Topical Verapamil for Peyronie’s Disease
February 22, 2023

What is Peyronie’s disease?

Peyronie’s disease is a fibrotic tissue disorder where scarring can cause penile deformity, sexual dysfunction, and pain.

How do you treat Peyronie’s disease?

To treat Peyronie’s disease, surgery is currently the most effective treatment. However there are oral, injectable, and topical medication options available.

What is verapamil used for?

Verapamil is a calcium channel blocker usually taken orally to treat high blood pressure. It is thought that verapamil promotes collagen breakdown. When applied topically, it can also be used as a non-invasive treatment for Peyronie’s disease and other fibrotic tissue disorders.

Recent Trials

The results of recent trials have not been conclusive on the effectiveness of topical verapamil for the treatment of Peyronie’s disease. A randomized controlled trial conducted in 2007 compared a solution containing 10mg verapamil and 4mg dexamethasone to intralesional injection. The plaque length, width and volume decreased in both groups. The only statistically significant difference was erectile pain, which decreased significantly in the group using the solution. However, in another study verapamil failed to accumulate in the target tissue, which weakens the argument for utilizing topical verapamil to treat Peyronie’s disease.

Frequently Asked Questions

  • What are the side effects of topical verapamil?

The most common side effect is skin irritation, which usually resolves within 3-4 days after starting treatment.

  • How quickly will topical verapamil start working?

Verapamil showed efficacy in one month, however in one trial, patients used verapamil for 6 months to see the full benefit.

  • Will it interact with my other medications?

Since the verapamil is applied topically, not much of it is absorbed systemically. However, it could interact with some medications including statins, beta-blockers, anti-seizure medications, or nicotine.

Lexi Smith, PharmD Candidate 2023

Midtown Express Pharmacy

References

  1. Farrell MR, Ziegelmann MJ, Levine LA. Minimally invasive therapies for Peyronie’s disease: the current state of the art. Translational Andrology and Urology. 2020 Mar;9(Suppl 2):S269-S283. DOI: 10.21037/tau.2019.08.06.
  2. Martin DJ, Badwan K, Parker M, et al. Transdermal application of verapamil gel to the penile shaft fails to infiltrate the tunica albuginea. J Urol 2002;168:2483-5. DOI:10.1016/S0022-5347(05)64173-0
  3. Mehrsai AR, Namdari F, Salavati A, et al. Comparison of transdermal electromotive administration of verapamil and dexamethasone versus intra-lesional injection for Peyronie’s disease. Andrology 2013;1:129-32. DOI:10.1111/j.2047-2927.2012.00018.x