Trimix Injections

A Compounded Medication for ED

Trimix is a compounded injectable medication prepared by Olympia Pharmacy in our 503A facility. Often used as part of a provider-guided men’s health plan, Trimix is intended for those seeking a non-oral option to support erectile function. It is available by prescription and compounded to meet individual dosing needs.

Trimix Injections

What is Trimix?

Trimix is an injectable medication comprised of papaverine, phentolamine, and alprostadil used as a treatment for erectile dysfunction (ED). Trimix injections can trigger an erection within 5 minutes and result in longer and firmer erections that last through climax. Because Trimix dosages differ based on how each patient responds to treatment, it must be prescribed by a healthcare provider.
Erectile dysfunction (ED), a sexual health condition characterized by the inability to achieve or maintain an erection, affects an estimated 15-30 million men in the U.S., with over 600,000 new cases arising each year.[1] While ED can occur in younger men, it becomes more prevalent after age 40. Additionally, large multinational studies have estimated the prevalence of ED in young men to be as high as 30%. It’s predicted that by 2025, 322 million men worldwide will have ED.
Trimix aims to provide a reliable way for men with ED to achieve and sustain erections firm enough for sex. Its main benefits include:

  • Simple storage
  • Long duration
  • Easy self-administration

Trimix was developed in 1983 when scientists discovered that adding phentolamine and alprostadil to papaverine, at the time a standalone ED treatment, created an improved compound.[4] Today, Trimix injections are an accepted second-line ED medication when oral PDE5 inhibitors, like Viagra, Levitra or Cialis, are ineffective or create side effects.[3]  Since Trimix works locally where it is injected, rather than circulating throughout the bloodstream like oral drugs, it tends to have a lower risk of side effects.
At Olympia Compounding Pharmacy, we specialize in Trimix medication. In this Trimix guide for patients as well as physicians, we’ll explain the components of Trimix, dosage, potential side effects, as well as how to get Trimix online for yourself or your patients. Learn more about our compounding pharmacy or use our contact form to reach us for additional help.
* Olympia Pharmacy is the official Trimix supplier to Memorial Sloan Kettering Cancer Center. *

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How to Self-Administer Trimix Injections

After receiving a physician’s instructions, Trimix injections are typically self-administered at home. While this may sound daunting, it’s actually an easy procedure that many patients find painless with practice. (See our injection instructions below.) However, it’s important to use proper injection technique with a 29-30 gauge x 1/2″ needle inserted fully into the shaft of the penis for intracavernosal administration.

Below are the general step-by-step instructions for self-administering Trimix. Be sure to follow the specific instructions of your medical provider. Always consult a healthcare provider before starting any new medication.

  1. Getting Set Up
    • Proper hygiene is important. Wash your hands and keep the penis clean to prevent infection.
    • Assemble the following: bottle of Trimix, alcohol pad, syringe.
    • Keep the Trimix cold by returning the bottle to the refrigerator or placing the bottle in a cup of ice.
  2. Prepare the Syringe
    • Wipe the rubber top of the vial with an alcohol pad to sanitize it.
    • After removing the cap of the needle, pull the plunger back to the desired dosage, filling this volume with air. Use a new needle and syringe each time.
    • Insert the needle through the rubber top and inject the air into the vial.
    • Turn the vial with the needle and syringe inserted upside down. Pull back on the syringe plunger in a slow and steady motion until the desired dosage is achieved.
    • Tap the side of the syringe (1cc tuberculin syringe with a 29 gauge needle) to allow any air bubbles to float towards the needle.
Avoid having these air bubbles in the syringe when self-injecting by first injecting out the collected bubbles that may form.
    • Remove the needle from the bottle and replace the protective cap on the needle.
  3. Select and Prepare the Site for Injection
    • The proper location for injection is at the 9-11 and 1-3 o’clock positions, between the base and mid-portion of the penis. (See the diagram in Step 3 of our Trimix Self-Injection Instructions PDF.) Avoid the midline because of the potential for injury to the urethra (6 o’clock for urinary passage) and the penile arteries and nerves (near 12 o’clock). Avoid any visible veins or arteries on the surface.
    • Grasp and pull the head of the penis toward the side of your leg with the index finger and thumb (use the left hand, if right handed). While maintaining light tension, select a site for injection.
    • Clean the site with an alcohol pad.
  4. Inject Trimix and Apply Compression
    • With a steady and continuous motion, penetrate the skin with the needle at a 90-degree angle. The needle should then be advanced to the hub. Slight resistance is encountered as the needle passes into the proper position within the erectile tissue (corporeal body).
    • Inject the Trimix over approximately 4 seconds. Withdraw the needle from the penis and apply compression to the injection site for approximately 1 minute. Several minutes of compression may be required to avoid bleeding, especially if you are an aspirin user.
    • Replace the cap on the needle and dispose of it properly.

For additional information, please contact us or refer to the video or PDF instructions below.

How to Inject Trimix Medication Video

See our instructional video for guidance on self-administering Trimix injections.

Trimix Self-Injection Instructions PDF

Download our PDF for step-by-step instructions and a visual diagram of how to self-administer Trimix.

Trimix Instructions Download

*Remember, these Trimix self-injection instructions are meant to serve as a general guide only. Always follow the specific instructions provided by your healthcare provider.

Olympia Pharmaceuticals – Jonathan Ramnauth

Meet Our Trimix Expert

Dr. Jonathan Ramnauth

Dr. Jonathan Ramnauth is a distinguished Sterile Compounding Pharmacist at Olympia Pharmaceuticals, holding a Doctor of Pharmacy degree from the University of Florida, earned in 2018. His academic and professional journey is marked by a relentless pursuit of excellence, culminating in his recognition as a leading expert in TriMix injections, a specialized area of pharmacy that requires precision and deep knowledge of compounded medications.

Since obtaining his Pharm.D., Dr. Ramnauth has dedicated himself to setting the highest standards in patient care and medication management. His expertise is not just limited to the technical aspects of pharmacy; he is equally committed to patient education. Dr. Ramnauth excels in communicating complex medication information to clients, ensuring they have a comprehensive understanding of their treatments, including potential drug interactions and side effects. This dedication to patient care ensures continuity and coherence in treatment plans prescribed by their healthcare providers.

Dr. Ramnauth’s commitment to excellence extends beyond patient interaction to the operational aspects of pharmacy practice. He is vigilant in monitoring the daily operations of his practice environment, ensuring strict adherence to organizational standards, industry regulations, and compliance with local, state, and federal laws. His proactive approach to maintaining operational excellence is critical in the highly regulated field of sterile compounding, where precision and adherence to strict protocols are paramount.

Through his expertise in TriMix formulations and his unwavering commitment to patient care and operational excellence, Dr. Jonathan Ramnauth embodies the ideals of the pharmacy profession. His contributions not only enhance patient outcomes but also elevate the standards of practice in the field of sterile compounding pharmacy.

Dr. Jonathan Ramnauth has medically reviewed and approved the content on this page.

Why Choose Olympia?

Hear From Our Patients

“If you have issues like me and many many men in their 50s and nothing seems to work and you’ve been too embarrassed to ask, put all that aside and give Chris Alvarez at Olympia Pharmacy a call. You’ll be glad you did.”

John B.
John B

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Contact us to learn more about Trimix injections today.