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Priapism is a medical condition in which the erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours. Improper dosing of Trimix can cause priapism. Phenylephrine injections can be an antidote to an erection that would not come down after 4 hours. Prolonged erections can cause fibrosis and long term erectile dysfunction.
For treatment of ischaemic priapism: Phenylephrine is currently the drug of choice due to its high selectivity for the alpha-1-adrenergic receptor, without concomitant beta-mediated inotropic and chronotropic cardiac effects.
Phenylephrine use has potential cardiovascular side-effects and it is recommended that blood pressure and pulse are monitored every 15 minutes for an hour after the injection. This is particularly important in older men with existing cardiovascular diseases.
Inject 1mg (1mL) of Phenylephrine HCl 0.1% into the penis every 3-5 minutes until detumescence occurs for up to one hour. After injection, the puncture site should be compressed and the corpora cavernosa massaged to facilitate drug distribution. Smaller volumes should be used in children and patient with severe cardiovascular disease.
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