TriMix Injections for Erectile Dysfunction:
A Guide

What Do You Need to Know About

TriMix & Erectile Dysfunction?

Erectile dysfunction, or ED, is sexual dysfunction characterized by the inability to develop or maintain an erection sufficient for intercourse. While erectile dysfunction can affect men of any age, it is most common in men over the age of 40. Studies have estimated that the number of men with erectile dysfunction in the United States is more than 30 million.

What is TriMix?

TriMix is an injectable ED medication commonly used when oral medications can not be used or do not produce satisfactory results. TriMix is a mixture of Papaverine, Phentolamine, and Alprostadil (PGE). These drugs produce a vasodilating effect when injected into the penis, relaxing and dilating the blood vessels. The American Urological Association recognizes TriMix injection therapy as a viable treatment for erectile dysfunction.

The injection is administered using a very small needle inserted into the proper area along the shaft of the penis so the drug mixture is delivered into the corpus cavernosum. The mix of drugs causes the corpus cavernosum to relax, dilate, and become filled with blood, producing an erection.

TriMix is generally an effective, low-cost treatment for ED, especially for those patients who have not had good results or experience moderate to severe side effects from PDE5 inhibitors (Viagra®, Levitra®, Cialis®).

 TriMix injections offer a solution for ED that is:

• – Safe
• – Reliable
• – Fast-acting
• – Long-lasting
• – More affordable than oral medications
• – Not affected by alcohol consumption

According to the American Urologic Association, an intracavernous injection is the most effective non-surgical treatment for ED. Penile injections, unlike most oral medications, can trigger an automatic erection in less than 5 minutes. In addition, triMix medication can provide longer and fuller erections that may last through climax, allowing you to maintain and improve your sexual health.

Who Is a Candidate for TriMix Injections?

The inability to achieve or maintain an erection can affect a man at any time. It can happen once in a while or more frequently, and there can be many different causes. Some common causes include:

• – Low testosterone
• – Cardiovascular disease
• – Diabetes
• – Prostate issues
• – Depression
• – Anxiety
• – Nerve/spinal cord damage
• – Effects of taking medications

TriMix injections may be recommended if other treatments, such as oral medications, have been unsuccessful or caused undesirable side effects. TriMix injections can also be a good option for individuals who have medical conditions that prevent the use of oral medications, such as men who have undergone prostate surgery or have certain cardiovascular conditions.

What Are TriMix’s 3 Main Ingredients?

TriMix is comprised of three ingredients that act synergetically when combined into a sterile injection. These ingredients include Papaverine, Phentolamine and Alprostadil. Each of these ingredients can be indicated for several conditions independently, but they can have highly effective results in treating ED when combined. This combination has become one of the go-to treatment options for men who do not have effective results from conventional PDE5 inhibitors.

Papaverine

Papaverine, as a standalone medication, is typically prescribed to patients with circulation problems to increase blood flow. As a vasodilator, papaverine relaxes and dilates blood vessels to help blood flow more easily to the heart and throughout the body. In addition, papaverine relaxes smooth muscle within large blood vessels, especially coronary, systemic peripheral and pulmonary arteries, and is almost completely devoid of effects on the central nervous system.

This ingredient is helpful for men struggling with ED because it helps to provide improved circulation to the penis, enabling patients to obtain and maintain a full erection for intercourse.

Phentolamine

Phentolamine is a lasting, adrenergic, alpha-receptor-blocking agent that enhances blood flow to the skin, mucosa and abdominal viscera and lower blood pressure. Phentolamine works by blocking alpha receptors in the body, which can be found in the muscle that lines the walls of blood vessels. When these alpha receptors are blocked by phentolamine, muscles relax and blood vessels widen, resulting in a substantial increase in blood flow.

Alprostadil

Alprostadil can be used to address symptoms of erectile dysfunction in men. Alprostadil, also a vasodilator, is used to relax the muscles and blood vessels in the penis to allow a steady flow of blood to the penis so the user can achieve and maintain an erection. In three different studies conducted on the efficacy and safety of this ingredient used for intracavernosal treatment, it was found that alprostadil is an effective therapy with tolerable side effects.

What Is the Appropriate TriMix Injection Dosage?

The initial Trimix Injection dose should be .05cc to .2cc, depending on the patient’s level of ED. Wait 48 hours before increasing dosage. Then, increase by 0.025 cc to 0.050 cc until a satisfactory dose is reached. The maximum dose is 0.50 cc. Do not be discouraged by a poor result with the first few injections, as the initial dose should be kept low to avoid a prolonged erection.

TriMix injections are a medication that is very customized to the patient’s needs. Olympia will work together with the physician and patient to develop a formula that is most effective for the individual patient.

TriMix FAQs

What Are the Goals of Injection Treatment?

Our TriMix injection treatment plans aim to provide men with a reliable, easy-to-use, safe method of achieving and maintaining an erection suitable for sexual relations. There are many benefits to using TriMix injections for ED: they’re safe, effective, easy to store, long-lasting, easy to administer and more. Once you receive a prescription, or if you have additional questions, contact us.

Why Consider Injections as an Alternative to Tablets?

TriMix injections are an alternative to PDE5 Inhibitor tablets (Viagra®, Levitra®, Cialis®) and are most commonly comprised of a mixture of three drugs; phentolamine, papaverine and alprostadil. These penile injections can be especially useful when patients are unable to take PDE5 Inhibitors because they are taking nitrates, certain beta-blockers, or if they experience severe side effects from the oral medications.

How Does TriMix Work?

TriMix is a combination of three medications—alprostadil, papaverine, and phentolamine—that work together to improve blood flow to the penis and facilitate an erection. Alprostadil relaxes blood vessels, allowing more blood to flow into the penis, while papaverine and phentolamine further enhance this effect by relaxing smooth muscle cells and blocking constriction in the blood vessels. When injected into the penis, TriMix promotes vasodilation and increased blood flow, resulting in a firm and sustained erection for sexual activity.

Does TriMix have side effects?

Yes, TriMix injections can have side effects, although they may vary from person to person. Some common side effects associated with TriMix injections include:

• Mild to moderate penile pain or discomfort
• Priapism
• Penile fibrosis or scarring
• Hematoma or temporary bruising
• Hypotension or dizziness
• Allergic reactions

It’s important to note that the side effects mentioned above are not exhaustive, and individuals may experience other less common or individual-specific side effects. It is crucial to consult with a healthcare professional who can provide personalized guidance, monitor the response to treatment, and address any concerns or side effects that may arise.

Are TriMix injections safe?

All of our formulas undergo extensive third-party testing before being released to patients. TriMix injections are a common and well-tolerated method of obtaining an erection used by men with symptoms of ED for more than 30 years. It’s especially useful for men with severe ED caused by high blood pressure, high cholesterol, smoking, diabetes and obesity.

Are TriMix injections effective?

TriMix ED injections are incredibly effective. According to the American Urologic Association, intracavernous injections are currently the most effective option for non-surgical ED treatment.

Do TriMix injections act quickly?

Unlike oral ED medications, injections trigger an automatic erection — most in 10 minutes or less. Some men may not begin to see the effect until after sexual foreplay has begun. In the beginning, we recommend using a lower dose to prevent prolonged erections. Your doctor may recommend adjusting your dosage after the initial exposure.

Is TriMix long-lasting?

TriMix injections provide longer and fuller erections than most oral alternatives that can last through the climax, helping men achieve improved sexual health and performance. Erections should last between one and two hours.

When using TriMix or any other ED medication, an erection should never last four or more hours. Erections that last more than four hours are considered a medical emergency. Please immediately contact your local emergency room to be treated if you are experiencing this symptom.

Are TriMix injections easy to self-administer?

For some, penile injections may seem too painful to self-administer. However, for many who’ve tried it, the process couldn’t be easier and more painless! Check out these simple self-injection instructions to see how easy it can be to do it yourself:

— Wash your hands with soap and water and keep the penis clean.
— Keep the medication cold and the syringe sterilized.
— Administer the injection at the 9-11 and 1-3 o’clock positions, between the base and mid-portion of the penis.
— Dispose of your needle properly after injection.

Is TriMix affected by alcohol consumption?

Unlike some medications, the effectiveness of TriMix injections is not usually altered by consuming alcohol. While using this medication, patients can drink responsibly and still have the same results as they would have without it.

Are TriMix injections easy to store?

TriMix injections are best stored in the refrigerator (between 32 – 39°F) and should be kept away from light. If your prescription is for more than one vial of medication, please store your medication as follows:

— Store the vial being actively used at normal refrigeration temperature. For convenience, Olympia’s TriMix can be stored at room temperature for short periods while in use. However, every effort should be made to keep the medication refrigerated or frozen. When traveling, TriMix can be transported with an ice pack.

— The remaining vials should be placed in a freezer and kept frozen. Frozen vials (between 0-31°F) have a beyond-use date of up to one year.

TriMix is shipped with ice packs overnight to ensure stability and optimum results. It is normal for the ice packs to melt and the medication to arrive unfrozen or even slightly warm. The effectiveness of the medication is not compromised.

Download TriMix storage instructions here.

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How Do I Get TriMix?

Are You a Physician?

We support physicians and have more than 35 years of compounding expertise. We provide custom formulation and custom dosing to fit your needs.

To prescribe TriMix injections for patients:

1. Download and print the TriMix Prescription Form.
2. Fill out and fax the signed prescription form to Olympia Pharmacy at 407-673-1234.
3. Olympia will ship injections directly to the patient.

Download Form

Are You a Patient?

While our erectile dysfunction medications do require a prescription from a licensed physician, following these steps will make the process simple and easy:

1. Download and print the TriMix Prescription Form.
2. Present the form to your physician (usually your family doctor or urologist).
3. Your physician will fax the completed form to Olympia Pharmacy. Then, Olympia will ship the medication directly to you.

TriMix is also available online for those without a doctor or those who wish to get the medication without involving their doctor. Patients can complete our simple online form and a member of our scheduling staff will be in contact to set up an evaluation over the phone with a licensed telemedicine physician.

Ready to get started? Buy TriMix online now and be on your way to experiencing a healthier, happier sex life!

Buy TriMix Online

Where Can I Find a Trimix Injection Instructions Video?

Watch this helpful video for complete instructions on how to properly inject TriMix medication, or click the instructions linked below:

Video Transcript:
In this video, we’re going to show you how to properly inject TriMix medication.

Inside of the brown bottle, you’ll find the antidote to the medication, which is called Phenylephrine. Inside the clear bottle, you’ll find the TriMix medication.

To get started, you’ll want to remove the syringe from the packaging. There’s a protective cap over the needle on the syringe, and there’s also a protective cap on the back of the syringe. You’ll use the alcohol prep pad to clean the top of the vial as well as the injection site. On the top of the TriMix vial, there’s a protective seal. You’ll want to remove the protective seal and expose the rubber membrane.

Open the alcohol prep pad and use it to clean the rubber membrane on the top of the TriMix vial. Remove the cap on the back of the syringe, exposing the plunger.

Then, remove the front cap and expose the needle. Before you place the syringe inside the vial, you’ll want to draw back the same amount of units you’ve been prescribed to inject. In this case, we’re going to draw up 20 units into the syringe.

Insert the syringe into the vial through the rubber membrane. You’ll want to press down on the plunger and push the air into the vial. You’ll then want to slowly draw back the required amount of units into the syringe. Pull the syringe straight out of the vial, set the vial down, and then re-cap the front of the syringe.

The area of the penis that you’re injecting the medication into is called the corpus cavernosum. The corpus cavernosum runs on either side of the penis. You’ll want to make sure to inject at the 10 o’clock or 2 o’clock position. Do not inject on the same side each time you use the medication. You’ll want to make sure that you’re alternating sides between usage. This diagram shows where the corpus cavernosum is located inside the penis.

Before you apply the medication, you’ll want to clean the area of injection with the alcohol prep pad. As you go to apply the medication, make sure that you don’t pull on the penis or twist the penis in any way, because this may affect the injection site.

Now, you’re ready to apply the medication. You’ll want to remove the cap, and in one swift motion, you’ll apply the medication. Make sure that you avoid any veins. Pull the syringe straight out of the penis.

After injecting, you’ll want to apply pressure to the injection site. You’ll then want to massage the area of entry for about one minute and allow the medication to spread evenly throughout the entire penis.

To give you an idea of the amount of pressure you’ll want to apply to the plunger when you go to administer the medication, try drawing up water into one of the syringes. You’ll place your thumb on the back of the plunger and lightly press on the back of the plunger. This is the same amount of pressure you’ll want to apply to the plunger when you go to inject the TriMix medication. If you find that you have to apply more pressure than this, then you may not be in the corpus cavernosum, which means the medication will not be effective.

If you experience an erection lasting longer than two hours, you’ll want to apply the antidote to the medication, which is called Phenylephrine. You’ll apply the Phenylephrine the same way you apply the TriMix medication. First, draw up air into the syringe, and then insert the syringe into the vial of Phenylephrine. Slowly draw back 50 units of Phenylephrine into the syringe. Pull the syringe straight out of the vial and then re-cap the front of the syringe. You’ll want to inject one inch above the base of the penis at the 10 o’clock or 2 o’clock position. You want to make sure that you avoid any veins. And again, you’ll want to massage the area of entry for about one minute right after you administer the medication.

Thank you for watching. If you have any questions or concerns, email us directly at trimix@olympiapharmacy.com.

What Do TriMix Injection Studies Show?

For detailed information about TriMix injections and their results, read this study conducted by the International Journal of Impotence Research below.

Introduction and Objective:

Intracavernous injection of Trimix (Tx) is indicated for patients unsuitable for prostaglandin E₁ (PgE₁) injection due to lack of response, pain or cost. We believe that the ideal ratio of ingredient doses in Tx is yet to be found. We postulated that increasing the doses of individual drug components in an orderly manner would convey important data on penile hemodynamic response. Such information is needed to choose an effective and less costly alternative to PgE₁ with least side effects. We set out to evaluate the impact of varying the ingredient dosage on response and short-term safety of Tx compared with PgE₁. We prospectively randomized 180 consecutive patients with erectile dysfunction into nine equal groups and each group received a different dose of Tx, namely phentolamine (1 mg) plus one dose of PgE₁ (2.5, 5 or 10 μg) and one dose of papaverine (5, 10 or 20 mg). Each patient was injected with 20 μg PgE₁ and one dose of Tx in two clinic visits 1 week apart. Following injection, duplex ultrasound of cavernous arteries and axial rigidometry were carried out. Patients ranked the quality of erection, estimated overall satisfaction and reported time to detumescence and side effects. Patients’ mean age was 50.5±11.7 y with underlying organic condition in 91.1%. We set out to evaluate, by means of an acute, prospective, randomized, single blind study, the various dose combinations of Tx versus PgE₁ 20 μg using both subjective and objective end points.

Hypothesis:

We think that the ideal ratio of ingredient doses in Tx is yet to be found. The effect of increasing individual drug components on penile response is not known. Such information is needed to choose an effective and less costly alternative to PgE₁ with least side effects.

Results:

In spite of oral drug therapy for ED, there is a considerable number of candidates for self-injection therapy. These include patients who do not respond to or have a contraindication for PDE-5 inhibitor treatment. In addition, some patients prefer the rigidity provided by injections. In patients undergoing ICI therapy and given the option to try sildenafil, 36.2% decided to use injections most of the time or at least sporadically. The association of multiple vasoactive drugs produces a full erectile response in more than 90% of patients. In nonresponders to doses as high as 40 μg PGE₁, Tx combination produced a response in 31%. The cost of the medication is another important issue where Tx has an advantage. Learn more in the study here.

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Want to Learn More About TriMix?

Browse these helpful resources:

• TriMix Injection Side Effects: What You Need to Know
• How Do I Get Trimix? Ways to Buy TriMix Injections Online
• Your Guide to TriMix Injections
• What Is TriMix Used For? | Your TriMix FAQs Answered

References

Sooriyamoorthy, T., & Leslie, S. W. (2023). Erectile Dysfunction. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK562253/

“Definition & Facts for Erectile Dysfunction | NIDDK.” National Institute of Diabetes and Digestive and Kidney Diseases, July 2017, www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts.

Huang, S. A., & Lie, J. D. (2013). Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. P & T : a peer-reviewed journal for formulary management, 38(7), 407–419.

Burnett, Arthur, et al. “Erectile Dysfunction (ED) Guideline – American Urological Association.” Www.auanet.org, American Urological Association, 2018, www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline.

National Center for Biotechnology Information (2023). PubChem Compound Summary for CID 4680, Papaverine. Retrieved from https://pubchem.ncbi.nlm.nih.gov/compound/Papaverine.

National Center for Biotechnology Information (2023). PubChem Compound Summary for CID 5775, Phentolamine. Retrieved from https://pubchem.ncbi.nlm.nih.gov/compound/Phentolamine.

Jain, A., & Iqbal, O. A. (2023). Alprostadil. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK542217/

Linet, Otto I., and Francis G. Ogrinc. “Efficacy and Safety of Intracavernosal Alprostadil in Men with Erectile Dysfunction.” New England Journal of Medicine, vol. 334, no. 14, 4 Apr. 1996, pp. 873–877, https://doi.org/10.1056/nejm199604043341401.

Seyam, R., Mohamed, K., Akhras, A. et al. A prospective randomized study to optimize the dosage of trimix ingredients and compare its efficacy and safety with prostaglandin E1. Int J Impot Res 17, 346–353 (2005). https://doi.org/10.1038/sj.ijir.3901313