Prescription
Prescription RequiredCompoundedQuad-Mix
This compounded injectable medication (often called “Quad-Mix”) contains four active drugs that work together to improve erectile function in adult men. When injected into the side of the penis before sexual activity, the medicine relaxes smooth muscle, widens blood vessels, and reduces outflow so more blood stays in the erectile tissue. A very small volume is used, and the effect starts within about 5–20 minutes and can last 30–90 minutes. Because it is a sterile compound prepared for each patient, strength ratios and vial size may vary based on your prescriber’s order.
Requires a valid prescription from your provider. Not sure if it's right for you? Ask a pharmacist.
These statements have not been evaluated by the Food and Drug Administration. Compounded products are not FDA-approved and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. This information is for educational purposes only and is not medical advice — always consult your healthcare provider before starting any new treatment.
Clinical information
Medication information for patients and providers.
Use exactly as directed by your healthcare provider. Inject the prescribed amount into the side of the penis 5–20 minutes before sexual activity. Do not use more than once in 24 hours or more than 3 times in a week unless instructed otherwise. If you forget a dose, skip it—never double up. Your provider will decide how long you should continue treatment.
Each ingredient targets a different pathway to improve blood flow. Papaverine blocks an enzyme that tightens blood vessels, causing them to relax. Phentolamine blocks alpha-adrenergic receptors that would normally narrow arteries. Alprostadil opens vessels by raising a chemical messenger called cAMP, while Atropine reduces nerve signals that trigger veins to drain blood away. Together they let more blood enter and stay in the penis. Most men notice firmness within 5–20 minutes; the effect usually lasts up to 90 minutes but can vary. The drugs stay active locally and wear off as blood flow returns to normal.
Do not use if you have a known allergy to Papaverine, Phentolamine, Alprostadil, Atropine, or any similar drugs. Do not use if you have sickle cell disease, leukemia, multiple myeloma, or any condition that raises the risk of prolonged erections (priapism). Avoid if you have severe penile scarring, implants, or significant curvature (Peyronie’s disease) unless cleared by a specialist. Not for use in women, children, or adolescents. Do not use if you have uncontrolled heart disease, recent stroke, or low blood pressure unless your cardiologist approves.
Using other medicines that lower blood pressure (such as nitrates, alpha-blockers, or some heart drugs) can cause dizziness or fainting. Combining with oral erectile-dysfunction pills (like sildenafil, tadalafil, or vardenafil) may increase the chance of priapism—only combine if your provider instructs. Blood thinners (warfarin, apixaban) can raise the risk of bruising or bleeding at the injection site. Large amounts of alcohol may worsen low-blood-pressure effects. Tell your provider about all prescription drugs, over-the-counter medicines, vitamins, and herbal products before starting Quad-Mix.
Very common (more than 1 in 10): mild penile pain or burning at injection site. Common (1–10 in 100): small bruise, redness, or swelling; temporary dizziness or flushed face. Uncommon (1–10 in 1,000): prolonged erection over 4 hours (priapism), penile nodules or scar tissue, low blood pressure with light-headedness, rapid heartbeat. Rare but serious: severe allergic reaction (rash, swelling, trouble breathing), persistent curvature, or infection at injection site. Most minor effects pass within a few hours. Seek emergency help if an erection lasts longer than 4 hours or if severe pain, swelling, or breathing trouble occurs.
Store vials in the refrigerator at 36-46 °F (2-8 °C). Keep in the original amber vial or carton to protect from light. Do not freeze. Remove from the fridge only long enough to draw up each dose; return promptly. After first puncture, discard any unused medicine after 28 days or the beyond-use date on the label, whichever comes first. Keep out of reach of children. Return expired or unused vials to a pharmacy take-back program or place in a sharps container before disposal.
Frequently asked questions.
Wash your hands, swab the rubber stopper and injection site with alcohol, and use a new sterile needle each time. Inject into the side of the shaft (not a vein) while seated or standing. Never inject into the top, bottom, or head of the penis.
Most men get an erection 5–20 minutes after injecting. The firmness usually lasts 30–90 minutes, but it can be shorter or longer. If the erection lasts over 4 hours, seek emergency care.
Only combine Quad-Mix with oral ED medications if your healthcare provider specifically tells you to. Using both can raise the risk of low blood pressure and priapism.
Call your provider or local poison center right away. If you develop a painful or prolonged erection, go to the nearest emergency room even if symptoms seem mild at first.
Most men feel only a brief pinch. Using a very small needle, rotating injection sites, and allowing the vial to warm to room temperature for a few minutes can make it more comfortable.
Keep vials refrigerated at home. For short trips, place the vial in an insulated bag with a cold pack, but do not let it freeze. Use within the 28-day in-use period even if some medicine remains.
Men with certain blood disorders, severe heart problems, significant penile scarring, or allergies to any ingredient should not use Quad-Mix. Always review your full medical history with your prescriber first.
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