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Trimix is a prescribed penile injection medication for erectile dysfunction (ED). It consists of three active ingredients: alprostadil, papaverine and phentolamine. Together, these medications help relax, expand, and fill the corpus cavernosum (erectile tissue) with blood, resulting in an erection shortly after administration.

Unlike oral ED medications, Trimix penile injections target the intended area directly. This localized approach means the medication does not need to flow through the bloodstream to other parts of the body. Trimix injections are self-administered, making it convenient to perform in the comfort of your own home.


Trimix is an injectable medication indicated for males with erectile dysfunction, particularly those who do not respond well to oral medications, such as Viagra or Cialis.

What 3 Medications Are Combined to Form Trimix Injections?

  • – Papaverine: A vasodilator that expands blood vessels. When injected into penile tissue, papaverine causes the smooth muscles to relax, allowing blood to flow through the corpus cavernosum and resulting in an erection.
  • – Alprostadil: Also known as prostaglandin E1 (PGE1), this naturally occurring prostaglandin is used to relax the smooth muscles and improve blood flow within the penis, aiding in vasodilation. Isolated in 1957, alprostadil has been in medical use in the United States since 1981 and is listed on the World Health Organization’s List of Essential Medicines.
  • – Phentolamine: A nonselective alpha-adrenergic antagonist that primarily causes vasodilation, increasing cardiac output. Phentolamine works by blocking certain receptors that normally tighten blood vessels. By blocking these receptors, phentolamine helps blood vessels remain open, further improving blood flow into the penis.

Trimix is a medication that is very customizable to the patient’s needs. In order to receive the most effective results, it is imperative that the patient, provider, and pharmacy work together to determine the correct formula.

Be aware that the first few administrations of Trimix may not deliver a satisfactory result. Increasing the dosage little by little will help reach the individual patient’s goal. To do this, the initial dose should be 0.05cc (mL) to 0.2cc (mL), depending on the level of the patient’s ED. The max dose is 0.50cc (mL). Always contact your provider before increasing your dosage.


Trimix injections should not be used by patients with:

  • Allergies to any components of Trimix
  • Sickle cell anemia
  • Blood clotting disorders
  • Conditions predisposing to priapism
  • Leukemia
  • Anatomical deformations of the penis
  • Penile implants
  • Direct instructions from a physician to abstain from sexual activity

Inform your healthcare provider about all medications you are currently using, including non-prescription drugs, illegal drugs and herbal and dietary supplements. Some chemicals within Trimix penile injections can interact with other medications, causing ineffectiveness or adverse effects.

Related reading: 5 Questions to Ask Your Doctor About ED

Common Side Effects of Trimix:

  • – Pain: Pain from penile injections is typically minimal due to fewer nerve endings in the injection area.
  • – Bleeding:  This can occur if a tiny blood vessel is hit. Apply pressure until it stops and avoid sexual activity until bleeding ceases.
  • – Infection: Maintain good hygiene. Clean the area and use alcohol swabs before injection. Wash your hands before and after administration.
  • – Priapism: A medical emergency if an erection lasts more than 4 hours. If your erection persists for over 2 hours, take 2–4 pseudoephedrine tablets and apply an ice pack. Do not take additional pseudoephedrine if it continues beyond 3 hours — instead, seek immediate medical attention.

If you experience swelling, numbness, tenderness, redness or lumps on your penis or surrounding areas, contact your provider immediately. Learn more about the side effects of Trimix injections.

Want more information about Trimix penile injections? View our full guide online.

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