Description
Super Quadmix Injection is a compounded intracavernosal medication used in the treatment of refractory erectile dysfunction (ED)—especially in cases unresponsive to oral phosphodiesterase type 5 (PDE5) inhibitors and standard injection therapies. It is an advanced, four-drug formulation that builds upon the pharmacologic synergy of Super Trimix, with the addition of a fourth agent to enhance vasodilation and therapeutic effect.
- Prostaglandin E1 (Alprostadil) – 40 mcg/mL: A prostaglandin E1 analog that induces smooth muscle relaxation via the cAMP pathway, increasing penile arterial inflow.
- Papaverine Hydrochloride – 60 mg/mL: A non-specific phosphodiesterase inhibitor that elevates intracellular cAMP and cGMP, resulting in vasodilation.
- Phentolamine Mesylate – 2 mg/mL: An alpha-adrenergic antagonist that blocks sympathetic tone, preventing vasoconstriction and aiding erection maintenance.
- Atropine Sulfate – 0.2 mg/mL (typical concentration): An anticholinergic agent that reduces parasympathetic inhibition, further supporting erection in select patients.
Mechanism of Action:
- Alprostadil and Papaverine directly promote vasodilation and corpus cavernosum smooth muscle relaxation.
- Phentolamine blocks sympathetic-mediated vasoconstriction, sustaining erection.
- Atropine, as an antimuscarinic, may reduce inhibitory parasympathetic tone and enhance hemodynamic response in select patients.
The combined effect results in enhanced arterial inflow, trapping of blood, and a firm, sustained erection, often within 5–15 minutes of injection.
