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In this review
In this review
Over 50% of men over age 40 experience erectile dysfunction (ED)1 - and that can have wide-ranging effects on confidence, self-esteem, and relationships.
And if you’re part of the 30%+ of men who don’t respond to traditional oral medications like Viagra (sildenafil) or Cialis (tadalafil)2 you may feel hopeless. Fortunately there are several alternative ED treatments - from injections to gels and suppositories - that promise results.
In this review, our 42 year old tester (we’ll call him Paul) - who struggles with persistent ED - tested and reviewed the most popular alternative treatments: Rugiet Ready sublingual tablets, Trimix injections and gel - Alprostadil suppositories, and Eroxon topical gel.
We consulted Dr. Robert Woodward, men’s health physician who treats ED, for his expert medical opinion. We found one clear winner - read on to find out which, and why.
Why Traditional ED Meds May Not Work for You
ED usually occurs from a lack of blood flow to the penis, or when arousal signals from the brain aren’t firing properly. PDE-5 inhibitors like Viagra (sildenafil) and Cialis (tadalafil) relax blood vessels, increasing blood flow to where it’s needed, leading to “stronger, longer-lasting erections,” says Dr. Woodward.
The problem? These drugs don’t address the brain’s part in getting hard. Stress, anxiety, confidence, and underlying health problems all can play a role in blocking blood flow to the penis - which is why physical-only treatments like Viagra and Cialis often fail.
That’s where alternatives come in. Injectables and suppositories bypass the mental aspect entirely with direct application to the penis. And formulations with dopamine agonists like apomorphine actually boost mental arousal signals to strengthen erections from where they start - the brain.
So, how do Rugiet, Trimix, Alprostadil, and Eroxon compare? Let’s find out.
Convenience & Comfort: Rugiet Wins
Each of our five treatments has a different dosage form and for Paul (and most men) that’s a deciding factor.
🥇 Rugiet Ready is the most convenient and comfortable treatment. A sublingual tablet (dissolves in about 5-10 minutes), it’s discreet, quick, and doesn’t require advanced planning or clean-up. “This was by far the easiest treatment to take,” says Paul. “Tastes like a breath mint.”
🥈 Eroxon is a topical gel that’s non-invasive and (usually) painless. You need to apply this 10 minutes before sex and it is messy - not conducive to spontaneous moments.
❌ Trimix gel and Alprostadil urethral suppositories both require an applicator placed into the urethra - not a needle, but not much more appealing. You insert the applicator an inch into the opening of the penis and release the medication.
❌ Trimix injection - a self-injection in the penis via hypodermic needle - not surprisingly, can be painful. Syringes require refrigeration, need to be used 10-20 minutes before sex, and the entire ½ inch needle must be inserted into the base of the penis - requiring planning (and bravery) every time.
Paul called the Trimix injection the “most uncomfortable treatment” - requiring a painful needle poke and 3 minutes of pressure after to avoid bleeding at the injection site. Paul experienced some burning with both Trimix Gel and Alprostadil suppositories. The Eroxon gel, meanwhile, was “messy and not conducive to spontaneity” but not painful.
Effectiveness & Formulation: It’s a Tie Between Rugiet & Trimix
It’s no surprise that tablets and topicals are the easiest to use. But that’s only important if the treatment actually works. Here are Paul’s experiences and the science behind them.
🥇 Rugiet Ready wins with a combination of two physical erection boosters (sildenafil and tadalafil, the active ingredients in Viagra and Cialis) and apomorphine, a dopamine agonist that boosts arousal signals. In a study of 5,000 men, apomorphine led to a 103% increase in erections compared to baseline without apomorphine.3
Rugiet works in about 15 minutes on average and lasts for up to 36 hours. When testing Rugiet, Paul said he “felt it in about 15 minutes” and was in the mood for “spontaneous sex, with effects lasting through the next day.” He described the feeling on Rugiet as “relaxed, confident, and in the mood,” leading to more satisfying sex.
🥇 Trimix Injections feature three ingredients (alprostadil, papaverine, and phentolamine) that are highly effective when injected directly into the penis. These bypass the mental aspect entirely - with success rates of 89% in a clinical study.4 Trimix Injection increases blood flow within 15 minutes of application, but the effects only last 1-2 hours.
While the medication is effective at causing erections, Paul felt that it was “unnatural” as it didn’t promote actual arousal. “It didn’t help me get in the mood,” Paul said, even though it caused a physical erection quickly.
❌ Alprostadil suppositories and Eroxon Gel are the least effective of the treatments we reviewed, improving erections in only 50-60% of users in trials.5,6 Paul noticed minor improvements, but “not enough for sustained sex.”
Alprostadil suppositories contain only one of the three ingredients (alprostadil) present in Trimix. Any effects kick in within 20 minutes and last up to an hour. Eroxon is an over the counter ED treatment, but instead stimulates blood flow by cooling and then warming the penis. Any effects start within 15 minutes and only work for a single erection.
❌ Trimix intraurethral gel was slightly more effective than the Eroxon topical gel and Trimix gel and Alprostadil suppositories, said Paul. Trimix gel contains the same formulation as the Trimix Injection, but takes longer to kick in (15-30 minutes); it's less effective as it relies on absorption through the urethra, rather than direct injection.
Side Effects: Rugiet Wins
🥇 Rugiet Ready wins with side effects that are both minimal and rare (think flushing and indigestion).7,8
🥈 Eroxon comes in second with moderate possible side effects - headache, itching, and burning.9
❌ Alprostadil suppositories can have more severe side effects including priapism (prolonged erections), dizziness, and fainting.10
❌ Trimix injections can also have severe side effects including pain, scarring, and priapism.11
❌ Trimix gel potential side effects are less severe than injections - localized burning/irritation.12
Price & Value: Rugiet Wins
🥇 Rugiet is the best value at $10 per dose - the second cheapest tested - with an innovative formulation packed into an easy-to-take tablet form.
🥈 Trimix injections & gel vary widely in cost depending on pharmacy and compounding, but expect to pay $15-$30 per dose.
🥉 Eroxon is the cheapest at $6.50 per dose, but delivers much lower value and effectiveness than our top picks.
❌ Alprostadil is by far the most expensive - $80-$100 per suppository dose.
The Overall Winner: Rugiet Ready
Which ED treatment is best to try when Viagra and Cialis don’t work? After testing the five leading alternative treatments, we recommend the one that works in minutes, boosts both physical blood flow and mental arousal, and is the most convenient, comfortable, and discreet treatment. And that’s Rugiet Ready.
Dr. Woodward, our expert in men’s health, agrees: “I recommend Rugiet Ready. It’s an effective ED treatment that supports both sexual arousal and performance.”
Ready to try Rugiet? With TCD, use code READY15 for 15% off:
