Oral Medications for Peyronie’s Disease: What Actually Works?

Last updated: September 3, 2026

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“Doctor, is there just a pill I can take for this?”

It is almost always the first question a man asks after being told he has Peyronie’s disease — the condition in which a fibrous scar, called a plaque, forms inside the penis and causes it to bend during erection. The hope behind the question is easy to understand. Injections sound uncomfortable. Surgery sounds frightening. A tablet sounds manageable.

I want to give you the honest answer, because I think men deserve one: no oral medication has ever been approved anywhere in the world for treating Peyronie’s disease, and none has been proven to reliably straighten an established curve. That is the headline, and it has not changed despite decades of research.

But that is not the same as saying oral therapy is useless. Some medications still have a legitimate role — just not the role most men are hoping for. This article walks through what has been tried, what the evidence actually shows, and what a tablet can realistically do for you.

Before Anything Else: When a Bend Is an Emergency

Peyronie’s disease develops gradually, and almost nothing about it is urgent. A few closely related situations are, and they are worth recognising before you read on:

• A sudden bend after an injury during intercourse, particularly with a popping sound or sensation, immediate loss of the erection, pain and rapid bruising or swelling. That is a penile fracture, and it is a surgical emergency — outcomes are far better when it is repaired early rather than watched.
• An erection lasting longer than four hours. Priapism is a urological emergency and needs treatment within hours to protect the tissue permanently. It is relevant here because tadalafil, discussed below, is one of the medications that can rarely trigger it.
• Sudden loss of vision or hearing after taking tadalafil or a similar tablet — rare, but it needs same-day assessment rather than waiting to see whether it settles.
• A firm lump in the penis in a man who has never had a bend, especially with skin changes, bleeding or weight loss. That is not typical Peyronie’s disease and deserves prompt assessment rather than a trial of tablets.

In Thailand the emergency number is 1669. Everything below assumes none of these applies to you.

First, Timing Matters More Than the Drug

Peyronie’s disease moves through two distinct phases, and understanding which phase you are in explains most of what follows.

The acute or active phase typically lasts somewhere between six and eighteen months. During this period, erections are often painful, the curve is still changing, and inflammation is actively driving the scar to form. Think of it as wet cement — still being poured, still capable of being influenced.

The chronic or stable phase follows. The pain has usually settled, the curve has stopped changing, and the scar has matured. The cement has set.

Oral medications are considered almost exclusively during the acute phase, and the logic is straightforward: a drug that calms inflammation or interferes with scar formation has a chance of doing something while the scar is still forming. Once the plaque is mature and firm, no tablet is going to dissolve it. That is precisely why treatments delivered directly into the plaque — and ultimately surgery — occupy the stable phase instead.

The Medications That Have Been Tried

Every drug on this list was proposed for a sensible reason. Each targets one of the processes that creates the plaque: inflammation, excess collagen production, oxidative stress, or poor tissue oxygenation. The problem has consistently been that a good idea in the laboratory does not automatically become a good result in patients. Every one of them is used off-label for this condition, meaning the drug was approved for something else entirely.

Vitamin E — the most prescribed, and the least justified

Vitamin E has probably been given to more men with Peyronie’s disease than any other tablet, mainly because it is cheap, safe, and easy to reach for. The theory was that its antioxidant effect might reduce the tissue damage that leads to scarring.

It does not work. A large, properly designed trial comparing vitamin E against a dummy tablet found no improvement in pain, curvature, or plaque size over six months. The American Urological Association now explicitly recommends against it. It continues to be prescribed anyway — largely because it feels harmless and patients want to be given something — but men should know they are taking it on hope rather than evidence.

Tamoxifen — promising in theory, disappointing in practice

Tamoxifen, a drug better known in breast cancer care, showed genuinely encouraging antifibrotic effects in laboratory studies. When tested in men with Peyronie’s disease, however, it produced no improvement in pain, curve, or plaque size compared with a dummy tablet. It also carries real side effects, including hot flushes, reduced libido, and a small risk of blood clots. Guidelines recommend against it.

Potaba — an old option with a heavy burden

Potassium para-aminobenzoate, sold as Potaba, is one of the oldest treatments for this condition. Trial results were mixed: it did not straighten curves better than a dummy tablet, though plaque size shrank somewhat more.

The practical obstacle is the dose. Treatment requires around twelve grams a day, split across four doses and taken with meals to spare the stomach. That is an enormous number of tablets, often for months, frequently with nausea and diarrhoea. Guidelines disagree about it — European urologists advise against it, while American and Canadian bodies list it as an option — which itself tells you how thin the evidence is.

Colchicine — early promise, later disappointment

Colchicine, an anti-inflammatory drug long used for gout, interferes with collagen production and encourages the body’s own collagen-clearing enzymes. Early small studies reported encouraging plaque and curvature improvements, and pain relief was common.

Then a rigorous placebo-controlled trial found no difference from a dummy tablet in pain, curve, or plaque size. Guidelines now file it under “possibly promising, insufficient evidence.” It is also not a benign drug — diarrhoea and nausea are common and often dose-limiting, and in men with kidney or liver problems it can cause more serious harm.

Pentoxifylline — interesting, unproven

Pentoxifylline is a circulation drug with an unusually broad profile: anti-inflammatory, antioxidant, antifibrotic, and vessel-relaxing all at once. Laboratory work on tissue taken from men with Peyronie’s disease showed it genuinely dampens the collagen-producing signal that drives the plaque — and did so more strongly in Peyronie’s tissue than in normal tissue, which is intriguing.

The clinical evidence has not caught up. One study without a proper comparison group reported that most treated men had plaque improvement or stabilisation, considerably more than those left untreated — but a study with no control group cannot separate the drug from the natural course of the disease, and no rigorous randomised trial has confirmed it. Pentoxifylline sits alongside colchicine in the “possibly promising” category, and it needs a proper trial rather than more enthusiasm.

The One Genuinely Encouraging Development: Daily Tadalafil

If there is a bright spot in oral therapy, this is it.

Tadalafil belongs to the same family of medications used for erectile dysfunction. Taken as a small daily dose rather than on demand, it appears to do more than assist erections. By improving blood flow and oxygen delivery to the erectile tissue, it may counteract one of the drivers of scarring — because poorly oxygenated tissue scars more readily. There is also evidence it interferes directly with the transformation of ordinary cells into the scar-producing cells that build the plaque.

In men studied during the acute phase, a daily low dose of tadalafil slowed the rate at which the curve worsened compared with simply watching and waiting, while also improving erectile function and overall symptoms. A separate study found that internal scars within the penis resolved far more often in treated men than in untreated ones.

Two caveats belong with that, because this is the one place in the article where hope is justified and therefore most easily overstated. The main supporting study was a retrospective comparison rather than a randomised trial, so it can show a difference between groups but not prove the drug caused it. And tadalafil must never be taken with nitrate medicines for chest pain, or with riociguat — that combination can cause a sudden and dangerous fall in blood pressure. It also needs care alongside alpha-blockers for prostate symptoms.

Note carefully what is being claimed here. Tadalafil is not straightening existing curves. It appears to slow the disease down while it is still active — and because most men with Peyronie’s disease also have some degree of erectile difficulty, it addresses two problems at once. That combination is why it has become the oral medication I am most willing to discuss with patients in the acute phase.

Newer treatment approaches published in 2026 build daily tadalafil into broader combined protocols — pairing it with injections into the plaque and daily traction therapy — reflecting a shift away from searching for one magic tablet and toward attacking the problem from several directions at once.

What Oral Therapy Can Realistically Achieve

Here is how I frame expectations in clinic:

• Straightening an established curve — no. No tablet has demonstrated this reliably in high-quality trials. If a curve is already fixed and troubling you, oral therapy is not the answer.
• Slowing progression during the active phase — possibly. This is where daily tadalafil has shown the most credible promise.
• Pain relief — likely, but be careful how you read it. Pain in Peyronie’s disease usually resolves on its own within twelve to eighteen months. If pain improves while taking a tablet, the tablet may deserve no credit at all. Simple anti-inflammatory painkillers are a reasonable option for the pain itself.
• Shrinking the plaque — sometimes, but so what? A modest reduction in plaque size that does not change the curve or your ability to have intercourse is a laboratory result, not a clinical one.
• As part of a wider plan — yes. Oral medication works best as one component alongside traction, injections, and careful monitoring — not as a substitute for them.

The most thorough independent review of non-surgical treatments for this condition reached a blunt conclusion: there is little good evidence that they work, and most trials have been too small or too poorly designed to answer the question properly. That is an uncomfortable finding, but pretending otherwise does patients no favours.

The only medication formally approved for Peyronie’s disease anywhere is not a tablet at all — it is an injection placed directly into the plaque. I have written separately about how that injection treatment works and who qualifies for it. It is not in routine use here; if it is something you are interested in, please email the Urology department at bhquro@bdms.co.th to enquire first.

Side Effects Worth Knowing About

Because these medications are used off-label with modest expected benefit, their side effects carry proportionally more weight in the decision.

• Potaba: nausea, loss of appetite, diarrhoea, and a punishing number of tablets each day. Must be taken with food.
• Vitamin E: usually well tolerated, but sustained high doses have been linked in some analyses to increased cardiovascular risk. Not as harmless as it looks.
• Colchicine: diarrhoea and nausea are common. In men with kidney or liver impairment, more serious effects on blood counts, muscles, and nerves can occur, and it interacts with a number of other medications.
• Tamoxifen: hot flushes, stomach upset, reduced libido, and a small risk of blood clots.
• Pentoxifylline: nausea, dizziness, headache. Not suitable after recent bleeding in the brain or eye, and requires caution alongside blood thinners.
• Tadalafil: headache, facial flushing, blocked nose, indigestion, back or muscle ache. It must never be combined with nitrate heart medications or riociguat, needs care alongside alpha-blockers and in men with significant heart disease, and rarely can cause a prolonged erection or sudden visual or hearing loss — all of which need urgent attention.

Always tell your urologist about every medication and supplement you take. Several of these interact in ways that matter. And do not start, stop or change any of them on your own — that includes stopping a medicine you suspect is contributing.

The Bottom Line

Decades of research into oral medication for Peyronie’s disease have produced a long list of sensible ideas and very few convincing results. Vitamin E and tamoxifen are recommended against. Potaba, colchicine, and pentoxifylline remain unproven, and each brings side effects that are difficult to justify for an uncertain benefit. Daily low-dose tadalafil is the one agent with genuinely encouraging recent evidence — and even then, its role is to slow the disease during the active phase and improve erections, not to straighten a curve that has already set.

If you take one message from this article, let it be this: do not spend the active phase of your disease waiting for a tablet to fix it. That window is when the condition is most influenceable, and it is far better spent under proper assessment — establishing which phase you are in, measuring the curve accurately, checking your erectile function, and building a plan that may combine medication, traction, injections, and if necessary surgery.

See how Peyronie’s disease treatment is structured in practice, including when penile prosthesis surgery becomes the more appropriate route.

If you have noticed a bend developing, pain with erections, or difficulty with intercourse, please seek assessment rather than self-medicating. Dr. Soarawee Weerasopone offers specialist consultations in men’s health and Peyronie’s disease at Bangkok Hospital Headquarters and at Samitivej Sriracha Hospital, Chonburi — 088-022-1445.

Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. Samitivej Sriracha is in-person only. For any enquiry about the cost of consultation or treatment, please contact the hospital directly at the same address, or Samitivej Sriracha on 088-022-1445.

Frequently Asked Questions About Oral Medications for Peyronie’s Disease

Is there a pill that cures Peyronie’s disease?

No. No oral medication has been approved anywhere in the world for Peyronie’s disease, and none has been shown in high-quality trials to reliably straighten an established curve. Every oral agent used for this condition is prescribed off-label. The only formally approved medication is an injection placed directly into the plaque, not a tablet. Oral therapy is best understood as a way to possibly slow the disease during its active phase and manage symptoms, rather than as a cure.

Does vitamin E help Peyronie’s disease?

The evidence says no. A large, well-designed trial comparing vitamin E against a dummy tablet found no improvement in pain, curvature, or plaque size over six months, and the American Urological Association explicitly recommends against its use. It is still widely prescribed because it is cheap and feels harmless, but sustained high doses have been linked in some analyses to increased cardiovascular risk, so it is not entirely without downside.

Can daily tadalafil help Peyronie’s disease?

Daily low-dose tadalafil is the most encouraging oral option currently available. In men studied during the acute phase, it slowed the rate at which the curve worsened compared with observation alone, while also improving erectile function. It appears to work by improving blood flow and oxygen delivery to the erectile tissue, since poorly oxygenated tissue scars more readily. Two honest caveats: the main supporting study was a retrospective comparison rather than a randomised trial, and tadalafil must never be combined with nitrate heart medicines or riociguat. Importantly, it is not straightening existing curves — its value lies in slowing active disease and treating the erectile difficulty that commonly accompanies Peyronie’s disease.

When should oral medication be started for Peyronie’s disease?

Oral medication is considered almost exclusively during the acute or active phase, which typically lasts six to eighteen months and is marked by painful erections and a curve that is still changing. During this window the scar is still forming and may be influenceable. Once the disease enters the stable phase, with pain resolved and the curve fixed, no tablet will dissolve a mature plaque, and treatments delivered directly into the plaque or surgery become the appropriate options.

When is a penile bend an emergency?

A sudden bend following an injury during intercourse — particularly with a popping sound or sensation, immediate loss of the erection, pain and rapid swelling or bruising — suggests a penile fracture, which is a surgical emergency and does far better when repaired early. An erection lasting more than four hours is also an emergency. So is sudden loss of vision or hearing after taking tadalafil or a similar tablet. A new firm lump in a man who has never had a bend, especially with skin changes or weight loss, needs prompt assessment rather than a trial of tablets. In Thailand the emergency number is 1669.

Can I discuss Peyronie’s disease by telemedicine before travelling to Bangkok?

Yes, for the initial conversation. Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients, and is arranged in advance by email to the Urology department at bhquro@bdms.co.th. It is a sensible first step for reviewing your history and current medications. A curve cannot be measured remotely, however, so the deformity must be assessed in person before a treatment plan is settled. Samitivej Sriracha is in-person only.

References

1. Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–753. PubMed
2. Chierigo F, Fallara G, Tozzi M, et al. Guideline of guidelines: Peyronie’s disease. BJU Int. 2026;137(5):770–782. PubMed
3. Rosenberg JE, Ergun O, Hwang EC, et al. Non-surgical therapies for Peyronie’s disease. Cochrane Database Syst Rev. 2023;7:CD012206. Cochrane Library
4. Spirito L, Manfredi C, La Rocca R, et al. Daily low-dose tadalafil may reduce the penile curvature progression rate in patients with acute Peyronie’s disease: a retrospective comparative analysis. Int J Impot Res. 2024;36(2):129–134. PubMed
5. Safarinejad MR, Hosseini SY, Kolahi AA. Comparison of vitamin E and propionyl-L-carnitine, separately or in combination, in patients with early chronic Peyronie’s disease. J Urol. 2007;178(4):1398–1403. PubMed
6. Safarinejad MR. Therapeutic effects of colchicine in the management of Peyronie’s disease: a randomized double-blind, placebo-controlled study. Int J Impot Res. 2004;16(3):238–243. PubMed
7. Ilg MM, Mateus M, Stebbeds WJ, et al. Antifibrotic synergy between phosphodiesterase type 5 inhibitors and selective oestrogen receptor modulators in Peyronie’s disease models. Eur Urol. 2019;75(2):329–340. PubMed
8. Hayat S, Brunckhorst O, Alnajjar HM, et al. A systematic review of non-surgical management in Peyronie’s disease. Int J Impot Res. 2023;35(6):523–532. PubMed

Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Every oral medication discussed here is used off-label for Peyronie’s disease, and none is approved for it. Dr. Soarawee does not provide medical assessment, advice, diagnosis or prescriptions through personal messaging channels, direct messages or social media. Always consult a qualified healthcare professional before starting, stopping or changing any medical treatment. In an emergency, attend the nearest emergency department — in Thailand the emergency number is 1669.