Transdermal Verapamil (40mg/ml)
for the Treatment of Peyronie’s Disease
Peyronie’s disease has been reported to affect 1% to 3.5% of the male population. Medical therapy has not been consistently effective. Levine has reported success using injectable Verapamil. We have previously reported success with transdermal Verapamil. It is proposed that calcium channel blockers, when applied topically, migrate into the collagenase plaque and block the cellular entry of divalent calcium ions, thereby altering fibroblast metabolism which decreases the production of collagen. Simultaneously the production of collagenase is increased by the maturation of fibroblast collagenase. The collagenase causes degradation and remodeling of the fibrotic plaque. Due to the roles of divalent calcium and zinc in the production of collagenase, the collagenase is classified as a Metaloprotease. We are now updating the report of our clinical experience using Verapamil gel in 645 patients.
Verapamil gel (40mg) was applied twice daily to the penis of 645 patients with Peyronie’s disease. Length of treatment ranged from 1-16 months with the mean being 3.8 months. Patients were evaluated for change of curvature, plaque size, quality of erection, pain relief, and side effects.
Of the 608 patients with curvature, 406 (66.8%) noticed decreased curvature with treatment. Of the 587 patients with measurable plaque, 499 (85%) has measurable improvement. 489 (91.2%) of 536 patients with decreased quality of erection reported improvement of erection rigidity. Of the 272 patients with pain, 262 (96.3%) had complete pain relief. Five patients (0.8%) developed contact dermatitis. Three of these improved using topical corticosteroid. Two patients previously on antihypertensive drugs were able to discontinue drug and remain normotensive. No hypotensive episodes occurred. There were 113 patients treated for six months or longer. In this group, 69.4% noted improvement of curvature. 89.1% had decrease in plaque, 92.1% noted improved quality of erections, and 95.8% had improvement in pain. It has been noted throughout this study that patients taking beta-adenergic blocking agents have either not responded or have responded minimally to transdermal Verapamil. United States FDA approved manufacturers’ inserts state that beta-adnergenic blocking agents may cause Peyronie’s disease. It has also been noted that many patients taking glucosamine and chondroitin sulfate do not respond well.
Transdermal Verapamil is an effective and well-tolerated drug for the treatment of Peyronie’s disease.