Prolonged erection (priapism)

What's happening

Priapism is an involuntary erection that lasts more than four hours and doesn't go down after ejaculation. For anyone using trimix or another injection (ICP) therapy, it is the main serious risk to know cold — because acting quickly is what protects your long-term function.

Lower the risk before it happens

• Never combine an injection with an oral ED pill. Don't take trimix or any ICP injection within the same 24 hours as Viagra, Cialis, Levitra, or similar.
• Start low, go slow. Your prescriber sets your dose. First doses are kept small and increased only under their direction — never self-adjust.
• Keep your rescue plan within reach. If your prescriber gave you rescue instructions or a rescue medication, store them somewhere you can find in seconds.

If an erection won't go down — act by the clock

• Safe first steps you can do now: apply an ice pack to the perineum/scrotal area, and walk or climb stairs to help redirect blood flow.
• Rescue medication is prescriber-directed. Some clinicians recommend an over-the-counter first step (pseudoephedrine) or provide a rescue prescription to keep on hand (such as terbutaline or phenylephrine). Use these only as, and in the exact amounts, your prescriber told you. We don't publish rescue doses here on purpose — the right ones come from the clinician who prescribed your injections.
• At 4 hours — or sooner if it's severely painful — go to the ER. Don't keep waiting for it to resolve on its own.
• Afterward, if you notice lumps, curvature, swelling, or tenderness, contact your prescriber.

If you're struggling beyond the physical

Sexual health and mental health are tied together, and reaching out is the strong move. In the U.S., the 988 Suicide & Crisis Lifeline is free and confidential, 24/7 — call or text 988. Outside the U.S., contact your local emergency number or a crisis line in your country.