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The Need for More ED Care Options

Erectile dysfunction (ED) affects a significant portion of the male population, and while oral medications like sildenafil, tadalafil, and vardenafil are commonly used, they may not be the best option for every patient. 

The First Line of Defense

Oral ED options (known as PDE-5 inhibitors) include medications such as sildenafil, tadalafil, and vardenafil. They are often the first care plan recommended to patients because of their ease of use.

At Olympia, we compound oral medications with the following ingredients:

  • Sildenafil (Generic Viagra ®)
  • Tadalafil (Generic Cialis ®)
  • Vardenafil (Generic Levitra ®)

In some cases where these individual ingredients may not appear to be the right strength for certain patients’ needs, combo medications may be prescribed. Olympia offers combination oral tablets such as:

  • Sildenafil / Tadalafil
  • Sildenafil / Vardenafil
  • Tadalafil / Apomorphine / Methylcobalamin B12
  • Tadalafil / Vardenafil
  • Vardenafil / Papaverine
  • Tadalafil / Oxytocin
…and more!

Even with the introduction of combo tablets, some patients may not be good candidates for oral tablets as a whole. Whether it’s due to contraindications or the medications do not respond as expected, this prompts a need for additional care options.

When to Consider Injectable Therapy

Three vials of compounded Trimix injection vials stand in a line. From left to right, a Bimix vial with a gold cap and label, a Trimix vial with a blue-striped cap and blue label, and a Quadmix vial with a blue cap and blue label.

For patients who do not respond to or cannot take oral medications, injectable therapy may be considered. There is a variety of terms in which this type of therapy is referred to, including:

  • ED shot 
  • Penile shot 
  • Penile injection 
  • Intracavernosal injection therapy

No matter the terminology used, they all mean the same thing. This method of care is often seen as a viable pathway for patients dealing with more serious cases of erectile dysfunction.

When it comes to injectable therapy, one of the most common options prescribed to patients is known as Trimix Injection.

What Is Trimix?

Trimix is a compounded injectable medication that typically combines three active ingredients: alprostadil, papaverine, and phentolamine. It is administered via injection into the corpora cavernosa of the penis, also known as the penile tissue, under provider guidance. As a combination drug, it is compounded in a sterile environment by compounding pharmacies like Olympia.

Comparison Chart: Oral vs. Injectable ED Therapies

Aspect Oral PDE-5 Inhibitors (Sildenafil, Tadalafil, Vardenafil) Injectable Therapy (e.g. Trimix)
Concentration and route of administration Rapidly dissolving tablets administered orally Injections administered intracavernosally
Onset Typically 30-60 minutes Typically within 5-20 minutes
Customization Fixed doses available Can be titrated per patient
Use Case First-line care Considered if patient has poor response to oral medications
Monitoring Minimal Follow-up and monitoring recommended

Safety and Handling Considerations

Providers should ensure proper patient education on injection technique, sterile handling, and dosing. Monitoring for adverse events and following up with patients is recommended.

Role of L-Arginine as a Supplement

In some cases, clinics may recommend dietary supplements such as L-Arginine. This amino acid, when found in the body, supports nitric oxide production, which plays a role in vascular health. As with any additions to a patient’s care regimen, providers should review patient health profiles before suggesting any supplement to ensure there is a fit.

Practical Considerations for Clinics

Clinics offering injectable ED therapy should:

  • Partner with an FDA-registered facility. 
  • Provide training on administration and handling. 
  • Establish protocols for dosing and follow-up. 
  • Offer educational resources for patients.

Be advised that compounded products are not approved by the FDA, nor are they evaluated by the FDA for safety, efficacy, or quality. This article was written for informational purposes, and is not intended to replace or substitute for medical advice. Always consult with a medical professional before beginning any medical regimen.

 

For clinics and providers looking to expand their ED care options, injectable therapy such as Trimix can be part of a comprehensive solution for patients who need alternatives to oral medications.

Interested in learning more about how your clinic can offer injectable ED therapy? Contact us to speak with a representative about protocols, patient education, and support resources.

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