Invicorp for Erectile Dysfunction Explained

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What is Invicorp and how does it work for erectile dysfunction?

Invicorp is a dual-chamber syringe system that delivers a combination of alprostadil (a prostaglandin E1) and aviptadil (a vasoactive intestinal polypeptide) directly into the corpus cavernosum of the penis via intracavernosal injection [7]. Alprostadil relaxes smooth muscle and dilates blood vessels in the penis, increasing blood flow and producing an erection independently of sexual arousal or nerve signals [7]. Aviptadil is thought to enhance the effect of alprostadil and may reduce the risk of painful erections.

The injection is self-administered into the side of the penis using a very fine needle, typically 5–20 minutes before sexual activity. An erection usually develops within 5–15 minutes and lasts for about 30–60 minutes, though duration varies between individuals [7]. Because Invicorp works locally rather than systemically, it can be effective in men with diabetes, spinal cord injury, prostate surgery, or other conditions where nerve damage or vascular disease has caused erectile dysfunction [2][7].

Invicorp is a prescription-only medicine in the UK and must be initiated and supervised by a specialist (usually a urologist or sexual health physician). The first dose is given in a clinical setting to determine the correct dose, teach injection technique, and monitor for side effects. Subsequent doses are self-administered at home after appropriate training [7].

Who may benefit from Invicorp for erectile dysfunction?

Invicorp may be suitable for men who have not responded to oral PDE5 inhibitor tablets (sildenafil, tadalafil, vardenafil, or avanafil), cannot take them due to contraindications (such as nitrate use), or prefer a non-tablet option [2][7]. It is particularly useful in men with neurogenic erectile dysfunction (e.g. following spinal injury, multiple sclerosis, or radical prostatectomy) where nerve pathways are damaged, because Invicorp does not require intact nerves or sexual stimulation to work [7].

Men with severe vascular disease, diabetes, or those who have undergone pelvic surgery or radiotherapy may also find Invicorp effective when tablets have failed [2]. It can be used by men taking nitrates or other medicines that interact with PDE5 inhibitors, as alprostadil works by a different mechanism and does not share the same contraindications with nitrates [7]. However, Invicorp is not suitable for men with conditions that predispose to priapism (sickle cell disease, leukaemia, multiple myeloma), anatomical deformities of the penis, or hypersensitivity to alprostadil or aviptadil [7].

Because the injection requires manual dexterity, good eyesight (or a willing partner to assist), and confidence in self-injection, it is not ideal for everyone. A healthcare professional will assess suitability, provide training, and ensure the patient can safely administer the injection at home [7].

When tablets are not an option

Men taking nitrates for angina (GTN spray, isosorbide mononitrate or dinitrate) or nicorandil cannot use PDE5 inhibitor tablets due to the risk of a dangerous drop in blood pressure, but Invicorp is a safe alternative because it does not interact with nitrates [7]. Similarly, men with certain cardiovascular conditions where sexual activity is considered safe but oral ED medicines are contraindicated may be offered Invicorp after specialist assessment [2].

When to get urgent help

• Erection lasting more than 4 hours (priapism) — go to A&E immediately or call 999
• Sudden severe chest pain during or after sex — call 999
• Sudden loss of vision in one or both eyes — seek urgent medical attention
• Signs of infection at the injection site (increasing pain, redness, swelling, discharge) — contact your GP or specialist the same day
• Severe allergic reaction (difficulty breathing, swelling of face or throat) — call 999

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.

How effective is Invicorp compared with tablets?

Clinical studies of intracavernosal alprostadil (the main active ingredient in Invicorp) report erection success rates of 70–90% in men with various causes of erectile dysfunction, including those who have not responded to oral tablets [7]. The addition of aviptadil in Invicorp is intended to improve efficacy and tolerability, though head-to-head trials directly comparing Invicorp with oral PDE5 inhibitors are limited.

Oral PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) are effective in approximately 60–80% of men with erectile dysfunction when used correctly, but they require sexual stimulation, intact nerve pathways, and adequate blood flow to work [1][2]. In men with severe vascular disease, diabetes, or nerve damage, response rates to tablets can be lower. Invicorp bypasses these requirements by acting directly on penile tissue, making it more reliable in men with complex or refractory erectile dysfunction [7].

However, many men prefer the convenience and discretion of a tablet over an injection. Tablets are taken orally 15 minutes to 1 hour before sex (depending on the drug), whereas Invicorp requires self-injection shortly before intercourse, which some men find off-putting or uncomfortable [2][7]. The choice between Invicorp and tablets depends on individual circumstances, underlying causes of ED, contraindications, and personal preference, and should be made in consultation with a healthcare professional.

Side effects and safety of Invicorp for erectile dysfunction

The most common side effect of Invicorp is penile pain or discomfort at the injection site, reported by around 30–50% of users, though this is usually mild and resolves quickly [7]. Other local side effects include bruising, bleeding at the injection site, and prolonged erection (priapism). Priapism—an erection lasting more than 4 hours—is a medical emergency requiring immediate treatment to prevent permanent damage to the penis; it occurs in fewer than 5% of users but the risk increases with higher doses [7].

Systemic side effects are uncommon because alprostadil acts locally, but some men may experience dizziness, flushing, or a drop in blood pressure, particularly with higher doses [7]. Rarely, fibrosis (scarring) of the penile tissue can develop with long-term use, so regular follow-up with a specialist is recommended. Men should be trained to recognise the signs of priapism and instructed to seek urgent medical help if an erection lasts more than 2 hours [7].

Invicorp is contraindicated in men with conditions that increase the risk of priapism (sickle cell anaemia, leukaemia, multiple myeloma), anatomical penile deformities (severe curvature, Peyronie's disease), penile implants, or hypersensitivity to the active ingredients [7]. It should not be used with other intracavernosal treatments or in men for whom sexual activity is not advisable. A specialist will assess medical history and provide detailed safety advice before prescribing Invicorp.

Recognising and managing priapism

Priapism is a prolonged, painful erection unrelated to sexual stimulation. If an erection lasts more than 2 hours after using Invicorp, apply a cold compress and try gentle exercise (e.g. climbing stairs). If the erection persists beyond 4 hours, go to A&E immediately or call 999; delayed treatment can cause permanent erectile dysfunction [7]. Your specialist will provide written instructions on what to do in this situation.

At a glance

Is Invicorp available on the NHS?

Invicorp is a prescription-only medicine in the UK and is available on the NHS in certain circumstances, but access is restricted. NHS England guidance states that treatment for erectile dysfunction is generally not funded unless the condition causes severe distress or is due to specified medical causes, such as diabetes, prostate cancer treatment, spinal cord injury, multiple sclerosis, or other neurological conditions [2]. Even when NHS funding is available, treatment is usually initiated and supervised by a specialist in urology or sexual health, not by a GP.

In practice, many men who might benefit from Invicorp obtain it via private prescription, either through a specialist clinic or an online prescribing service, because NHS provision is limited and waiting times can be long [2]. Private prescriptions allow faster access and ongoing supply once the treatment has been initiated and the correct dose established. Men considering Invicorp should discuss NHS eligibility with their GP or ask for a referral to a specialist urology or sexual health service.

It is important to note that the first dose of Invicorp must be given under medical supervision to determine the correct dose, teach injection technique, and monitor for side effects such as priapism [7]. Subsequent supplies can be obtained via repeat prescription (NHS or private) once the patient is confident and competent in self-administration. Online pharmacies in the UK, including Cured Pharmacy, do not typically supply Invicorp, as it requires specialist initiation and is not suitable for remote prescribing without prior face-to-face assessment.

How does Invicorp for erectile dysfunction compare with other non-tablet treatments?

Besides Invicorp, other non-tablet treatments for erectile dysfunction include Vitaros (alprostadil cream applied to the tip of the penis), Caverject (alprostadil-only injection), vacuum erection devices, and penile implants [2][7]. Vitaros is a topical cream containing alprostadil that is absorbed through the urethra; it is easier to use than an injection but less effective, with success rates around 40–50% [7]. It is suitable for men who prefer a non-invasive option but may not work well in severe ED.

Caverject is an intracavernosal injection of alprostadil alone (without aviptadil) and works in a similar way to Invicorp. Both are highly effective, but Invicorp's dual-agent formulation may offer slightly better tolerability and a lower risk of painful erections in some men [7]. Vacuum erection devices are non-drug mechanical aids that draw blood into the penis using suction; they are safe, reusable, and can be used alongside other treatments, but many men find them cumbersome and less spontaneous than injections or tablets [2].

Penile implants (surgically inserted devices) are a permanent solution for men with severe, treatment-resistant erectile dysfunction and offer the highest satisfaction rates, but they require surgery, carry surgical risks, and are irreversible [2]. Most men try oral tablets first, then consider injections (Invicorp or Caverject) or Vitaros if tablets fail, reserving vacuum devices and implants for later-line treatment. A specialist can help navigate these options based on individual needs, preferences, and underlying health conditions.

Combining treatments

In some cases, a specialist may recommend combining treatments—for example, using a low-dose PDE5 inhibitor tablet alongside a vacuum device, or trying Invicorp after partial response to tablets. However, you should never combine two intracavernosal injections or use Invicorp with Vitaros without specialist advice, as this increases the risk of priapism [7]. Always discuss combination approaches with your doctor or specialist.

In summary

• Invicorp is an alprostadil injection that works directly on penile tissue, producing an erection within 5–15 minutes without sexual stimulation.
• It suits men who cannot use or have not responded to oral tablets, including those taking nitrates for angina.
• Common side effects include penile pain and bruising; priapism (erection lasting over 4 hours) is rare but requires urgent medical help.
• Invicorp must be initiated by a specialist in a clinical setting; it is not available via remote online prescribing.
• NHS availability is limited to specific medical causes of ED; many men access Invicorp via private prescription after specialist assessment.

Frequently Asked Questions