When The Blue Pills Stop Working

If you are a man suffering from erectile dysfunction (ED) and have been taking Viagra or Cialis or Livitra for many years with satisfactory results, there may well come a time when these medicines no longer help. Its age related.


As you go on through your seventies and into your eighties you may find that, even doubling up on the dose, you can no longer have intercourse. So what do you do now? Give up? Go for the dreaded penile implant? I strongly advise you do neither for the moment.


Penis self-injection


I would urge you to consider self-injection of your penis some minutes before intercourse is contemplated. This can and should avoid the necessity of penile implant or at least postpone that day indefinitely. Penile injection is almost painless, despite of what you might think.


Here is the order in which I would choose penis injections:


  1. Alprostadil. This usually comes in the form of Caverject although you may find a compounding pharmacist who can make it up for you.  It comes in strengths of 5, 10 and 20 micrograms. However, if the top strength is letting you down (as it were) you can double up to 40 or even 60 micrograms. This can be very expensive if you are paying for it yourself and you would probably do better having a compounding chemist make it up for you at the strength you require.
  2. Papaverine.  This comes in 30 mg and 60 mg 2ml vials. Start with 30 mg and double the dose if necessary. Often Papaverine on its own is insufficient to bring about a sufficient erection.
  3. Papaverine and Phentolamine mix. This is sometimes marketed under the brand name of Bi Mix or Androskat licensed by Takeda in the Netherlands and Germany. The two drugs work synergistically the former as a vasodilator the later as a muscular relaxant. In the case of Androskat it contains 30 mg of papaverine and 1 mg of phentolamine.


Here it is necessary to sound a word of warning. Any drug injected into the penis can cause priapism. Priapism is defined as an erection, often painful, that lasts for more than 4 hours. It is a very rare complication of Alprostadil and Papaverine given on their own or in combination.  But when phentolamine is introduced into the equation things can change radically. Priapism in association with phentolamine has an occurrence rate of 8 to 10 %. And priapism, let go for much after 4 hours, has the strong potential of permanently destroying your delicate erectile tissue. So now you have been warned. Introduce phentolamine slowly starting with a ¼ dose even if this does not produce an erection. Far better that than going straight to the top dose and ending up in the ER department of your local hospital!

How To Inject Your Penis:

  • Best while standing up.
  • Hold loaded syringe and needle such as they are parallel to the floor.
  • Introduce the needle into the side of your penis towards the base far back on the abdominal end.
  • Do this in one quick movement going in for full length of needle given that its about 12 mm in length. You will know you are in the right place because there will be no resistance to the fluid flowing in. If there is resistance then you are in the wrong place.

If I can help you with anything covered here please contact me through

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.