Erectile Dysfunction Sterile Injectable Therapy

What Are Intracavernosal Injections for Erectile Dysfunction?

Sterile injectable medications for erectile dysfunction are given by intracavernosal route, meaning the active pharmaceutical ingredients are directly injected into the penis. Doing so allows the drugs to rapidly enter the site of interest and can encourage more immediate activity.

What Are the Benefits of Injectable Erectile Dysfunction Support?

  • While oral PDE-5 inhibitors (sildenafil citrate, vardenafil, and tadalafil) are considered first line therapy for erectile dysfunction, not all patients see success with these agents. Absorption variation, onset delays, and side effects can contribute to challenges individuals face when seeking appropriate erectile dysfunction therapy.
  • Compounded intracavernosal injections are an alternative option for patients who have not succeeded or are ineligible for oral therapy.
  • When the moment strikes, waiting for medication to help isn’t always a reasonable request. Intracavernosal injections are thought to offer a more immediate onset of action for those unplanned intimate opportunities.

What Are the Compounded ICI Prescription Options for Erectile Dysfunction?

  • Alprostadil is a prostaglandin and vasodilator. It can relax the smooth muscle of the penis, dilating local arteries to increase blood flow and promote an erection.
  • Alprostadil may be a promising alternative for patients that do not succeed with oral phosphodiesterase type 5 inhibitors (PDE5i), like sildenafil citrate, tardenafil, or vardenafil.
BiMix (Papaverine HCL /Phentolamine Mesylate)
  • Papaverine HCl is a non-selective phosphodiesterase (PDE) inhibitor that can prompt smooth muscle relaxation and vasodilation in the penis.
  • Phentolamine Mesylate is a non-selective alpha-adrenergic antagonist that can help promote an erection by blocking vasoconstriction.
  • These medications are used in combination only and can serve as an alternative to alprostadil monotherapy. Together, they can provide synergistic vasodilation of the penis.
TriMix (Alprostadil/Papaverine HCL/Phentolamine Mesylate)
  • This drug trio is thought to provide a promising and well-tolerated erectile dysfunction intervention. Combining three therapeutic options allows multiple mechanisms of action to work simultaneously, with increased potential for sexual satisfaction.
  • This multimodal formulation may improve sexual outcomes with lower individual medication strengths, limiting the potential for side effects.

To learn more about how to perform ICI, click here

Who Should Avoid These Medications?

  • Patients with an increased risk of priapism – erections lasting 4 hours or more – should seek medical advice before starting injectable medications for erectile dysfunction. Conditions like sickle cell disease, leukemia, and multiple myeloma can be predisposed to priapism and are encouraged to discuss appropriateness of therapy with a provider. Use is contraindicated for those with Peyronie’s disease, bleeding disorders, or recurrent priapism.
    • Patients with higher likelihood for priapism should also discuss risk management, such as rescue medications, for emergent situations. Our sterile facilities offer injectable phenylephrine, which can serve as a therapeutic option for these case
  • There are other conditions that may affect your candidacy for compounded erectile dysfunction injectable medications. Please reach out to your medical provider for more clinical information and to discuss therapies appropriate for you.

Non-Pharmacologic Options

  • Lifestyle changes, such as improvements in diet and exercise and avoiding smoking, can make a big difference for sexual wellbeing. These interventions may decrease risk of developing conditions known to contribute to sexual dysfunction and prevent erectile dysfunction early signs from worsening.

Learn More About Erectile Dysfunction

If you’re dealing with or concerned about one of the conditions listed above, visit our Conditions page to find resources and guides to help you discuss compounding solutions with your doctor.

If you’re a clinician who’s interested in prescribing compound medications for your patients, visit our Belmar Solutions page to find a formulary and learn more about the solutions Belmar offers.

Contact Belmar Pharma Solutions

If you're a patient, we're here to help you fill prescriptions or provide you with the information you need to work with your doctor to help decide if a compounded prescription might be a good therapy for you.

Prescribers, for a complete formulary or access to our clinical resources, fill out the form below. If you are new to compounding, you may also find our page on How to Write a Compounding Prescription

I'm a Patient
I'm a Prescriber