Avoid extremes in temperature. The cause of this ache can be put down to a number of factors however the common thinking is that potassium that is present in the medication causes this added ache – in such cases where the ache is untenable, use of an alternative branded solution such as TriMix can then be used. This will help remove any air bubbles.

Using a circular motion, wipe off the top of the vial with an alcohol swab.

Aside from pills like Viagra, Levitra, and Cialis, for example, there are surgical, therapeutic, even do-it-yourself treatments that can bring back that lovin’ feeling. Self-injection lessons should be given in your doctor's office by an experienced professional. Malpractice also includes failing to inform the patient that if they develop priapism they should seek medical attention immediately with a urologist or at the closest emergency room. The medical malpractice attorneys at Crandall & Pera Law fight for those injured due to negligent use of these injections. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. The erection may also be associated with a painful sensation. However, if the erection is lasting longer, say four hours, then that is considered a medical emergency and you need to go to hospital. It can be used twice a day but not more than 7 times a week.

  • The erection will last long enough for sex, and maybe longer.
  • Otherwise, taking an over-the-counter decongestant medicine called Sudafed® (pseudoephedrine HCI) in tablet form may help.
  • The injection therapist will tell you the best amount to start with (see contributors below).

Lab Tests

After you have completed the injection, put pressure on the place of injection to prevent bruising. The lowdown on glycemic index and glycemic load. He was never diabetic before, but he was prescribed Lipitor about seven years ago. Priapism is an erection that lasts too long. Do not discard this swab; you will need to use it later.

There may be certain warnings. Men most often start having sex with their penile implants by eight weeks after surgery. Sign up for our newsletter, cialis and Levitra are not currently available as generics.). Do not inject more than one dose in a day. Depending on the frequency that you decide to take penile injections, you shouldn’t experience any long-term pain however in some instances men do experience some aching pain at the location of the injection for up to 60 minutes following the injection being undertaken.

You will take a preloaded syringe that has the needle connected already, which is the prescription we will write for you.

Medication & Erectile Dysfunction

Cleanse the injection site with alcohol. The patient (or his partner) is taught by a nurse or doctor how to inject the drug directly into the shaft of the penis when he wants an erection (up to a maximum of 3 times per week and not more than once daily). This information will help you learn to inject medication into your penis. With proper training, 75 out of 100 men can get a working erection using a vacuum erection device. Erections that last more than 6 hours can cause serious damage to the penile tissue and may result in permanent impotence. If the cartridge is damaged, the cake may shrink in size. Wash your hands with an anti-bacterial soap. Papaverine should not be injected just under the skin.

In rare cases, the drug Cialis® can cause or increase back pain or aching muscles in the back. ED medicines that you take by mouth don't work for everyone. The dose of this medicine will be different for different patients. However, it wasn’t until 1982 that Dr.

Using a sterile needle, inject the medicine slowly and directly into the base of the penis as instructed by your doctor. Sometimes, a small nodule or lump may develop if the same site is injected again and again. Prepare the injection based on the medical advice provided to you by your consultant or medical professional. Check with your doctor immediately if any of the following side effects occur: This is not an indication of a security issue such as a virus or attack.

You can also visit the NHS Choices website at www.

Interesting Facts About The Penis Including Average Penis Size, Erections, Sensitivity And Sexual Pleasure

Carefully follow the instructions for administration which are described below. Please call your APP when your supplies run low. Using papaverine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. MUSE® has few side effects. You may be asked to change certain food habits, stop smoking, increase workouts or stop using drugs or alcohol. It should be used no more than 2-3 times a week and only once a day. In general, men who suffer from erectile dysfunction and who respond positively to test injections are candidates for this treatment. And now in about 20 seconds you have basically loaded your auto injector.

The most common type of side effect from a penile injection (a symptom experienced and reported in more than 37% of cases) is that of an ache that occurs between 5 to 20 minutes after initial injection. Now firmly grasp the head of your penis whilst it’s in a flaccid state and gently pull the penis outward (do not twist), away from your body allowing for the sides of the penis to be clearly visible and accessible. If she is, or may be pregnant, you should use a condom. Priapism (prolonged erection) emergency room treatment. He showed that when stored in a refrigerated temperature of 5 degrees Centigrade, Papaverine lost less the 3% of its activity and Phentolamine lost less than 7%. Papaverine hydrochloridewas initially the most often used medication.

The erection will last 30 minutes to an hour or up to orgasm. Go to the closest emergency department if you have an erection that lasts longer than 3 to 4 hours. These are all common systemic side effects that occur with medications. This helps your penis get hard and stay that way long enough for sex. Brindley, professor of Physiology at the Institute of Psychiatry in London, first reported that 11 impotent men were able to have intercourse following the injection.

Health Solutions

And then you'll draw down to the amount of liquid that you're going to inject. In general, minor side effects that may occur with penile injection therapy include: Set the injection device down on a clean, level surface and do not allow the needle to touch anything. In those rare cases where a low sex drive and low blood levels of Testosterone are at fault for ED, Testosterone Therapy may fix normal erections or help when combined with ED drugs (PDE type 5 inhibitors). So the way to go. If the erection is lasting two hours, you can start to manually bring the erection down using methods to constrict the blood vessels. When traveling, do not store in checked luggage during air travel or leave in a closed automobile.

This improves the chance that your erectile function will return. If too much is used, the erection may become so strong that it lasts too long and does not reverse when it should. Invicorp may work well for men who have found little success with other ED treatments and some may find it less uncomfortable to use than alprostadil injections. Don’t take extended-release or long-acting tablets, such as Sudafed 12 hour. Stretch the penis out away from your body. Do not use the cartridge if it appears damaged or the cake is substantially reduced in size.

Speak with your APP about how to travel with your injection medication. To best avoid breaking the needle, you should pay careful attention to your doctor's instructions and try to handle the injection device properly. Do this quickly to reduce discomfort. Papaverine and phentolamine also belong to this group of medicines called vasodilators (drugs that relax smooth muscle tissue, causing arteries to open and allowing an influx of blood flow). The P-shot or the Priapus shot, named after the Greek god of fertility, is a blood-based treatment used to cure erectile dysfunction and increase penis size in patients. Related posts, vascular stent Just as coronary stents can help treat heart disease, there’s some reason to hope that vascular stents might be able to help treat ED. The treatments below are available to treat ED directly. Proper injection technique and individual dose titration are essential for the safe use of this product. TriMix is a more expensive “branded” version of Alprostadil and although isn’t necessarily stronger (some have suggested in terms of results it’s marginally weaker than Alprostadil) has been shown to produce far less discomfort where aches and pain are concerned.

This is mostly good, but it could be embarrassing if the house caught fire or guests came to visit.

  • The overall incidence of penile scarring in the studies was 3 percent.
  • You have to cock it so that the spring is loaded.
  • The following information includes only the average doses of this medicine.
  • Store at 25°C (77°F); temperature variations between 15° - 30°C (59° - 86°F) are allowed.
  • In the case of erectile dysfunction it is available as a urethral suppository or administered by injecting slowly into the penis.

Penile Injection Video

Then you basically drop the syringe into the auto injector and put this over. Other possible side effects include headache, dizziness, and more rarely fainting – usually at the thought of sticking something up one’s urethra! Do not touch the exposed needle (Figure B). Move your finger so that your index finger or thumb can push in the plunger.

We also have a number of factsheets and booklets on sexual problems and related issues for men and women that can be downloaded from our website or requested. If you’re currently receiving chemotherapy for cancer, ask your oncologist (cancer doctor) when you can safely inject. Even less frequently is an increase in the liver enzymes usually associated with the Papaverine injections. Have a healthy sexual intervention with this useful herbal plant. Some men may require a 30 minute wait before a fully rigid erection is obtained.

  • Notably the appearance of your medication should never change – it should always be clear/translucent (never cloudy).
  • A typical erection after one of these injections lasts about an hour, and that is the time-frame we aim for with injection-induced erections.
  • In the rare and unlikely event that bleeding persists after 10 minutes of pressure being applied, you should seek medical attention as quickly as possible.
  • Place the cap back on the syringe without touching or bending the needle.

What Is A Penile Injection?

For more information, read the “Pseudoephedrine HCl (Sudafed)” section above. Apply pressure with your index finger on the injection site and your thumb on the opposite side of the penis. It is generally advised not to use Penile Injections and PDE5 Inhibitors (such as Viagra/Cialis) together. The first injectable drugs commonly used in the UK for erection problems were papaverine and phentolamine, but these were not licensed for ED and have now been replaced by alprostadil. Although you probably find the idea of injecting something into your penis unappealing, many men are highly satisfied with this therapy and will testify to the ease and effectiveness of the injections. Still, it helps to ask your health care provider about side effects that could result from each option: Alprostadil is a prostaglandin, PGE-1, that is quite effective for erectile dysfunction. We use a very small syringe and a small voluminous solution is injected directly into the penis, usually along the side.

Liver disease—Papaverine can cause liver damage when it is given in ways that allow it to get into the bloodstream (by mouth or by injection into a muscle, a vein, or an artery); when papaverine is given by intracavernosal injection, liver damage is much less likely because the medicine enters the bloodstream very slowly. Continue to apply firm pressure until bleeding stops. It’s very important that you inject into the side of the penis as this is where the corpus cavernosum vein that we want to stimulate is located. These videos below, including those from xtube. This helps the medicine spread to all parts of the penis, so that it will work better. You put a tiny needle into the side of your penis and inject a medicine.

Let us know in the comments below and share your experience with our community. Papaverine, Phentolamine, and Prostaglandin E1. Just to again review. Keep out of the reach of children. “Because this area has been numbed with the anaesthetic cream, the patient feels little or no pain. It's of great value to have the first shot in the doctor's office before doing this on your own. The suppository form is called “MUSE” (which stands for Medicated Urethral System for Erection).

Does A Penile Injection Hurt?

Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options. When oral medications fail, physicians may treat the problem by injecting medications, such as alprostadil, papaverine, phenoxybenzamine and papaverine. Hold the medication bottle so that your fingers do not touch the rubber stopper through which the needle is inserted. The devices are reliable, but in the case of mechanical malfunction, the device or a part of the device will need to be replaced surgically.

Site Information Navigation

If the tube that drains the bladder and the urethra is injected, the medication may leak out of the tip of the penis. However, this treatment is effective and it another option for patients who suffer from erectile dysfunction. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result. None of these videos is pornographic and all are purely instructional with some of them featuring members of this forum. You draw air into the syringe (an insulin syringe is most commonly used), down to the amount that you're going to dose with - this isn't going to be a guessing game. Use only the dose prescribed by your doctor. Alprostadil (also referred to Prostaglandin ED – PGE1) is a naturally occurring liquid that has a very diverse hormone enhancing effect.

Shift your finger so that your index finger or your thumb can push in the plunger. Do not turn the protective caps counterclockwise as this will loosen the needle. Although there is no specific information comparing the use of papaverine for erectile dysfunction in the elderly with use in other age groups, papaverine is not expected to cause different side effects or problems in older people than it does in younger adults. Alprostadil is a vasoactive agent that is a synthetic version of the chemical prostaglandin E. Improper injection and any subsequent scarring can lead to penile curvature and nodules in the penis, so it is important to get proper training before beginning injection therapy. A small amount of bleeding at the injection site may occur. Two of those studies, conducted at several medical centers in the United States and elsewhere and involving more than 400 patients since 1992, were considered pivotal. You might experience bruising to the site of injection, this is not uncommon, however it is not permanent or damaging.

Although your consultant will recommend a starting dosage for your injections, it is possible to gradually increase or decrease your dosage depending on the results you achieve however this should only be done when discussed and agreed with your consultant. There can be bruising along the side of the penis. Men who are reluctant to have surgery find the injection method to be a good alternative to penile prosthesis. If you feel you’re going to struggle actually preparing the syringe with the correct amount of medication, it is now possible to obtain pre-filled syringes hence reducing the margin of error. Use papaverine injection exactly as directed by your doctor.


Extracorporeal shock wave therapy (ESWT) - low-intensity shock waves that aim to fix the erectile tissues and help restore natural erections. Many men may be prescribed medicines that go directly, via injection, into the penis. Priapism is easily reversed when treated early. Your healthcare provider will show you how to do self-injection the first time. Supplements are popular and often cheaper than prescription drugs for ED. So, it is one approach that can be used for patients who have undergone prior surgery and have erectile dysfunction as a result of injury to the nerves.

Don’t let go of the vial, or the needle will bend.

Money & Education

Once inserted, carefully push down on the plunger to administer the dosage. Some men would like a different treatment for erectile dysfunction. The pharmacological treatment has been successful in producing an erection in over 80% of the patients in the Erectile Dysfunction Unit. Papaverine and Phentolamine may produce a painful, prolonged erection known as priapism.

Precautions While Using Papaverine

Discomfort, bruising and swelling after the surgery will last for a few weeks. Insert the cartridge into the injection device with the tip facing toward the attached needle (Figure F). There is generally no change to a man's feeling or orgasm. Is quite important that you keep a record of each injection and how effective it was based on the erection scale – this will ensure you’re getting the level of results you need and will also allow your consultant to increase or decrease your dosage as required. High-flow priapism involves problems with the body’s vascular system. There are risks to prosthetic surgery and patients are counselled before the procedure. Insert the needle at a 90° angle (perpendicular) to the shaft.

They will order more supplies for you and will let you know if refills are included. Rest your forearm on your thigh for support. It should not be painful. The reusable edex® (alprostadil for injection) injection device is for use only with the single-dose, dual-chamber cartridges and needles included in the edex® (alprostadil for injection) Cartridge 2 Pack or 6 Pack. In injection form, alprostadil relaxes the penile muscles and blood vessels. This ache is increased by standing, and subsides when the erection is gone. But in general do not take them together.

Gaining An Erection

Follow your doctor's orders or the directions on the label. Let's talk about how we do penile injection therapy. In summary, the long-term effects of intracavernous injections are unknown. Spiros, in front of it is a tall virile the blaze youtube building with a white stone structure, extremely high, and many students go in and out Elegantly they reflected their sense of superiority. In general, these men are active in life and would like to remain sexually active. Virag, a surgeon in France, formally noted that the pressure inside the penis increased after an injection of Papaverine. Position the penis along your inner thigh. You may report side effects to the FDA at 1-800-FDA-1088.

Occasionally, there are times when the diagnosis is not clear, and the tilt table test is designed to evaluate that possibility. Occasionally, penile injections can cause fainting, dizziness and low blood pressure. The bruising is caused by little capillaries bursting. Copyright 2020 Truven Health Analytics, Inc.

Rarely, your erection may last too long (see the section below ‘What if my erection lasts too long? )Don’t twist your penis, since this could lead to injecting the wrong area. Harnessing the upsides of stress, this sudden influx of blood causes an erection by expanding, straightening and stiffening the penis. A rubber band will be applied to the base of the penis. Tubing joins these cylinders to a pump placed inside the scrotum (between the testicles). We want you to get in almost always, if not always.

Age & Erectile Dysfunction

Furthermore, the injections may not continue to work, especially in the conditions (high cholesterol, high blood pressure, etc.) Injecting blood isn’t the only treatment being trialled to improve sexual dysfunction - a study in the Journal Of Urology researching new therapies for erectile dysfunction found that "neovascularisation using vascular growth factors have been demonstrated to be feasible in animal models". The most common side effects of IU alprostadil are a burning feeling in the penis. A patient will either go home on the same day or spend one night in the hospital. Not all bi-mix or tri-mix medications are identical - the amount of the individual drugs may vary from pharmacy to pharmacy. If you wear sunscreen whenever you are outside, your skin may not be making vitamin D. This is called "priapism" and can cause permanent damage to the erection tissue of the penis. One of the toxic effects reported of Papaverine is a skipped heartbeat or abnormal conduction in the heart, which usually only occurs with a large dosage.

When men are interested in penile injection therapy, the first trial injection is performed by the urologist in the office to be sure that the patient has no side effects.

Shock Wave Therapy

You should not use Vitaros® if you have Peyronie’s disease (see our factsheet ‘ Peyronie’s disease ’), or if you have sickle cell anaemia, leukaemia, or multiple myeloma, as these may cause a prolonged erection. How is Penile Injection Therapy done? This is generally well-tolerated by the patient and does not interfere with intercourse. Please feel free to add to this list of links. You should not use alprostadil injections if you have Peyronie’s disease (see our factsheet ‘ Peyronie’s disease ’), or if you have sickle cell anaemia, leukaemia, or multiple myeloma, as these may cause a prolonged erection. Advanced erectile function tests, is DMAA banned in the military? 8 percent in one study where duration of use was 18 months. Small amounts of bleeding at the injection site can increase the risk of transmission of blood-borne diseases between partners. What are the risks of using edex® (alprostadil for injection) ?


Once the injection has been taken it can take anywhere from 10 to 30 minutes for the effects to be felt, whilst the level of arousal can remain for approximately one hour or until an orgasm has occurred. We recommend alternating the injection site each time to prevent this (one side one week, then the other side the other week). You must always wipe the rubber stopper with alcohol before you insert the needle. Do not inject within 72 hours (3 days) of taking tadalafil (Cialis) 10 mg or 20 mg. To improve comfort and to reduce bruising and swelling, make sure that you alternate the side of the penis you inject in – if your last injection was on the left side of your penis, this time use the right side and vice versa. (’) You should not use MUSE® if you have Peyronie’s disease (see our factsheet ‘ Peyronie’s disease ’), or if you have sickle cell anaemia, leukaemia, or multiple myeloma, as these may cause a prolonged erection. Read on to find out about nine common remedies for ED, plus the truth about which ones live up to the hype and which fall flat. Grasp the head of your penis firmly with your thumb and forefinger (don’t just pinch the skin).

Eating for Stronger Erections

Please consider upgrading. Papaverine usually begins to work in about 10 minutes. Erectile dysfunction (ED) is when you are unable to get or keep an erection suitable for sexual intercourse or another chosen sexual activity (see our factsheet ‘ Erectile dysfunction ’). Hold the syringe in your hand like you hold a pen or dart. Your APP will order your supplies for you from a compounding pharmacy. The guidelines for treating a prolonged injection recommend 120 milligrams, so for Sudafed you would take two tablets. Tell your doctor if you have ever had any unusual or allergic reaction to papaverine or any other medicines. If your erection lasts longer than 4 hours, you should go to a hospital casualty unit or Accident and Emergency Department as soon as you can, because a long delay may damage the penis.

The number of injections is not to exceed 12 each month, and should be spaced as evenly as possible. Current, the date of initial ED diagnosis per the patient or per the medical record if the patient did not know was recorded as the date of ED onset. But check with the pharmacist that it is ok for you to take this if you have other health problems or are taking other medications. What is urethral treatment? The solution may initially appear cloudy due to small air bubbles. If refills are included, you can contact the compounding pharmacy directly to set up your billing and shipping.

The penile implant procedure takes about 45 minutes to an hour. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm. Then we take the auto injector, which is basically a spring loaded device that pushes the needle in automatically. For more information on injection therapy and MUSE, see: It is safe for patients who are taking Aspirin, Persantine and Coumadin.

Papaverine Side Effects

Please make sure to include the information below in your injection reports. Oral and transdermal medications, 6 degree change per subject (p <0. Your APP will call the Urgent Care Center so they know to expect you. First, the medication is drawn into a syringe, usually an insulin-type syringe with a short, very fine needle. But with practice, it will get easier. Maintain traction on the head after cleaning the side of the penis.