Viridal Duo

Viridal Duo is one of several medicines used by men to treat erectile dysfunction. It helps to keep an erection hard enough for sexual activities when a man cannot or has difficulty in doing so.

Can I buy Viridal Duo online?

The Online Clinic can prescribe Viridal Duo online if you have had this medication before or if you have used another injectable medication to treat erectile dysfunction, such as Caverject (a similar medication) or Invicorp.

What is Viridal Duo?

Viridal is a type of medicine called a prostaglandin, containing the active ingredient alprostadil. It is similar to prostaglandin E1 that occurs naturally in the body. It works by widening the blood vessels in your penis, which increases the blood flow to your penis, thereby helping you get and maintain an erection. Your doctor may give you Viridal if you have a low level of prostaglandin E1 or if other erectile dysfunction medications have failed to work.

How to use Viridal Duo

Viridal comes in one of three strengths, alprostadil 10, 20 or 40 mcg. Viridal must be prepared and taken the way your doctor has explained. It is supplied in a glass cartridge with two chambers (hence Duo) - one chamber contains the powdered medicine (alprostadil) while the other contains sodium chloride solution. The two are mixed together producing a solution for injection into the penis.

Firstly, prepare the injection as follows. After putting the needle on the end of the injector, unscrew the plunger from the injector, clean the tip of the cartridge with an alcohol swab, and insert the cartridge into the injector. The plunger is then screwed back on to the injector. With the needle pointing upwards, push the plunger until the two grey cartridge stoppers meet. This mixes the contents of the two chambers; gently shake. Remove the two protective needle caps. With the needle pointing up, tap the injector until all bubbles have moved upward, and push the plunger until a drop of medicine is ejected and all air is removed. Push the plunger until the upper edge of the front grey stopper has reached the dose your doctor has prescribed for you.

You are now ready to take the medicine. Thoroughly clean your penis and use an alcohol swab to clean the injection site (near the base of the penile shaft). Hold the injector level with your penis and insert the needle almost completely straight. Using your thumb, gently and slowly depress the plunger, taking 5-10 seconds to inject the solution. After injection, remove the needle from your penis; if there is bleeding, apply pressure to the site with a clean pad. Remove the needle, remove the cartridge from the injector body, and wash the injector with warm water and a mild detergent. Dispose of the needle, cartridge and any unused medicine as your doctor has directed.

An erection takes between 5-15 minutes to develop, and usually lasts for about one hour. Discuss with your doctor erections lasting for 2-4 hours and get medical advice immediately if they last longer than 4 hours or you take too much Viridal. It is recommended that you inject on alternate sides of the penis each time you take the medicine, and not to use Viridal more than 2 or 3 times a week and to leave 24 hours or longer between injections.

Who can use Viridal Duo?

Viridal should not be used if you are allergic to alprostadil or any of the other Viridal ingredients. It should also be avoided by men with a penis deformity, disease or implant, or who have been advised not to have intercourse for health reasons. This also applies to those with sickle-cell disease, leukaemia, and multiple myeloma. Your doctor will want to know if you have or have had heart or lung problems, fainting spells, or temporary changes to your speech, hearing or vision. Your doctor will also want to know what medicines you are taking, specifically antidepressants, blood thinners, antihypertensives, blood clotting agents, and other drugs to treat erection problems.

A condom should still be used to protect from sexually transmitted diseases, especially if you bleed from the injection site. A condom should also be worn if your partner is, could be or could become pregnant to avoid the risk of vaginal irritation, pre-term birth, or harm to the baby.

Viridal Duo side effects

Men who take Viridal commonly experience penile pain, a temporary burning sensation during injection, a feeling of tension in the penis, injection site pain and bruising, uncontrollable muscle movement, more frequent and longer erections and, after long-term use, lumps or a bend or kink in the penis.

Sometimes the tip of the penis, foreskin and testicles may become swollen and red, and the injection site becomes red, itchy, tender and blistered. Urinating may be painful and more frequent, and blood may appear in the urine. Other effects may include nausea, headache, dilated pupils, increased heart rate, low blood pressure, and sweating. Rarely, you may experience serious reactions causing dizziness and breathing difficulties, or skin rashes and blistering, when you should get medical attention as soon as possible.

References

Viridal Duo efficacy study
https://pubmed.ncbi.nlm.nih.gov/10736486/

Summary of Product Characteristics
https://www.medicines.org.uk/emc/product/1452/smpc

Alprostadil intracavernosal injections
https://www.nejm.org/doi/full/10.1056/NEJM199604043341401

Reviewed by: Dr Loraine Haslam MBBS, DRCOG, DFSRH, LoC SDI, LoC IUT, MRCGP
GMC registration number: 4524038
Date: 9 June 2024
Next review: 8 June 2026
All UK registered doctors can have their registration checked on
The Medical Register at the GMC website.

Information Leaflet

Source and further information

Download Viridal Duo Patient Information Leaflet