Endoprost (Alprostadil) India — What Hospitals Need to Know

For hospital pharmacists, neonatologists, vascular surgeons, and urologists sourcing critical-care injectables in India, Endoprost (Alprostadil) is one of the most clinically important — and procurement-sensitive — medicines on any formulary. This guide covers what hospital procurement teams across India need to know about Alprostadil: what it is, which clinical departments depend on it, how it is supplied, and how to ensure uninterrupted cold chain-compliant stock through a licensed medicine distributor in Delhi.

A.K. Pharma supplies genuine Endoprost (Alprostadil) 125mcg and 250mcg injections, manufactured by Bharat Serum and Vaccines, to hospitals, NICUs, nursing homes, and specialist centres across India. Contact us at 011 4172 6999 or WhatsApp +91 9810034827 for availability and pricing.

1. What is Alprostadil (Endoprost)?

Alprostadil is a synthetic analogue of Prostaglandin E1 (PGE1) — a naturally occurring lipid mediator that acts on vascular smooth muscle to produce vasodilation, inhibit platelet aggregation, and maintain patency of the ductus arteriosus in neonates. It is one of the few drugs with genuine multi-specialty application in a hospital formulary, used across neonatal ICUs, vascular surgery units, and urology departments.

In India, Alprostadil is marketed under several brand names. Endoprost, manufactured by Bharat Serum and Vaccines, is available in 125mcg and 250mcg injection strengths. It is classified as a Schedule H drug in India and is available only on a valid prescription to licensed hospital pharmacies and institutional purchasers.

Mechanism of Action

According to published clinical literature, Prostaglandin E1 acts on EP receptors on vascular smooth muscle cells, producing vasodilation and increasing blood flow to ischaemic tissue. In neonatal medicine, PGE1 prevents closure of the ductus arteriosus by relaxing ductal smooth muscle. In peripheral arterial disease, Alprostadil improves microcirculatory blood flow and promotes healing of ischaemic ulcers. In urology, intracavernosal injection produces smooth muscle relaxation in the corpus cavernosum, resulting in erection within 5–20 minutes. Full prescribing information is available at the FDA label for Alprostadil.

2. Clinical Indications: Which Hospital Departments Use Alprostadil?

Alprostadil is one of the few injectable medicines with approved indications across three distinct hospital specialties. Procurement teams should be aware of which departments may requisition it simultaneously — a factor that makes consistent stock and rapid replenishment particularly important.

2a. Neonatal ICU — Ductal-Dependent Congenital Heart Disease

The most time-critical use of Alprostadil is in neonatal intensive care. According to established neonatal cardiology guidelines, intravenous PGE1 infusion is the universally accepted first-line intervention for maintaining ductal patency in neonates with ductal-dependent congenital cardiac lesions — including pulmonary atresia, tricuspid atresia, transposition of the great arteries (TGA), hypoplastic left heart syndrome (HLHS), interrupted aortic arch, and critical aortic stenosis.

In these neonates, survival depends on the ductus arteriosus remaining open until surgical or catheter-based correction can be performed. Without PGE1 infusion, the ductus can close within hours to days of birth, leading to cardiovascular collapse. The American Heart Association and the American Academy of Pediatrics both recognise PGE1 as an essential neonatal resuscitation agent. For NICUs managing these cases, Endoprost is not elective — it is a mandatory emergency drug.

See also: NCBI StatPearls — Alprostadil clinical overview for a peer-reviewed summary of PGE1 indications in neonatal cardiology.

2b. Vascular Surgery — Peripheral Arterial Disease and Critical Limb Ischaemia

In vascular surgery, Alprostadil is used for adults with critical limb ischaemia (Fontaine Stage III–IV peripheral arterial disease) who are not suitable candidates for revascularisation surgery or angioplasty. Published clinical literature, including studies referenced by the European Society of Cardiology (ESC) guidelines on PAD, supports intravenous Alprostadil infusion cycles for rest pain, ischaemic ulcer healing, and improvement in walking distance.

Additional indications include ischaemic ulcers in diabetic patients with PAD, severe refractory Raynaud’s phenomenon, and Buerger’s disease (thromboangiitis obliterans). Multiple randomised controlled trials have demonstrated improvements in rest pain and ulcer healing in patients with Fontaine Stage III–IV PAD treated with IV PGE1 infusion cycles.

2c. Urology — Erectile Dysfunction (Second-Line)

In urology, intracavernosal Alprostadil injection is recognised as a second-line treatment for erectile dysfunction refractory to oral PDE5 inhibitors (sildenafil, tadalafil, vardenafil). Guidelines from the European Association of Urology (EAU) support its use in post-radical prostatectomy ED, neurogenic ED (spinal cord injury, diabetes, multiple sclerosis), and vasculogenic ED where oral therapy has failed.

Intracavernosal Alprostadil produces reliable erections in the majority of appropriately selected patients and is an important option for hospital urology departments managing complex ED cases. The dose is individually titrated in a clinic setting before patient self-administration is initiated.

3. Available Strengths and Standard Use Context

Endoprost (Alprostadil) by Bharat Serum and Vaccines is available in two strengths:

Endoprost 125mcg injection — used in PAD (peripheral arterial disease) and urology indications
Endoprost 250mcg injection — used in neonatal ductal-dependent CHD (dose titrated by body weight) and PAD

All dosing is determined by the treating physician according to the approved label and clinical context. The standard dose in neonatal CHD is an IV infusion titrated from a starting dose of 0.05–0.1 mcg/kg/min, with dose adjustments based on clinical response and monitoring parameters. Refer to the full prescribing information for dosing guidance.

Note: This table is for procurement reference only. All clinical dosing decisions rest with the treating physician.

4. Why Cold Chain Compliance Matters for Alprostadil

Alprostadil is temperature-sensitive. Endoprost must be stored at 2°C to 8°C in a validated pharmaceutical refrigerator at all times. Storage outside this range — including freezing — can compromise the drug’s stability and clinical efficacy. This creates a significant procurement challenge: not all pharmaceutical distributors have the infrastructure to maintain cold chain integrity from warehouse to hospital pharmacy.

For hospital pharmacies ordering Alprostadil:

Verify that the distributor uses temperature-monitored insulated packaging for every consignment
Confirm that warehouse storage conditions are maintained at 2°C–8°C with validated equipment
Reject any consignment that shows evidence of temperature excursion or has been frozen
Check vial integrity and expiry date on receipt before accepting stock

As a licensed pharmaceutical distributor in Delhi, A.K. Pharma dispatches all Endoprost with cold chain-compliant insulated packaging and temperature monitoring — a critical logistical requirement that not all distributors can reliably provide. We supply to hospitals and NICUs across India, including Tier 2 and Tier 3 cities.

5. Administration Overview (For Prescriber Reference)

The following is a general administration overview based on the manufacturer’s prescribing information, for reference by prescribing clinicians. All dosing and administration protocols must be determined by the treating physician.

Neonatal / PAD Indication — IV Infusion

Prepare infusion by diluting Alprostadil in appropriate diluent per manufacturer instructions
Administer by continuous IV infusion; titrate rate to clinical response under physician supervision
Reconstituted solutions should be used promptly per manufacturer stability data
Continuous cardiorespiratory monitoring required during infusion in neonatal settings
Monitor blood pressure continuously during IV infusion for PAD indication
Monitor for apnoea in neonates — a dose-dependent effect of PGE1 infusion occurring in approximately 10–12% of patients; respiratory support must be immediately available

Urology Indication — Intracavernosal Injection

Dose individually titrated in urology clinic setting before patient self-administration
Patient training and follow-up required for intracavernosal self-injection
Monitor for priapism (erection lasting more than 4 hours) — urgent medical attention required if this occurs

Full dosing and administration guidelines are available in the manufacturer’s official prescribing information and on NCBI — Alprostadil pharmacology and clinical use.

6. Key Side Effects and Monitoring Requirements

Hospital teams using Alprostadil should be aware of the following side effects, as described in the approved prescribing information and clinical literature:

Common Side Effects

Fever (pyrexia) — a recognised and common effect of PGE1 infusion; monitor and manage per clinical protocol
Flushing, hypotension, and bradycardia — related to the vasodilatory mechanism; continuous haemodynamic monitoring required
Apnoea — particularly in neonates; approximately 10–12% incidence; respiratory support must be immediately available in NICU settings
Local pain at infusion site and oedema — commonly reported in PAD indication

Serious / Less Common Side Effects

Cortical proliferation of long bones — reported with prolonged PGE1 infusion (typically beyond 120 hours); radiological monitoring recommended for extended infusions
Priapism — in urology patients receiving intracavernosal Alprostadil; patients must be counselled on the need for urgent medical attention if erection persists beyond 4 hours

Full side effect and safety information is available at FDA Alprostadil Safety Information.

7. Alprostadil in India — Procurement and Availability

Alprostadil injectables are available in India under several brand names, with Endoprost (Bharat Serum and Vaccines) being one of the established institutional brands. As a Schedule H drug, Alprostadil can only be supplied to licensed hospital pharmacies and institutional purchasers against a valid purchase order and requisition.

Hospital procurement teams should note:

Alprostadil is not a high-volume commodity drug — not all pharmaceutical distributors maintain consistent stock
Cold chain infrastructure requirements mean that pan-India supply requires a distributor with dedicated temperature-controlled dispatch capability
NICUs and cardiac surgery programmes should maintain buffer stock given the emergency nature of its neonatal use
Both 125mcg and 250mcg strengths should be kept on formulary to serve NICU, vascular, and urology departments simultaneously

A.K. Pharma — a trusted medicine distributor in Delhi — maintains consistent Endoprost stock in both strengths, tracks expiry dates, and provides full GST documentation and institutional purchase order support. We supply to hospitals and NICUs across Delhi NCR and pan-India.

See our full Endoprost (Alprostadil) product page for complete product information, sourcing details, and quote request.

8. Related Hospital Medicines Available at A.K. Pharma

Hospitals managing multi-specialty caseloads can source companion critical-care and specialty medicines through A.K. Pharma:

Beyfortus (Nirsevimab) — RSV monoclonal antibody prophylaxis for neonates and infants
Zoladex (Goserelin) — GnRH agonist for prostate cancer and endometriosis
Imfinzi (Durvalumab) — PD-L1 inhibitor for lung and biliary tract cancers
Bonrange PTH (Teriparatide) — anabolic therapy for severe osteoporosis
Browse all Hospital Medicines available at A.K. Pharma

9. Frequently Asked Questions

What is Endoprost (Alprostadil) used for in India?

Endoprost (Alprostadil) is used in neonatal ICUs to maintain patent ductus arteriosus in ductal-dependent congenital heart disease, in vascular surgery for critical limb ischaemia and peripheral arterial disease, and in urology for erectile dysfunction refractory to oral PDE5 inhibitor therapy. It is supplied to hospitals, NICUs, and specialist centres across India by licensed pharmaceutical distributors. More clinical information is available at NCBI StatPearls — Alprostadil.

Is Alprostadil injection available in India?

Yes. Alprostadil injection is available in India under brand names including Endoprost (Bharat Serum and Vaccines) in 125mcg and 250mcg strengths. It is a Schedule H drug and is supplied only to licensed hospital pharmacies and institutional purchasers. Contact A.K. Pharma — a licensed pharmaceutical distributor in Delhi — for current availability and institutional pricing.

What is the difference between Alprostadil and Carboprost?

Alprostadil (PGE1) and Carboprost (PGF2α) are both synthetic prostaglandins but have entirely different clinical uses. Alprostadil is used for neonatal cardiac care (ductal patency), peripheral arterial disease, and urology. Carboprost Tromethamine is used for postpartum haemorrhage and obstetric indications. They act on different prostaglandin receptors and are not interchangeable.

Why does Endoprost require cold chain storage?

Alprostadil is temperature-sensitive. Storage outside 2°C–8°C or freezing can compromise the drug’s stability and clinical efficacy, which is particularly critical given its lifesaving role in neonatal emergencies. A.K. Pharma maintains cold chain storage and cold chain-compliant dispatch for every Endoprost order.

How do hospitals order Endoprost from A.K. Pharma?

Hospitals and NICUs can place orders for Endoprost by calling 011 4172 6999, WhatsApp +91 9810034827, or via the product page on akpharma.in. A.K. Pharma accepts institutional purchase orders and provides complete GST documentation.

Does A.K. Pharma supply Alprostadil pan-India?

Yes. A.K. Pharma supplies Endoprost (Alprostadil) with cold chain-compliant insulated packaging to hospitals and institutions across India, including Tier 2 and Tier 3 cities. Bulk supply is available for NICUs, hospital pharmacies, vascular surgery units, and urology centres.

10. About A.K. Pharma

A.K. Pharma is a licensed medicine distributor and pharmaceutical distributor based in Shastri Nagar, New Delhi, supplying specialty and critical-care medicines to hospitals, NICUs, oncology centres, and specialist clinics across India. We maintain cold chain storage and dispatch for all temperature-sensitive medicines and provide full documentation support for institutional purchases.

Address: E-2/257A, 2nd Floor, Shastri Nagar, New Delhi 110052
Phone: 011 4172 6999
WhatsApp: +91 9810034827
Website: akpharma.in

Disclaimer: This article is intended for informational and procurement reference purposes only and does not constitute medical or clinical advice. All treatment decisions, including drug selection, dosing, and administration, must be made by a qualified healthcare professional in accordance with the approved prescribing information. A.K. Pharma is a licensed medicine distributor and does not provide clinical guidance.

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