Patient Counselling Guide
Self-Administered Penile Injection Therapy
Practical pre-reading for patients who already have a prescription for compounded intracavernosal injection therapy. Your prescriber chooses the formula and dose. Our pharmacy compounds the medication, dispenses supplies, and counsels on handling, storage, injection-site safety, and refill logistics.
This guide does not replace in-person teaching from the urology team or written directions from your prescriber. If you have not been assessed yet, start with the erectile dysfunction overview.
Emergency warning: prolonged erection
A rigid, non-bendable erection that lasts too long can permanently damage penile tissue. Follow your written emergency plan. If you do not have a written plan, or if the erection remains rigid and does not resolve, go to the nearest emergency department. Do not go to sleep while still rigid.
Section 1
Before You Start
Your first injection and starting dose should be set by your prescriber or urology team. Do not change your dose, repeat a dose, or combine injection therapy with other ED medications unless your prescriber has given written instructions.
Read the full guide before your first at-home injection. Choose a private, clean, well-lit space where you can focus and where your supplies can stay organized.
Keep a brief log after each injection: date, dose, firmness, duration, side effects, and anything unusual. This helps the prescriber make decisions at follow-up.
Dose changes belong with the prescriber
If the response is too weak, too strong, too painful, or lasts too long, contact your prescriber or urology team before changing the dose.
Section 2
Supplies and Vial Check
What you need
- The labelled vial of medication
- One new syringe with attached needle
- Two alcohol pads
- A sharps container
- A clean, well-lit surface
- Your written prescription directions or dose record
Do not use the vial if
- The fluid is cloudy or has floating particles
- The rubber stopper is loose, cracked, or missing
- The label is unreadable
- You are unsure which vial it is
If a vial fails inspection, call the pharmacy before using it.
Section 3
Drawing Up Your Dose
- 1Wash your hands with soap and water, then dry them on a clean towel.
- 2Wipe the rubber stopper on the vial with an alcohol pad.
- 3Open a new syringe. If the needle touches anything other than the vial stopper, discard it in the sharps container and start with a new syringe.
- 4Pull the plunger back to your prescribed dose marking. This pulls air into the syringe.
- 5Insert the needle through the stopper and push the air into the vial.
- 6Turn the vial upside down. Keep the needle tip below the fluid line.
- 7Draw the medication back to the prescribed dose marking. If bubbles appear, ask us to demonstrate bubble removal during counselling.
- 8Confirm the dose marking before removing the needle from the vial.
Section 4
Choosing the Injection Site
The injection goes into the side of the shaft, usually described using a clock face. The common side zones are around 10 o'clock on the left side and 2 o'clock on the right side.
Inject in the middle third of the shaft only. Avoid the head of the penis, the top surface, the underside, and any visible large vein.
Alternate sides between injections unless your prescriber has given different written instructions.
The target is the side of one corpus cavernosum in the middle third of the shaft. The top contains important nerves and vessels; the underside contains the urethra within the corpus spongiosum. Use the site and angle taught by your prescriber.
Section 5
Injection Steps
- 1Stand if you can. Wipe the selected injection site with a fresh alcohol pad and let it dry.
- 2Hold the syringe like a pencil. If uncircumcised, retract the foreskin.
- 3Gently stretch the penis straight out or away from the injection side. Keep it steady and do not twist.
- 4Insert the needle using the angle taught by your prescriber, typically perpendicular to the shaft at the chosen side site.
- 5Push the plunger steadily while keeping the needle in place.
- 6Pull the needle straight out.
- 7Apply firm pressure with an alcohol pad for 2 to 3 minutes, or longer if your prescriber told you to because of blood thinner use.
- 8Drop the syringe directly into the sharps container. Do not recap it.
Section 6
After the Injection
Stay upright for several minutes after the injection. Sitting, standing, walking, or beginning foreplay may be part of the plan your prescriber discussed. Do not lie down during onset unless your prescriber gave different instructions.
The goal is an erection firm enough for intercourse that resolves within the expected window from your written plan. Record the dose, response, duration, and any discomfort or bruising.
If the injection does not work as expected, do not inject again that day. Contact your prescriber or urology team before changing dose or timing.
A better way to stay connected
- Request prescription refills from your phone
- Follow pickup or delivery updates
- Set reminders for ongoing medications
- Send pharmacy questions in one place
Section 7
Warnings and Urgent Symptoms
Do not
- Do not inject the head of the penis.
- Do not inject the top surface where the nerve bundle runs.
- Do not inject the underside where the urethra runs.
- Do not inject into a visible large vein.
- Do not use a syringe if the needle touches anything non-sterile.
- Do not recap a used needle.
- Do not repeat a dose because the first dose did not work.
- Do not change the dose unless your prescriber has given written instructions.
- Do not go to sleep while the erection is still rigid.
Priapism action plan
Priapism means an erection that stays rigid and does not become bendable. It can cause permanent tissue damage.
Follow the emergency instructions your prescriber gave you. Some patients are given a written medication plan for a prolonged erection; others are told to go directly to emergency care.
If the erection remains rigid beyond the threshold in your written plan, or if you are unsure what to do, go to the nearest emergency department.
Call Tache Pharmacy
- Vial inspection concerns
- Storage, refrigeration, refill, or travel questions
- Supply questions, including syringes, needles, or sharps containers
- Technique clarification after the prescription has been written
Call your prescriber or urology team
- Dose changes
- Poor response or response that lasts too long
- New pain, curvature, lumps, scar tissue, or bruising patterns
- New heart, blood pressure, blood thinner, cancer treatment, or medication changes
Go to urgent care or emergency
- A rigid, non-bendable erection lasting longer than the emergency threshold in your written plan
- Chest pain, fainting, sudden neurological symptoms, or severe allergic reaction
- Spreading redness, warmth, fever, or signs of infection
Section 8
Storage, Sharps, and Refills
Storage
Follow the label and prescription directions. If a preparation requires refrigeration, keep it refrigerated until use and ask us before travelling with it.
Sharps
Used needles and syringes go directly into a sharps container. Never place loose needles in household garbage or recycling.
Refills
Request refills early enough for compounding time. If your response has changed, contact your prescriber before requesting a dose change.
Sources and Review
This page is based on pharmacy counselling workflow, Tache's compounded ED injection practice, and external patient-education references. It should be reviewed by a Tache pharmacist before being treated as final counselling content.
- Cleveland Clinic patient teaching video by Dr. Peter Bajic, used as a structure reference only.
- American Urological Association erectile dysfunction guideline background.
- Tache Pharmacy historical ED injection, product, and supply education materials.
Have questions about your injection prescription?
Call us for supply, storage, refill, or handling questions. Contact your prescriber or urology team for dose changes or treatment decisions.