There are several kinds of ED creams currently available. However, Vitaros is the only one available on prescription for treating ED—and only in certain countries such as the UK and Canada.

Alprostadil Topical Erectile Dysfunction Cream (e.g., Vitaros, Stardill)

The manufacturer of Vitaros warns that it should not be used more than 2–3 times per week and only once every 24 hours. One of the concerns with drugs that can cause or prolong erections is that they can lead to priapism if overused. Priapism is a prolonged erection of the penis (e.g., more than 4 hours), which is usually painful and can potentially cause permanent damage to tissues inside the penis. Overdosing with Vitaros may also lead to a drop in blood pressure, dizziness, and fainting, although overdoses requiring treatment have not been reported so far. Vitaros may also interact with certain other drugs if you take them simultaneously, which you should discuss with your doctor or pharmacist. It is not currently available in the US due to a lack of FDA approval. Vitaros relies on an active ingredient called alprostadil, previously used in other formulations for treating ED.

  • Proper cleaning and hygiene are important before applying ED creams.
  • Use only the amount recommended by your healthcare provider.
  • ED creams are sometimes combined with oral PDE5 inhibitors for better results.
  • Penile skin sensitivity may increase with repeated use; monitor any changes.
  • The goal is to enhance natural blood flow and improve erectile reliability.

It became available in a cream formulation in Europe in 2013. In addition to alprostadil, Vitaros cream contains a proprietary ingredient called Nexact®, designed to enhance the absorption of alprostadil into the penis.

Product Dosage Quantity + Bonus Price
Levitra Soft Tabs20mg360 + 20 Pills682.21€ 649.72€
Kamagra Oral Jelly100 mg63 + 7 Sachets224.18€ 213.50€
Viagra Super Active100mg10 Pills28.76€ 27.39€
Viagra Oral Jelly100mg21 Sachets78.66€ 74.91€
Levitra Generic60mg90 + 6 Pills291.82€ 277.92€
Super Kamagra160 mg152 + 8 Pills729.11€ 694.39€
Viagra Generic150mg180 + 10 Pills236.46€ 225.20€
Tadalista Super Active20mg20 + 4 Pills92.35€ 87.95€
Viagra Original100mg14 + 2 Pills89.03€ 84.79€
Viagra Generic100mg30 + 4 Pills60.91€ 58.01€
Levitra Generic40mg120 + 8 Pills302.37€ 287.97€
Kamagra Polo100mg84 + 4 Pills244.49€ 232.85€
Cialis Black80mg180 + 10 Pills356.64€ 339.66€
Tadalista Super Active20mg270 + 30 Pills661.49€ 629.99€
Viagra Generic50mg120 + 6 Pills129.64€ 123.47€

Other creams are available over the counter that is advertised as being able to help with ED; whether they do or not remains unproven.

  • Use of ED creams is not recommended in case of penile infections or dermatological issues.
  • Ensure accurate dosing to avoid priapism, a prolonged erection.
  • Topical ED therapies are especially useful for men with contraindications to oral meds.
  • Careful storage and handling optimize the product’s shelf life.
  • Combining therapies under medical supervision can yield better outcomes.

Examples include creams containing L-arginine, a naturally occurring amino acid that your body can convert into nitric oxide. Creams for erectile dysfunction are relatively new on the market, and it is currently unknown what the best cream for ED is.

Have questions?

Alprostadil is available in the United States as an injectable for ED as well as an intraurethral suppository, but in other countries, there are alternatives such as intraurethral alprostadil. Vitaros is an intraurethral cream available in some European countries as well as Canada. It is 3mg/g alprostadil and is packaged in single dose syringes carrying 100mg of cream, equivalent to 300mcg alprostadil. Phase II and III trials demonstrated up to 83% efficacy with this product with only 3% of the treated population reporting systemic adverse effects.3 In addition to intraurethral administration, some studies have also evaluated topical/transdermal use. One study of alprostadil 1% had patients apply 0.25ml of alprostadil 1% or placebo gel to the glans penis.

MED3000 (Eroxon)

The study reported better responses to the alprostadil treatment at all timepoints, with greatest differences noted at 45 and 60 minutes after application. The study noted that of the tested patients 38.9% in the treatment group and 6.9% in the placebo group achieved an erection deemed sufficient for penetration.4 Some studies have also evaluated papaverine HCl for transdermal use. One study of drug release of papaverine HCl in a gel vehicle found an alcohol-containing penetration enhancer resulted in drug penetration both in vitro and in vivo in rabbits. The study suggested that their results supported the use of penetration enhancer to deliver papaverine HCl transdermally.5 Another study evaluated 15% and 20% papaverine HCl gel applied to the scrotum, perineum, and penis. Patient response was evaluated 45 minutes after treatment. Vitaros has been through phase II and phases III clinical trials, where it was shown to be generally safe and effective.

Ingredient Function Typical Use Safety Profile
L-arginine Boosts nitric oxide production Enhances blood flow Generally safe, few side effects
Yohimbine Vasodilator Improves erectile response Potential for increased heart rate
Ginseng Extract Reduces fatigue and improves libido Libido enhancement May cause insomnia
Maca Root Increases stamina and energy Sexual performance support Allergic reactions possible
DHEA Hormonal precursor Supports hormonal balance Should be used with caution
Capsaicin Sensory nerve stimulation Temporary sensation boost Skin irritation risk

The FDA has twice declined to approve Vitaros, most recently in 2018, citing safety concerns surrounding Nexact® and “deficiencies in chemistry, manufacturing, and control,” according to a document from the Securities and Exchange Commission.¹ While you may find other creams that claim to be able to treat ED for sale online or as over-the-counter medicines in pharmacies or supplement shops, in most cases, there isn’t much solid evidence to support their use.

  • Use of ED creams can sometimes cause penile pain if misapplied.
  • Cream effectiveness can depend on individual response and proper application.
  • Combining creams with other ED treatments may enhance results.
  • Potential interactions with other topical medications should be checked.
  • Patients should wash hands thoroughly after applying the cream.

One example is creams that contain L-arginine.

Publication types

How to use creams for erectile dysfunction How effective are creams for erectile dysfunction? Risks of using creams for erectile dysfunction What are the side effects of creams for erectile dysfunction? Erectile dysfunction (ED), also known as impotence, is a health condition in which men have persistent difficulty getting or maintaining erections, leading to unsatisfactory sex lives for themselves and their partners. ED is a very common problem, especially vardenafil vilitra 60 mg among older men. It can have various causes, both physical and psychological.

Cost of Eroxon in India

Fortunately, there are a variety of medications available for treating ED. Most of these are in the form of orally-administered pills such as Viagra or Cialis. However, in certain countries, ED medications are available as creams—most notably Vitaros in the UK and Canada. We make it easy for you to participate in a clinical trial for Erectile dysfunction, and get access to the latest treatments not yet widely available - and be a part of finding a cure. Erectile dysfunction creams help men with erectile dysfunction get and maintain erections to have more satisfying sex for themselves and their partners. These are sometimes marketed as “male enhancement” creams that can help with ED. Theoretically, such creams could work by promoting nitric oxide (NO) production.

Method Typical Dosage/Use Frequency Application Area Additional Tips
Topical Creams Apply 2-3 times daily Penis shaft and glans Wash hands after application
Gel Application Use a pea-sized amount Penile surface Avoid contact with eyes
Ointments Once before sexual activity Penile skin Conduct patch test beforehand
Spray As needed External genital area Avoid inhalation, wash hands afterward

This is because the body uses L-arginine to make NO, and NO is a vasodilator that could increase blood flow into the penis. However, over-the-counter medications and supplements generally are poorly regulated products that may or may not do what they claim.

Beyond Creams: A Holistic Approach to Men’s Health

The transdermal route could be considered for patients who prefer not to use oral or injectable medications. Check out the Fagron Academy site for related formulas. If you have further questions, feel free to reach out to Fagron Academy Technical Support Services! Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the United States. Drop-out reasons and complications in self-injection triple vasoactive drug mixture in sexual erectile dysfunction.

Papaverine Gel

Cuzin B. Alprostadil cream in the treatment of erectile dysfunction: clinical evidence and experience. Goldstein I, Payton T, Schechter P. A double-blind, placebo-controlled, efficacy and safety study of topical gel formulation of 1% alprostadil (Topiglan) for the in-office treatment of erectile dysfunction. Ming Wen M El-Kamel A, Khalil S. For example, the FDA has issued warnings about sexual enhancement products tainted with unlabeled active ingredients.

LinkOut - more resources

Systemic enhancement of papaverine transdermal gel for erectile dysfunction. Kim E, el-Rashidy R, McVary K. Papaverine topical gel for treatment of erectile dysfunction. Yonessi M, Saeedi M. A double-blind placebo-controlled evaluation of the effect of topical sildenafil on erectile dysfunction.

Key Ingredients in ED Creams

Nifedipine cream versus sildenafil cream for patients with secondary Raynaud phenomenon: a randomized double-blind, controlled pilot study. Possible benefit of tadalafil cream for the treatment of Raynaud’s phenomenon and digital ulcers in systemic sclerosis. Fossel E. Improvement of temperature and flow in feet of subjects with diabetes with use of a transdermal preparation of L-arginine: a pilot study. How does cream work for erectile dysfunction? Other creams are undergoing clinical trials, including a cream containing sildenafil, the same active compound in Viagra.

Other Topical Agents: Papaverine, Verapamil, and More

The treatment was well tolerated and papaverine HCl was minimally systemically absorbed, the researchers hypothesized that effects seen, mainly increase in duration of erection compared to placebo, were a result of local rather than systemic absorption.6 Phentolamine mesylate, while sometimes included in transdermal erectile dysfunction combination products, has not currently been studied in well controlled trials for its potentially efficacy via the transdermal route. Sildenafil is a PDE5 Inhibitor commercially available for oral use for ED, but there is some information to suggest that it may be efficacious transdermally as well. One placebo-controlled study compared sildenafil 1% gel to sildenafil 100mg tablets. The topical gel group applied 0.5g of sildenafil 1% gel to the glans of the penis approximately 5 minutes before sexual activity and the tablet group took a 100mg tablet 1 hour before sexual activity. In the gel group, 25% of patients achieved complete or moderate erections compared to 75% of the tablet group.

Penis sleeve

Though oral tablets demonstrated increased likelihood of complete or moderate erection, both groups did see benefit and onset of erection in the patients who applied sildenafil gel was 7.4 ±3.6 minutes, but was 37.8 ± 14.9 minutes in the group who used oral tablets.7 Though there aren’t many other studies on sildenafil cream topical for erectile dysfunction, other studies for conditions such as Raynaud’s have demonstrated benefit and increased blood flow as a result of local administration of sildenafil 5% cream, further suggesting that sildenafil may be absorbed from topical administration.8 Though currently information regarding other in vivo studies on other PDE5 inhibitors topically for erectile dysfunction are not available, some studies have found benefit for tadalafil used topically for Raynaud’s, suggesting transdermal penetration and potential local efficacy.9 Future studies are needed to confirm the potential of tadalafil as a topical treatment for erectile dysfunction. Other active ingredients used transdermally to increase blood flow are sometimes also considered for combination topical ED mediations. Arginine, sometimes used at 3-6% in female sexual dysfunction creams, was found in a study of diabetic patients to improve blood flow. These patients applied transdermal arginine 12.5% cream to the feet and noted improved blood flow with a doppler flow meter and with an infrared thermometer 30 minutes after application.10 Despite this promising information, not enough data yet exists to suggest that arginine transdermal is appropriate for the vardenafil 10 mg tablet management of ED. Though there is limited information to support transdermal application of medication for ED, some data exists to suggest efficacy.