Urethral Gels for Men's Sexual Health

Stronger Harder Erections

Erections occur when blood flow increases to the penile erectile tissue. These compounded medications work by relaxing blood vessels and improving blood circulation, resulting in firmer, longer-lasting erections.

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Common Ingredients

Alprostadil

A synthetic prostaglandin (PGE1) that increases intracellular cyclic AMP (cAMP), causing dilation of cavernosal arteries and improved erectile rigidity.

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Aminophylline

A nonselective phosphodiesterase inhibitor and adenosine receptor antagonist that relaxes vascular smooth muscle and enhances penile blood flow.

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Arginine (L-Arginine)

A precursor to nitric oxide (NO), which promotes vasodilation and increases blood flow to erectile tissue.

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Papaverine

A nonselective phosphodiesterase inhibitor that increases cAMP and cGMP levels, enhancing smooth muscle relaxation and penile blood flow.

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Pentoxifylline

Improves blood viscosity and red blood cell flexibility, enhancing microcirculation. It also exhibits mild anti-inflammatory effects.

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Phentolamine

A rapid-acting, nonselective alpha-adrenergic blocker that promotes peripheral vasodilation and increases penile blood flow.

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Sildenafil

A PDE-5 inhibitor that enhances nitric oxide–mediated vasodilation, improving blood flow and erectile responsiveness.

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Onset and Duration

• Effects typically begin within 5–30 minutes

• Erections last 1–2 hours

 

Combos We Prescribe

Aminophylline/Arginine/Sildenafil 3/6/2% Scream Cream

Alprostadil/Papaverine/Pentoxifylline 0.3/20/20 mg/mL Cream

Alprostadil//Papaverine/Phentolamine 0.1/20/0.5 mg/mL TriMix Cream

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Cautions and Precautions

• Response varies by individual.

• Effectiveness may be reduced when used alongside certain medications, including antihypertensives, decongestants, and appetite suppressants.

• Always inform your provider of all medications you are taking.

• These medications should only be used under medical supervision.

• Contact your provider if you experience any side effects. Call 911 in case of emergency.

 

How to Apply Intraurethral Cream

1. Empty your bladder prior to application.

2. Wash your hands thoroughly.

3. Hold the penis upright in a vertical position.

4. If uncircumcised, gently retract the foreskin.

5. Gently stretch the penis to open the urethral opening.

6. Place the applicator tip at the urethral opening — do not insert into the urethra.

7. Administer the prescribed dose.

8. Any excess cream at the opening may be gently massaged inward using a fingertip.

9. Continue holding the penis upright for 30 seconds to allow absorption.

10. Do not urinate for at least 15 minutes after application.

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Common Side Effects

• Mild aching or burning sensation

• Redness

• Penile irritation

• Inflammation of the glans (balanitis)

 

Less Common Serious Side Effects

• Dizziness or lightheadedness due to low blood pressure

• Prolonged erection lasting more than 4 hours (seek emergency care immediately)

• Penile infection

 

Precautions & Safety Information

• Wash hands thoroughly after application (may irritate eyes).

• Do not exceed prescribed dosing.

• Do not use more than once in a 24-hour period or more than 2–3 times per week, unless directed.

• Avoid use if you have conditions associated with increased blood viscosity or clotting risk, including sickle cell disease or trait, polycythemia, multiple myeloma, leukemia

• Consult your provider if you have penile deformity (e.g., Peyronie’s disease).

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