Trimix is a prescribed, injectable medication consisting of three active ingredients- alprostadil, papaverine, and phentolamine. Together, these three medications help to relax, expand, and fill the corpus cavernosum (erectile tissue) with blood resulting in an erection shortly after administration. Unlike oral medications, Trimix is localized to the intended area rather than having to flow through the bloodstream into other areas of the body. Trimix is self-administered and easy to perform in the comfort of your own home.
Indications: Trimix is indicated in the treatment of males with erectile dysfunction. This injectable medication is for patients unsuitable for the oral medication prostaglandin E1.
What are the 3 medications that are combined to form this sterile injection?
Papaverine: This is a vasodilator which helps to expand the blood vessels. When injected into the penile tissue, this medication causes the smooth muscles to relax. In turn, this allows blood to flow through the corpus cavernosum resulting in an erection.
Alprostadil: Also known as prostaglandin E1 (PGE1), alprostadil is a naturally occurring prostaglandin used as a medication. This medication is also within the vasodilator class. It, too, is used to help open the blood vessels by relaxing the smooth muscles within the penis. Alprostadil is listed on the World Health Organization’s List of Essential Medicines and was isolated in 1957 and approved for medical use in the United States in 1981.
Phentolamine: This medication is a reversible nonselective a-adrenergic antagonist. Its primary action is vasodilation. Because it is a nonselective a-blocker, this medication also increases cardiac output.
Trimix injection 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 in determining the correct formula. Be aware that it is possible that the first few administrations may not deliver the individual’s 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. Max dose is 0.50cc (mL). Always contact your provider before increasing your dosage.
Contraindications: The use of Trimix injection is contraindicated in patients with allergies to any components in this medication, sickle cell anemia, blood clotting disorders, any condition that can predispose you to priapism (a painful erection lasting more than 4 hours), leukemia, anatomical deformations of the penis, penile implants, and if you have direct instructions from your physician to abstain from sexual activity.
It is important to provide your healthcare provider with a list of all drugs that you are currently using. This includes all non-prescription drugs, illegal drugs, herbal, and dietary supplements. Some chemicals within Trimix can interact with your medication causing them to become ineffective or leave you with adverse effects.
Common side effects:
Pain- This is very minimal though as there are not many nerve endings in the area of injection.
Bleeding- This could be due to the angle administered or possible may result from hitting a tiny blood vessel. If this occurs, apply pressure until bleeding has stopped. Do not engage in sexual activity until bleeding has ceased.
Infection- Good hygiene always prevents this. Make sure the area is clean and use alcohol swabs just prior to administering the injection. Always be sure to wash your hands before and after administration.
Priapism- This can be a painful erection lasting longer than 4 hours. This is a medical emergency. If unseen, the tissue can become damaged and the effects may be irreversible. If your erection lasts for more than 2 hours, take 2 – 4 pseudoephedrine tablets only once. You should then apply an ice pack. If this erection still persists after another hour, seek immediate medical attention.
While using Trimix, if you experience any swelling, numbness, tenderness, redness, and lumps on your penis or its surrounding areas, make sure to contact your provider immediately.