Erectile dysfunction (ED) is a challenging condition to manage for many men. While oral medications like Viagra, Levitra, Cialis, or Stendra are popular options, they don't always work for everyone.
Penile injections, like Caverject or Trimix, may be a good alternative for those who haven’t found success with pills. While they may seem daunting at first, they often provide great results.
One such injection is Caverject Impulse (alprostadil). But what is it exactly? How does it work? How to administer it, store it, and use it correctly? Here are some interesting points to explore, but without substituting your doctors' instructions... of course!

4AllFamily travel cooling bags for medications

What is Caverject?

Caverject is the brand name of an injectable medicine used to treat erectile dysfunction in men. Its active ingredient is alprostadil, a synthetic form of prostaglandin E1, a naturally occurring hormone that regulates blood flow and other physiological processes.

How does alprostadil work?

In the case of erectile dysfunction, Caverject (alprostadil) relaxes the muscles and widens the blood vessels in the penis, increasing blood flow into the penis and provoking an erection.
Normally, during sexual arousal, the nervous system releases a chemical called nitric oxide that stimulates the production of cyclic guanosine monophosphate (cGMP). This chemical relaxes the smooth muscles in the penis and increases blood flow. However, in men with erectile dysfunction, this process may be impaired, resulting in difficulty achieving or maintaining an erection as desired.
When injected, alprostadil has a similar effect to nitric oxide. It binds to specific receptors in the muscle cells and widens blood vessels in the penis, promoting better blood flow. This increased blood flow can help have an erection or maintain it for longer. 

How is Caverject administered?

Caverject is a sterile, freeze-dried powder that mixes with a solvent solution. It’s contained in prefilled dual-chamber syringes called Caverject Impulse.
It is administered through intracavernosal injection (an injection into the base of the penis). The patient is responsible for self-administration after his healthcare provider has instructed him on the proper injection technique.
Caverject Impulse has two strengths: 10 mcg (white) and 20 mcg (blue). The starting dose of Caverject is usually 2.5 to 5 micrograms. However, the dosage can be adjusted and gradually increased depending on the individual's response to the medication. Each syringe is disposable and designed for single use only, but the patient can choose between the total dose or 3 partial doses according to his doctor’s prescription.
Alprostadil can also be administered through topical cream or suppository. If you’re uncomfortable with needles and injections, talk to your doctor to consider alternative treatment options.

How often do you take Caverject?

Caverject is used as needed, 5 to 20 minutes before sexual activity. However, alprostadil injections should not be used more than once in 24 hours or more than 3 times per week.
Caverject (alprostadil) is a prescription medication. Never take it without medical supervision. Taking higher doses than prescribed by your doctor or injecting Caverject more often than recommended may cause serious side effects, including priapism, penis disorders, dizziness, fainting, low blood pressure, and bleeding at the injection site.

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Does Caverject Need to Be Refrigerated?

Most injections for erectile dysfunction, like papaverine, Trimix, and Bimix, are very fragile and require refrigeration or specific storage conditions. The same goes for alprostadil. If you've been prescribed Caverject, you must carefully follow its storage instructions. Failure to do so can significantly diminish the effectiveness and safety of your treatment.  

Related article: How to Freeze or Refrigerate Trimix and How Long Does it Last?

Caverject (alprostadil) storage instructions

According to Pfizer, Caverject's manufacturer, before reconstitution (mixing of the powder and the solvent), Caverject Impulse syringes do not need to be refrigerated. Instead, they can be stored at room temperature, not exceeding 77°F (25°C), with short and occasional excursions permitted to 86°F (30°C).
However, once reconstituted, Caverject becomes very unstable. Therefore, it must be injected immediately or within 24 hours if stored in the refrigerator. After 24 hours, any unused medicine must be thrown away.
If you refrigerate reconstituted Caverject for a maximum of 24 hours, make sure it does not freeze, as freezing temperatures could destroy the active ingredient (alprostadil). Also, never place it near the freezer compartment.

How to travel with Caverject injections?

As mentioned above, reconstituted syringes of Caverject do not need to be refrigerated, but they must be protected from heat and kept at room temperature below the threshold of 77°F (25°C).

Related article: Essential Tips for Traveling with Trimix Injections.
Although brief excursions to temperatures up to 86°F (30°C) are allowed, you should avoid them as much as possible.
Exposure to high temperatures can cause alprostadil, the active ingredient inside Caverject, to break down or degrade, making it less effective or even completely ineffective.
Heat can also cause physical changes to the medication, such as changing the consistency or color of the injectable fluid, making it difficult to use.
Therefore, men who live in or travel to places where the outside temperature frequently gets above 77°F (25°C) should carry their Caverject Impulse syringes in cooling cases.

4AllFamily’s Companion Travel Cooler is designed for such temperature-sensitive medicines as Caverject. It’s a convenient, lightweight, medical-grade cooling bag that works with simple biogel packs (included) and maintains a safe temperature below 79°F (26°C) for up to 10 hours even when it’s 104°F (40°) outside!

4AllFamily travel coolers for refrigerated medicines
Related article: How to Travel with Syringes & Injectable Medications?

How to use Caverject Impulse?

Self-injecting erectile dysfunction medicines like Caverject in the penis can be daunting at first. But this gesture quickly becomes second nature with practice. Your doctor or nurse must have instructed you how to inject Caverject before sending you how with your new prescription. You can also find detailed instructions for use in the package.
Here's a step-by-step reminder of how to use Caverject Impulse for penis injections:

  1. Wash your hands and your partner's hands if they are assisting you.
  2. Unpack one Caverject syringe, needle, and alcohol swabs from the Caverject Impulse pack.
  3. Open one of the alcohol swabs and clean the rubber membrane at the tip of the Impulse syringe.
  4. Remove the needle from its package and attach it to the syringe by pressing it onto the tip and screwing it clockwise until it is firmly in place.
  5. Remove the outer protective cap of the needle.
  6. Hold the device with the needle pointing upwards and turn the plunger clockwise until it is fully wound. This mixes the alprostadil powder with the diluent to reconstitute the Caverject solution.
  7. Remove the inner protective cap from the needle.
  8. Remove any large bubbles by gently tapping the clear chamber with your finger.
  9. Hold the device in one hand with the needle pointing upwards and remove air from the clear chamber by pressing the plunger rod as far as it will go. A few drops will appear at the needlepoint, and the solution will be free from bubbles.
  10. Turn the plunger rod clockwise to choose the correct dose, as your doctor prescribes. The number appearing in the window indicates the dose of the injection.
  11. Open the second alcohol swab packet and clean the injection site. Caverject must be injected into the corpora cavernosa on the sides of your penis, as shown by your doctor.
  12. Holding the penis with one hand, insert the entire needle length straight into the injection site, keeping the needle at a 90-degree angle.
  13. Push the plunger firmly with your thumb, and then withdraw the needle from your penis.
  14. Apply pressure to the injection site for at least five minutes with the alcohol swab.
  15. Discard the used syringe and needle into a puncture-resistant container, even if there's still liquid inside. Do not recycle them or put them in the regular trash.
For more detailed instructions about how to use Caverject Impulse, read the leaflet included in the package.
We hope you’ve found this article helpful!
Related article: Tips for Traveling with Medication Internationally!
April 24, 2023

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The information presented in this article and its comment section is for informational purposes only and is not intended as a replacement for professional medical advice. Always consult with a qualified healthcare provider for any medical concerns or questions you may have.