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Several blue injection vials to indicate Trimix penile injections.

Trimix is a penile injection that includes alprostadil, papaverine, and phentolamine.

These powerful ingredients work together to dilate blood vessels and improve blood flow to the penis, leading to strong and lasting erections in as little as five minutes.

Trimix is the most powerful treatment for erectile dysfunction (ED), or the inability to achieve and maintain an erection. Many men with severe ED have found success with Trimix when other ED medications fail.

Because Trimix is a penile injections, it’s more complex than other forms of ED treatment. We’ll go over how to inject Trimix correctly and how to spot potential side effects.

You can also download these steps in our Trimix Patient Handout, or watch our video on how to mix Trimix and how to inject Trimix.

How to Mix Trimix: Step by Step

Trimix comes in lyophilized powder form, and it has to be mixed before being injected.

Your order should come with the freeze-dried medication along with a vial of bacteriostatic water. Bacteriostatic water includes benzyl alcohol to sterilize it.

Step 1: Prep your materials.

Gather your materials and place them on a flat, clean surface. You will need:

  • Trimix vial
  • Bacteriostatic water vial
  • Alcohol wipes
  • Mixing syringe and needle
  • Sharps container for safe disposal

Wash your hands with soap and water and dry them. Then remove the lids from the bacteriostatic water vial and the Trimix vial and sanitize the top of each vial.

Step 2: Draw the bacteriostatic water.

Prepare your mixing syringe. It should come with your order, and it’s typically a 10 mL syringe. Your mixing syringe is not an injection syringe and should not be used to inject.

Tighten the needle to the hub of the mixing syringe and then pull back the plunger to bring in air into the syringe. Defy Medical offers Trimix in 5 mL vials, which requires 5 mL of water to mix.

Insert the needle into the rubber stopper of the bacteriostatic water vial. Push the plunger in to add the 5mL of air to the vial. The water should flow naturally into the syringe; you can tilt the vial upside down to help with the process.

Remove the needle from the bacteriostatic water vial once you have drawn the correct amount of liquid.

Step 3: Inject the bacteriostatic water into the Trimix vial.

Insert the needle into the vial of Trimix and push the plunger in to release the 5milliliters of bacteriostatic water.

Then draw out the same volume of air that you’ve injected (5 milliliters) from the Trimix vial before removing the needle. This will equalize the pressure within the vial.

Gently swirl the Trimix vial until the powder and bacteriostatic water are mixed.

Once your Trimix vial is mixed, be sure to store it in the refrigerator. Your Trimix may lose its effectiveness and turn cloudy if left out of the fridge for more than three days.

How to Inject Trimix

Now that your Trimix has been reconstituted, you can move onto your injection.

Step 1: Prep your materials.

Gather the materials you will need and place them on a clean surface. You’ll require:
• Your Trimix vial
• Alcohol wipes
• A fresh needle and syringe
• A sharps container for safe disposal

Wash your hands with soap and water and make sure they are thoroughly dry. Then clean the top of the Trimix vial using the alcohol swab. Allow the alcohol to air dry before moving forward.

Step 2: Draw the medication.

You’re now ready to draw your medication. Hold the syringe horizontally, pull the needle cover straight off, and place it on the table. Then remove the cap of the syringe.

Be careful not to touch the needle to anything except the vial and your skin, to avoid contamination.

Pull the plunger to bring air into the syringe. Draw up an amount of air equal to your dosage.

Insert the needle into the vial stopper and slowly inject the air into the vial. Then tilt the needle and the vial upside down to draw the correct dosage amount of the medication.

Tap the syringe gently and push the plunger to remove any air bubbles.

Step 3: Inject Your Trimix.

This step makes many first-time users nervous, but take a few deep breaths and stay calm and relaxed.

Sit in an upright or slightly reclined position when performing the injection. The injection site is the corpora cavernosa, or the spongy tissue on the side of the penis close to the base.

At this point, use an alcohol wipe to clean the skin at your injection site. Allow this to dry before injecting.

Once you’re ready, grip the head of the penis and stretch it lengthwise so you can clearly see the injection site. You’ll want to avoid any visible blood vessels when you inject. Hold the penis firmly against your thigh to avoid movement while you inject.

Steadily push the needle into the injection site until the needle is almost entirely in the penis. Press the plunger to slowly inject your Trimix medication. Go slowly and be gentle.

Once the medication is fully injected, pull the syringe straight out to avoid bending the needle and harming the tissue.

Then apply pressure to the injection site with an alcohol swab. Do this for about 5minutes.

Once the injection is complete, place your needle and syringe into a sharps container for safe disposable. Do NOT reuse needles!

Your erection should occur within 5-20 minutes of injection (results vary based on the individual patient).

Important Information About How to Inject Trimix

Trimix is a very powerful medication, and it’s important to follow the dosage you were prescribed. It is not advised to exceed your dosage, and doing so could put you at greater risk of priapism (a medical emergency in which the erection lasts longer than four hours).

You should also wait at least 24 hours between doses, and avoid using Trimix more than three times per week.

Trimix Storage Instructions

Your Trimix should be stored in the refrigerator to maintain its effectiveness.

Your pharmacy packaging will include an expiration date, and the medication should be disposed of once it’s past that date.

If you don’t think you’ll use your Trimix within the expiration window, the medication can also be placed in the freezer.

When freezing your Trimix, it’s important to remove it from the freezer and let it thaw completely at room temperature.

Do not apply a heat source, place it in the microwave, or warm it with hot water. You can inject the medication once there is no visible ice within the vial and it feels like it’s at room temperature.

More Trimix Resources

  1. What Is Trimix
  2. Trimix Frequently Asked Questions
  3. Downloadable Trimix Instructions
  4. How to Prevent and Treat Priapism
  5. How to Mix Trimix (Video)
  6. How to Inject Trimix (Video)
  7. How to Identify and Treat Priapism (Video)

Trimix Injections with Defy Medical

Trimix is a strong therapy for erectile dysfunction and can help men when other medications fail to work. Defy Medical offers convenient and affordable access to Trimix via telemedicine.

We help first-time users understand how to inject Trimix and answer any question in an in-depth consultation. Then we offer simple online ordering of the medication if prescribed.

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