ED Injection Therapy (ICP): Complete Guide

Intracavernosal pharmacotherapy (ICP), commonly known as ED injection therapy or penile injections, is one of the most effective treatments for erectile dysfunction. With success rates exceeding 85-95%, ICP offers reliable results for men who haven't responded to oral medications or cannot take them due to other health conditions.^[1]

What is ED Injection Therapy?

ED injection therapy involves injecting a small amount of medication directly into the corpus cavernosum (the spongy tissue of the penis) using a very fine needle. The medication causes the blood vessels to dilate, increasing blood flow and producing a firm erection within minutes.^[2]

Unlike oral ED medications that require sexual stimulation and arousal to work, ICP injections produce an erection through direct pharmacological action. This makes them particularly effective for men with nerve damage, diabetes-related ED, or psychological factors affecting arousal.

How ICP Injections Work

The medications used in ICP are vasodilators—drugs that relax smooth muscle tissue and expand blood vessels. When injected into the penis, they:

• Relax the smooth muscle in the erectile chambers
• Dilate the penile arteries, increasing blood flow
• Compress the veins that normally drain blood from the penis
• Result in a firm, natural-feeling erection within 5-15 minutes

The erection typically lasts 30-60 minutes depending on the dosage and individual response. Importantly, the erection does not immediately subside after ejaculation—it only goes down when the medication wears off.^[3]

Medications Used in ED Injections

Several FDA-approved medications are used in ICP therapy, either alone or in combination:^[4]

Alprostadil (Prostaglandin E1)

The most commonly used single-agent injection. Available as Caverject and Edex. Effective for many men but may cause a mild aching sensation.

Trimix (Combination Therapy)

A combination of three medications: alprostadil, papaverine, and phentolamine. This combination often provides better results with lower doses of each individual medication, reducing side effects. At our clinic, we custom-compound Trimix formulas tailored to each patient's needs.

Bimix

A two-drug combination (typically papaverine and phentolamine) for patients who cannot use alprostadil.

Who is a Good Candidate for ICP?

ED injection therapy may be right for you if:

• Oral ED medications (Viagra, Cialis, Levitra) haven't worked for you
• You cannot take oral medications due to heart conditions or medication interactions
• You have diabetes-related erectile dysfunction
• You've had prostate surgery or radiation therapy
• You have nerve damage affecting erections
• You want a reliable, predictable treatment option

Success Rates and Effectiveness

Research consistently shows ICP injection therapy is highly effective:^[1][2]

What to Expect from Treatment

Initial Consultation

During your first visit, we'll review your medical history, discuss your ED symptoms, and determine if ICP is appropriate for you. If so, we'll demonstrate the proper injection technique and administer your first dose in-office to determine the optimal dosage.

Learning Self-Injection

Most men master the self-injection technique quickly. The injection site is at the base of the penis where there are very few nerve endings, making the process nearly painless. We provide detailed training and support until you feel confident.

Ongoing Treatment

Once your optimal dose is established, you'll receive medication to use at home. Most men inject 5-10 minutes before anticipated sexual activity. The medication can be used 2-3 times per week, with at least 24 hours between doses.

ICP vs. Other ED Treatments

Potential Side Effects

Like all medications, ICP can have side effects. Most are mild and temporary:

• Mild aching: Some men experience brief discomfort that resolves within minutes
• Minor bruising: Occasional bruising at the injection site
• Prolonged erection (priapism): Rare but requires prompt treatment if erection lasts more than 4 hours

Proper training and dosing minimize these risks. We start with conservative doses and adjust based on your response.

Frequently Asked Questions