Dr. Pranitha Bangera is a gold-medalist dentist with a strong foundation in clinical training and patient care. Alongside her medical background, she has earned accolades in literature, reflecting her lifelong passion for storytelling. She now combines these skills to create engaging, research-driven healthcare content that empowers readers with reliable patient education. Her writing interests cover sexual health, mental health, and the latest healthcare innovations, where she simplifies complex medical concepts for a broader audience. Beyond writing, she has contributed to healthcare startups in roles such as community manager, creative director, and medical outreach coordinator, gaining valuable insights into healthcare marketing and patient engagement. A winner of several hackathons, including the Hult Prize on-campus round in 2024, Dr. Bangera continues to explore the intersection of medicine, digital health, and communication. Her goal is to make accurate healthcare information accessible, trustworthy, and easy to understand for people everywhere.
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Updated on 28th November 2025
Papaverine is an older injectable treatment for erectile dysfunction that works by relaxing penile muscles and boosting blood flow, often used when standard ED tablets don’t help. While it can produce strong erections, it carries higher risks, especially priapism and penile scarring, which is why it’s no longer a first-line option. Topical gels are being researched but aren’t reliable yet. If you’re considering papaverine or injections for ED, make sure it’s under a specialist’s guidance. Persistent ED should always be evaluated by a sexual health expert to find the safest and most effective treatment for you.
Erectile dysfunction can feel overwhelming, especially when the usual medications don’t seem to help. That’s often when men start exploring lesser-known treatments, and one name that comes up in many specialist discussions is papaverine. Papaverine has been around for decades, but it continues to play a role in certain complex cases of ED where other options fall short.
Papaverine helped many men by directly improving blood flow to the penis through injection therapy. Even today, it can still be useful for men who don’t respond well to oral ED medicines, particularly those with blood-flow–related or post-surgical erectile problems.
In this article, we’ll take a look at papaverine for erectile dysfunction, how it works, how it’s used, the papaverine dose for erectile dysfunction, possible risks and side effects, and when it might be considered as a treatment option.
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Papaverine is a medicine that helps relax and widen blood vessels (peripheral vasodilator), which improves blood flow. It can also help relax muscles( smooth muscle relaxant). Even though it originally comes from the opium poppy plant, it is not an opioid and does not behave like drugs such as morphine or heroin. It works completely differently and has no addictive or “drug-like” effects. [1]
Papaverine has been used since the early 1980s to help create an erection through medical means (pharmacologically induced erections) in men suffering from erectile dysfunction[2]. Doctors inject it directly into the spongy erectile tissue of the penis, which helps increase blood flow and produce an erection. This method is known as penile injection therapy.
Historically, papaverine played a big role in:
Research has found that papaverine can:
Over time, however, its role has shrunk because:
Today, papaverine is more of a second- or third-line option, used mainly in specialist settings, for complex ED or where standard treatments have failed.
To understand papaverine, it helps to understand what happens during a normal erection, briefly:
Upon sexual stimulation:
Papaverine works by directly relaxing these muscles and widening penile blood vessels, thus improving blood flow into the penis. It blocks certain chemicals, called enzymes, inside the penile muscles. When these enzymes are blocked, two natural chemicals (cyclic AMP and cyclic GMP) increase. Higher levels of these chemicals help the muscles in the penis relax. [3]
Once these muscles relax:
This results in a firm, long-lasting erection.
Some studies show that papaverine may also work through the body’s natural nitric oxide (NO) system, the same process involved in normal erections. It seems to help the blood vessels relax using a slightly different process than common ED tablets like Viagra, but the result is similar: better blood flow to the penis.
Papaverine may be used for:
Papaverine is effective, but it is not a casual or “mild” treatment. It’s usually reserved for men under specialist care (often a urologist) because:
Modern guidelines generally prefer:
So is it “safe”?
Papaverine is most commonly available as a Papaverine 60 mg Injection (papaverine hydrochloride solution). [3]
It is injected directly into the spongy erection-producing tissue of the penis (an intracavernosal or intracavernous injection).
Doctors usually begin with a low dose of 15–30 mg and slowly adjust it depending on how well the person responds. Some men, especially those with spinal cord injuries, may need much smaller doses, sometimes as low as 5–10 mg. After the injection, the erection usually starts within about 10 minutes and may last 1 to 4 hours. [3]
To keep the treatment safe and reduce complications, specialists advise:
To avoid needles or needle phobia, researchers have explored non-invasive forms like transdermal papaverine [4], which is papaverine that can be applied on the skin (usually as a gel or cream) so it can absorb through the skin into the penis, instead of being injected. Some of these include:
Studies have shown that these gels can:
However, these topical forms are still considered experimental and are not as reliable as injections.
Note: Papaverine is not a long-term fix for ED. It is an on-demand treatment, used shortly before planned sexual activity.
Papaverine can be used on its own as a single-drug injection or as part of a combination injection, for example:
These combinations can create a stronger and more reliable erection than papaverine alone.
Because papaverine acts directly on erectile tissue and blood vessels, it comes with both local and full-body risks.
Regular self-examination of the penis is essential during penile injections. Any lump, persistent pain, or curvature should be reported to a doctor.
If too much papaverine enters the bloodstream, it can cause:
Papaverine may interact with:
That’s why it’s important to let your doctor or pharmacist check all your medicines first, to make sure papaverine won’t react badly with anything you’re already taking.
Papaverine may not be suitable for:
Erectile dysfunction is not just about sex; it can also be an early sign of blood vessel problems, diabetes, or heart disease.
You should see a doctor or urologist if:
Needle-based treatments sound intimidating, but for the right patient, they can make a real difference. What matters most is getting the dose right and monitoring the response to keep things safe.
Papaverine has played an important role in the early treatment of erectile dysfunction, and it can still produce strong erections in men with complex or blood-flow-related ED. But because it carries a higher risk of priapism and penile scarring, requires careful injections, and has been replaced by safer options like PDE5 tablets and prostaglandin E1, it’s no longer used as a first choice.
Today, it’s mainly reserved for men who don’t respond to standard treatments or need specialised combination injections like tri-mix. If your erectile difficulties continue or don’t improve with basic treatments, it’s best to consult a sexual health expert who can guide you toward the safest and most effective options.
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