Injection therapy for Peyronie’s disease, which can include use of calcium channel blockers, verapamil and nicardipine, has been tried as a treatment option. Calcium channel blockers, also known as calcium antagonists, are drugs used to prevent calcium from entering cells in the blood vessel walls and heart. In the process, they relax and widen blood vessels, improve blood flow, and reduce blood pressure. These characteristics make calcium channel blockers suitable candidates for treatment of Peyronie’s disease. Two calcium channel blockers, verapamil and nicardipine, have been tried for this purpose.
Verapamil Injection Therapy for Peyronie’s Disease Treatment
Injection therapy for Peyronie’s disease with verapamil was first reported in 1994. In that study, the authors reported that 93% of men treated with 10 mg of verapamil had a reduction in pain, 42% had an improvement in curvature, and 58% experienced an improvement in erectile dysfunction. (Levine 1994)
This study was followed by several others that reported some positive results. In a 2007 study of injection therapy for Peyronie’s disease, for example, 77 men were divided into three groups and were treated with verapamil at different dilutions: 10 mg of verapamil diluted in 4 mL, 10mL, or 20 mL of water. After 8 months, men who had received the verapamil diluted in 20 mL had the most improvement in pain, plaque, penile curvature, and erectile function. (Cavallini 2007)
Some improvement in penile curvature was seen in a study of 131 men who had had Peyronie’s disease for less than one year. The men were treated with bimonthly injections of verapamil. Patients younger than 40 and whose penis was bent more than 30 degrees experienced a decline of more than 10 degrees in curvature after treatment. (Moskovic 2011)
Nicardipine Injection Therapy for Peyronie’s Disease Treatment
Another calcium channel blocker used to treat Peyronie’s disease is nicardipine. In a single-blind study, researchers injected either 10 mg of nicardipine diluted in 10 mL of distilled water (37 men) or 10 mL of saline (37 men) for a total of six biweekly injections. Men in the nicardipine group had a significantly better improvement in pain, erectile dysfunction, and plaque size when compared with the placebo group. However, men in both groups had a similar and significant improvement in penile curvature. (Soh 2010)
Dose and Side Effects of Injection Therapy for Peyronie’s Disease Treatment
The most common treatment for injected nicardipine is every two weeks for a period of 10 weeks to six months, and the suggested dose is 10 mg diluted in 10 to 20 mL of water. Thus far, this approach appears to be most appropriate for younger men. Side effects of injection therapy with calcium channel blockers are generally mild and may include bruising and temporary pain at the injection site, nausea, and lightheadedness.
Cavallini G et al. Open preliminary randomized prospective clinical trial of efficacy and safety of three different verapamil dilutions for intraplaque therapy of Peyronie’s disease. Urology May 2007; 69(5):950-54. Injection Therapy for Peyronie’s Disease
Levine LA et al. Intralesional verapamil injection for the treatment of Peyronie’s disease. J Urol. Jun 1994; 151(6):1522-24.
Moskovic DJ et al. Defining predictors of response to intralesional verapamil injection therapy for Peyronie’s disease. BJU Int Jul 6 2011.
Soh et al. Nicardipine vs. saline injection as treatment for Peyronie’s disease: a prospective, randomized, single-blind trial. J Sex Med Nov 2010; 7(11):3743-49.