Trimix Injections

Trimix medication contains papaverine, phentolamine, and alprostadil. Before using Trimix, you should consult a healthcare provider to confirm you are not allergic to any of these three components.

Papaverine

Papaverine aids men with ED by enhancing blood flow to the penis, allowing patients to achieve and sustain a firm erection for sexual intercourse. When used alone, papaverine is often prescribed for patients with circulatory disorders to improve blood flow.^[5] As a vasodilator, papaverine relaxes and widens blood vessels, facilitating blood circulation to the heart and body. Furthermore, papaverine relaxes smooth muscle inside large blood vessels, particularly the coronary, systemic peripheral, and pulmonary arteries, with minimal effects on the central nervous system.

Phentolamine

Phentolamine is a noselective adrenergic alpha-receptor blocker that increases blood flow to the skin, mucous membranes, abdominal organs, and reduces blood pressure.^[6] Phentolamine works by obstructing alpha receptors in the body, which are present in the smooth muscle lining blood vessel walls. When these alpha receptors are blocked by phentolamine, the muscles relax and blood vessels dilate, producing a boost in circulation.

Alprostadil

Alprostadil is a synthetic form of prostaglandin E1 (PGE1), a vasodilator the body produces naturally.^[7] As a vasodilator, alprostadil relaxes the muscles and widens the blood vessels in the penis, enabling continuous blood flow to achieve and sustain an erection. Research suggests that alprostadil can be used as an ED treatment with manageable side effects.^[8][9]

Once Trimix is injected directly into the shaft of the penis, the compounded mixture of papaverine, phentolamine, and alprostadil triggers a vasodilation effect that causes the relaxation and expansion of blood vessels, allowing for the increased blood flow needed to achieve and sustain an erection.

Trimix can work quickly, triggering an erection within minutes. Some men respond after foreplay begins. Your provider will adjust your dose so the erection lasts long enough for sex, often through climax, without lasting too long. Trimix is not designed to enlarge the size of the penis. However, it can help men with ED obtain and maintain a firm erection for longer periods.

With appropriate administration, Trimix can assist men in regaining their lost sexual function due to ED, enhancing their overall quality of life. Remember, erections lasting over 4 hours are a medical emergency requiring immediate care.

Trimix may be prescribed for men with symptoms of erectile dysfunction, especially if PDE5 inhibitors have proven ineffective or resulted in side effects.

Some common risk factors and conditions associated with ED include:

• Low testosterone
• Cardiovascular disease
• Diabetes
• Prostate issues
• Depression
• Anxiety
• Neurological/spinal cord injury

Trimix may also be appropriate for patients with medical conditions that preclude taking oral ED drugs, such as men who’ve had prostate surgery or certain cardiovascular diseases, or for patients who cannot take PDE5 inhibitors due to concurrent nitrate therapy or certain beta-blockers.

If you’re a patient, contact your physician to find out if Trimix is right for you. Here are questions to ask your doctor about ED to help start the conversation.

Tri-mix injections offer several advantages over erectile dysfunction (ED) solutions, such as:

• Swift onset with prolonged duration
• Straightforward and minimally invasive administration

Bimix combines papaverine and phentolamine without alprostadil. Pain after injection is the most common side effect of alprostadil, reported by 20% to 40% of patients,^[8] so Bimix may be an option for men who find Trimix uncomfortable. Without alprostadil, Bimix may be less effective for some patients. In one review, about 68% of men responded to papaverine and phentolamine with a rigid erection.^[10]

Trimix adds alprostadil to papaverine and phentolamine. Combining the three lets each ingredient be used at a lower dose, and studies of the triple combination have reported full erection responses in about 90% of patients.^[11] For most men, Trimix is the starting point for injection therapy.

Quadmix adds a fourth ingredient, atropine, to the Trimix formula.^[12] It may be considered for men who don’t get a satisfactory response from Trimix, or whose response has decreased over time.

The right formula depends on the cause and severity of your ED, how you respond to each ingredient and any side effects you experience. Olympia compounds Bimix, Trimix and Quadmix in a range of strengths. Contact us to learn more, or have your provider send a prescription.

While Trimix injections tend to cause fewer side effects than systemic ED medications, some adverse reactions may still occur, and they can vary significantly between individuals.^[13]

• Mild to moderate penile pain
• Bleeding or bruising at the injection site
• A warm or burning sensation in the penis that typically fades within an hour

• Priapism, an erection lasting longer than 4 hours. This is a medical emergency that requires prompt care to avoid permanent damage. It is also a potential risk with oral ED drugs like Viagra, Levitra and Cialis.
• Penile scarring (fibrosis), most often associated with improper injection technique or overuse
• Hematoma or infection, usually linked to injection technique or poor hygiene
• Low blood pressure or dizziness
• Allergic reactions

Contact your provider if you notice swelling, numbness, tenderness, redness or lumps on or around the penis. This list is not comprehensive, and patients may experience other uncommon or individual-specific side effects. It’s vital to work with a healthcare provider who can monitor your response, address concerns and adjust your dose if needed.

Trimix is not recommended for men with:

• Known allergies to Trimix ingredients
• Sickle cell anemia
• Bleeding disorders
• Conditions increasing priapism risk
• Leukemia
• Penile abnormalities
• Penile implants
• Explicit medical advice to refrain from sexual activity

It’s important to inform your provider of all medications, over-the-counter drugs, herbal products, and other substances you take. Trimix components can interact with some medications, potentially making them less effective or causing adverse reactions.

Trimix is available online from Olympia Pharmaceuticals. Follow the instructions below for patients and providers to get Trimix. Alternatively, you can view our guide on how to get Trimix.

Instructions for Patients:

Getting Trimix through Olympia is simple — even if you don’t currently have a physician or prefer not to involve your own doctor. Here’s how to get started:

Option 1: Already have a physician?

• 1. Download and print the Trimix Prescription Form
• 2. Bring it to your doctor (usually your primary care provider or urologist) and let them know you’d like your medication from Olympia Pharmaceuticals
• 3. Your physician faxes the completed form to 407-604-6434
• 4. We’ll ship the medication directly to your home

Option 2: Need help or prefer telemedicine?

Not sure where to start? Contact us, and an Olympia representative will walk you through the process. We’ll explain your options and connect you with a licensed telemedicine provider if needed.

Telehealth appointments are $59, paid directly to the provider.

Instructions for Physicians:

We make it easy for you to support patients interested in Trimix through Olympia.

• 1. Download and print the Trimix Prescription Form
• 2. Complete and sign the form
• 3. Fax it to 407-604-6434

Olympia will take care of the rest — we’ll ship the medication directly to your patient’s home (prescription orders only) or your office, depending on your preference.

Trimix Medical Study for Physician Reference

To better understand Trimix and its results, refer to this summarized International Journal of Impotence Research study.^[9]

Objective

The study evaluated Trimix (Tx) injections for patients unable to use prostaglandin E1 (PgE1) due to poor response, discomfort, or cost. Researchers systematically increased Tx drug doses to analyze penile hemodynamic response.

Key Findings

180 ED patients were prospectively randomized into 9 equal groups receiving varying Tx doses. Post-injection, cavernous artery ultrasound and axial rigidometry were performed. Patients rated erection quality, satisfaction, time to detumescence, and side effects.

Key results included:

• Many patients unresponsive to oral ED drugs or with PDE5 inhibitor contraindications were candidates for self-injection therapy.
• Some patients preferred injection rigidity, with 36.2% choosing injections over sildenafil.
• The Tx combination led to full erection response in over 90% of patients.
• In those unresponsive to 40μg PGE1, Tx evoked a response in 31%.
• TTx offered a cost advantage.

Read the full study here.