Several types of oral and injectable medications may help ED.
PDE5 Inhibitors
These medications, which you take by mouth, can boost the effects of nitric oxide — a chemical in your body that allows the blood vessels to dilate. This helps the penile tissues fill with blood, which supports getting an erection. Medications in this class include:
Depending on the medication, you may need to take it with or without food, daily or as needed, and at different times before sex. These medications may not be safe if you also takes nitrate drugs, alpha-blockers, or drugs that block an enzyme called CYP3A4, including itraconazole (Sporanox, Tolsura), ketoconazole (Extina, Ketozole, others), and ritonavir.
Common side effects of PDE5 inhibitors include:
- Headaches
- Flushing
- Blocked or runny nose
- Indigestion
Rarely, a prolonged erection (called priapism) might occur, which may cause permanent penile damage. Seek immediate medical attention if you have any erection that lasts for four hours or longer after taking a PDE5 inhibitor.
Injectable Combination Drugs
Other drugs can be delivered by injection or as a pellet inside your penis to help create an erection. Drugs in this category include:
- Trimix, which combines alprostadil (Muse), papaverine, and phentolamine, which are drugs from different classes that combine to relax smooth muscle and blood vessels in the penis
- Bimix, which combines phentolamine and papaverine
- Papaverine, which a doctor may prescribe on its own
A rare side effect of injections is Peyronie’s disease, which is a painful curvature of the penis. Incorrect injection technique can lead to scar tissue that affects how the penis curves, so be sure to talk to your healthcare provider about how to do the injections properly before moving forward. A medical professional will offer training on how to give yourself these injections at home, which often takes two consultations.
If you also take a PDE5 inhibitor medication, you should avoid taking a dose of it within 18 to 72 hours of an injection, depending on your medication and dosage. Talk to your doctor about these safety precautions.
Hormone Therapy
If your ED is linked to a low testosterone diagnosis, a doctor might recommend testosterone replacement therapy. Testosterone supplements (Androderm, AndroGel, or Fortesta) are available as pills, capsules, patches, gels, nasal gels, injections, or implantable pellets. The brand, dosage, and schedule will vary depending on which form you take.
Side effects are rare but might include acne, sleep apnea, swollen or tender breast tissue, or ankle swelling. Testosterone therapy also comes with risks if you overuse it, so talk to your doctor for any warnings and use only as directed.
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