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Injections For Erectile Dysfunction

Injections For Erectile Dysfunction

How Do Injections for Erectile Dysfunction Work?

Injections for erectile dysfunction is one option for erectile dysfunction (ED) treatment. While it might be a little embarrassing to talk to your doctor about ED, you can rest assured that there are several ways to treat it. Your doctor will ask you about your medical history and your symptoms to devise an ED treatment plan that is right for you. Treatment can include medications, such as Viagra or Cialis. Or, your doctor might recommend that you try penile injections. Also called intracavernosal injection therapy, a penile injection refers to the introduction of medications directly into the penis via an injection.

What types of injections are used to treat ED?

Oral medications don't work for everyone. Many men may be prescribed medicines that go directly, via injection, into the penis. Injection therapy may use a single drug or a combination of drugs. Single drug injection therapy uses alprostadil, a type of prostaglandinE1 (PGE1), and is called either Caverject® or Edex®. Combination therapies, called "bi-mix" (for 2 drugs mixtures) or "tri-mix" (for 3 drugs mixtures), are a mixture of either two, or all three, of the following most commonly used drugs: papaverine, phentolamine and/or alprostadil. Not all bi-mix or tri-mix medications are identical - the amount of the individual drugs may vary from pharmacy to pharmacy.

Alprostadil is a vasoactive agent that is a synthetic version of the chemical prostaglandin E. This chemical helps relax the smooth muscle tissue in the penis to enhance blood flow needed for an erection.

Storing your medication

The alprostadil in Trimix can weaken over time, so Trimix should be stored in the refrigerator and away from light. This can keep the medication good for a few additional months. If you’re using Bimix or papaverine, you don’t need to keep the medication in your refrigerator because these medications don’t contain alprostadil.

Don’t use the medication if:

  • It has particles or is cloudy.
  • The rubber stopper comes off of the vial.

After your second training visit, your medication will be delivered directly to your home from the compounding pharmacy (specialized pharmacy). Call the compounding pharmacy to make arrangements for billing and shipping. This will limit delays in delivery.


Prolonged erections greater than four hours in duration occurred in 4% of all patients treated up to 24 months. The incidence of priapism (erections greater than 6 hours in duration) was < 1% with long-term use for up to 24 months. In the majority of cases, spontaneous detumescence occurred. Pharmacologic intervention and/or aspiration of blood from the corpora was necessary in 1.6% of 311 patients with prolonged erections/priapism. To minimize the chances of prolonged erection or priapism, edex® (alprostadil for injection) should be titrated slowly to the lowest effective. The patient must be instructed to immediately report to his prescribing physician or, if unavailable, to seek immediate medical assistance for any erection that persists longer than six hours. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result.

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