica Privada Electrónica) is issued by a licensed doctor in Spain. It is a PDF carrying every field required by EU Directive 2011/24/EU (patient, prescriber with country of registration, active ingredient, dose), which makes it legally recognised across all 27 EU member states. In Spanish pharmacies it is dispensed from the QR; outside Spain, the pharmacist dispenses the locally marketed equivalent of the same active ingredient.
1) Fill in an online medical questionnaire in about 4 minutes. 2) The plan is €25/month for weight loss or €15/month (billed €45 every 90 days) for hair growth; sexual health is €35 per consultation and a skin consultation is €40. 3) An EU-licensed doctor reviews your case and, if appropriate, issues an electronic prescription. 4) Collect it at any EU pharmacy. If the review is not approved, the applicable fee is refunded in full.
The plan is €25/month for weight loss or €15/month (billed €45 every 90 days) for hair growth; a one-off sexual-health consultation is €35 and a skin consultation covering acne, rosacea, melasma and ageing skin is €40. Each includes a licensed doctor's review and an electronic prescription if approved. If the review is not approved, the applicable fee is refunded in full. Medication is paid for separately at the pharmacy at the price it sets.
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How your doctor decides

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A licensed doctor reads your full questionnaire.

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The decision is clinical, never an algorithm.

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Approved with an e-prescription, or refunded in full.

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Medicine information and safety

How does MUSE work?

A copy of prostaglandin E1. Alprostadil is chemically identical to prostaglandin E1, a signalling substance the body already makes. It is not swallowed. It is placed into or onto the penis itself, so it acts on the erectile tissue at the site rather than circulating through the whole body first.

Cavernosal muscle relaxes. The drug relaxes the smooth muscle of the corpora cavernosa, the two spongy cylinders that run the length of the penis, and widens the cavernosal arteries feeding them. Blood flow into the erectile tissue rises, and that increase in flow is what produces rigidity.

It does not need arousal. Because it acts on the tissue directly, alprostadil does not depend on the nitric oxide signal that sexual stimulation produces. In clinic testing it created erections on its own. That is the core difference from tablets, and it is also why an erection can outlast the encounter.

How to use MUSE

Get shown the technique first. Every form of alprostadil has to be demonstrated by a medical professional before you use it yourself. For the injection and the urethral pellet the first doses are given or supervised in a clinic, not at home, and that step cannot be skipped.

Empty your bladder first. Urinate before using the cream or the pellet. A moist urethra helps the medicine dissolve and spread. Do not urinate straight after the cream, because the dose can be washed out before it has had time to work.

Cream sits at the opening. Roll the single-dose container between your hands to warm it, hold the penis upright and squeeze the tip to widen the opening. Place the container at the opening without inserting it, push all the cream in, then hold the penis upright for about 30 seconds.

Pellet needs a stretch and roll. For the urethral pellet, stretch the penis upward to its full length, insert the applicator, press the button and withdraw it. Then roll the penis between your hands for at least 10 seconds so the medicine coats the urethral wall.

Stand or walk for ten minutes. After the pellet, sit or preferably stand or walk for about 10 minutes while the erection develops. An erection usually appears 5 to 10 minutes after the pellet and lasts roughly 30 to 60 minutes. The cream works in 5 to 30 minutes.

Injections rotate side and site. The injection goes into the upper side of the penis, along the third nearest the body, avoiding visible veins. Change both the side and the exact spot each time. Never straighten or reuse a bent needle, because needles can break.

Use a condom if pregnancy is possible. A condom is required if your partner is pregnant or could become pregnant, and it also reduces vaginal irritation, which is a reported reaction. Only latex condoms have been tested with the cream. Alprostadil is not a contraceptive and does not prevent infection.

Respect the frequency limits. The cream is used at most 2 to 3 times a week and once in 24 hours. Injections are at most once a day and three times a week. The pellet is at most 2 doses in 24 hours and 7 in 7 days.

Common side effects

Stop and get urgent medical help if (seek medical help immediately): An erection lasts 4 hours or more, which is priapism and a medical emergency that must not be left more than 6 hours, Penile pain will not settle, or you notice a new bend, lump or hard patch in the penis, You faint, feel close to fainting, or go dizzy with a sudden drop in blood pressure after a dose, You get chest pain, or sudden weakness, numbness or trouble speaking, Bleeding from the urethra will not stop, or there is blood in your urine, Hives, a spreading rash or swelling appear, which can signal an allergic reaction, A needle breaks and a fragment stays in the penis, which has needed surgical removal

Very common (very common (≥1/10)): Penile pain after intracavernosal injection, reported at least once by 30% of men and after 11% of injections, Penile pain after the urethral pellet, in most cases rated mild or moderate, Burning in the urethra after the urethral pellet

Common (common (≥1/100 to <1/10)): Burning, tingling, throbbing or numbness in the penis, with the cream, Redness, swelling, itching or general discomfort of the penis or genitals, with the cream, Urethral pain with the cream, or minor urethral bleeding with the pellet, An erection stronger or longer than expected, listed for all three forms, Peyronie's disease, penile fibrosis, angulation or fibrotic nodules, with the injection and the pellet, Bruising or a collection of blood at the injection site, Headache, dizziness, symptomatic low blood pressure and muscle spasms, with the pellet, Vaginal burning or itching in the partner, reported by about 6% of partners in the pellet studies, Skin rash, with the cream, Balanitis, inflammation of the head of the penis, with the cream

Uncommon (uncommon (≥1/1,000 to <1/100)): Prolonged erection or priapism, listed at this frequency for all three forms, Dizziness, fainting or a fall in blood pressure, listed for all three forms, Painful erection, excessive rigidity, or loss of sensation in the penis, Narrowing of the urethra, or inflammation of the urinary tract, with the cream, Painful or frequent urination, urgency, blood in the urine or urethral bleeding, Testicular or scrotal pain, swelling, redness or a lump, and pelvic or perineal pain, Phimosis, ejaculation problems, or erectile dysfunction reported as a reaction, Nausea, dry mouth, sweating, itching, rash, redness or a faster heartbeat, Itching of the vulva or vagina in the partner, with the cream, Widened pupils, extra heartbeats, a raised blood creatinine reading, or feeling weak

Rare (rare (≥1/10,000 to <1/1,000)): Urinary tract infection, listed at this frequency for the urethral pellet, Penile fibrosis, listed at this frequency for the urethral pellet

Very rare (very rare (<1/10,000)): Hives, known medically as urticaria, listed at this frequency for the urethral pellet

Frequency not known (not known (cannot be estimated from the available data)): Stroke, recorded in the injection product information as cerebrovascular accident, Reduced blood supply to the heart muscle, recorded as myocardial ischaemia

Do not use MUSE if

  • You have sickle-cell disease or sickle-cell trait, multiple myeloma or leukaemia, all of which predispose to priapism
  • You have another condition predisposing to priapism, such as thrombocythaemia, polycythaemia, a tendency to venous thrombosis, a hyperviscosity syndrome, or past recurrent priapism
  • You have a penile implant
  • Your penis is anatomically deformed, including angulation, curvature, cavernosal fibrosis, Peyronie's disease or severe hypospadias
  • You have urethritis or balanitis, or for the pellet a narrowing of the lower urethra
  • You are allergic to alprostadil or to any other ingredient in the product
  • A doctor has advised that sexual activity is inadvisable, for example with severe heart disease or unstable heart or circulation problems
  • You have orthostatic hypotension, or a history of heart attack or fainting, which rule out the cream
  • Your partner is pregnant or could become pregnant and a condom will not be used
  • You are already using another erectile dysfunction treatment, including a PDE5 inhibitor tablet or another injected agent

Medicines and substances that interact

  • PDE5 inhibitor tablets (sildenafil, tadalafil, vardenafil): Never studied together; both act on blood vessels, so cardiovascular risk could add up Not used together; the prescriber keeps you on one treatment at a time
  • Other injected erection agents (papaverine, phentolamine, thymoxamine): Raises the risk of priapism, a painful prolonged abnormal erection Not combined; alprostadil is prescribed on its own
  • Blood pressure medicines and other vasodilators: Blood pressure can fall further, and the risk is higher in older men Prescribed with caution, with clear warning about dizziness and fainting
  • Anticoagulants and antiplatelet drugs (warfarin, heparin): More bleeding after an injection, and more urethral bleeding or blood in the urine Prescriber weighs the bleeding risk and may rule out the injected route
  • Sympathomimetics, decongestants and appetite suppressants: May reduce the effect of alprostadil, so a working dose can seem to fail Prescriber reviews the full medicine list before changing any dose
  • Latex condoms: Only latex has been tested with the cream; other materials may be damaged by it Use a latex condom, which is required anyway if a partner could be pregnant

References

  1. Vitaros 3 mg/g cream: Summary of Product Characteristics electronic medicines compendium (emc), 2026
  2. Caverject Dual Chamber 20 micrograms: Summary of Product Characteristics electronic medicines compendium (emc), 2026
  3. MUSE 500 microgramos bastoncillo uretral: Ficha Técnica AEMPS, Spain, 2016
  4. Treatment of men with erectile dysfunction with transurethral alprostadil (MUSE Study Group) New England Journal of Medicine 336(1):1-7, 1997
  5. Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction (Alprostadil Study Group) New England Journal of Medicine 334(14):873-7, 1996
  6. EAU Guidelines on Sexual and Reproductive Health, limited update March 2025 European Association of Urology, 2025
  7. Alprostadil: authorised medicines register (Caverject, Virirec and alprostadil cream marketed; MUSE authorised but not marketed) AEMPS CIMA, Spain, 2026
  8. Alprostadil: Vitaros 300 microgrammes cream and Edex 10/20 microgrammes marketed, liste I, restricted reimbursement Base de données publique des médicaments, France, 2026
  9. Alprostadil products authorised in Ireland: Caverject 10 and 20 micrograms, Vitaros 3 mg/g cream medicines.ie, Irish medicines compendium, 2026
  10. Register of medicinal products: no ATC G04BE01 alprostadil product registered for erectile dysfunction Rejestr Produktów Leczniczych, Poland, 2026
  11. Nota 75: reimbursement of alprostadil by intracavernosal injection limited to defined neurological criteria AIFA, Gazzetta Ufficiale della Repubblica Italiana n. 7, 2017
  12. § 34 SGB V: medicines predominantly for erectile dysfunction excluded from statutory health insurance Bundesministerium der Justiz, Germany, 2026
  13. Regeling zorgverzekering: MUSE urethral stick 125 to 1000 micrograms listed on the Dutch medicines annex Wetten.overheid.nl, Netherlands, 2026
  14. Viagra (sildenafil): Summary of Product Characteristics, Annex I European Medicines Agency, 2025
  15. Cialis (tadalafil): Summary of Product Characteristics, Annex I European Medicines Agency, 2025
  16. Levitra (vardenafil): Summary of Product Characteristics, Annex I European Medicines Agency, 2024
  17. Alprostadil, human medicines with a currently valid German authorisation: Caverject and Caverject Impuls 10 and 20 micrograms (Pfizer Pharma GmbH plus parallel importers), Muse 500 and 1000 micrograms (Viatris Healthcare GmbH), Vitaros 300 micrograms/100 mg cream (The Simple Pharma Company Limited). The register publishes marketability, not whether a product is currently distributed. BfArM AMIce, public part, via PharmNet.Bund, Germany, 2026
  18. Alprostadilo: Caverject 0,01 and 0,02 mg/ml (Laboratórios Pfizer, Lda.) and Vitaros cream 0,3 mg/100 mg (Recordati Ireland Ltd.), each authorised with at least one marketed presentation INFARMED Infomed, Portugal, 2026
  19. Alprostadil: Caverject 10 and 20 micrograms and Vytaros 3 mg/g cream recorded as commercialised; Caverject Impuls 10 and 20 micrograms recorded as not commercialised FAGG-AFMPS medicines database, Belgium, 2026
  20. Alprostadil, ATC G04BE01: Muse 250, 500 and 1000 micrograms recorded as marketed; Caverject, Caverject Dual and Vitaros 3 mg/g cream authorised, with no marketing status published BASG Medikamente Info Austria, Arzneispezialitätenregister, 2026

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All content on this page has been medically reviewed by: Dr. Alejandro Infante, General medicine, on 27 July 2026. Registration: 080869277 View profile

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