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Trimix Injections
Powerful Treatment that Improves Erection Strength and Stamina
Penile Injections: A Brief History

The discovery of intracavernous injection therapy (into the base of the penis) for erectile dysfunction is thought to have started with a 1982 publication discussing the use of papaverine injected into the penis to improve erections in men experiencing dysfunction (ED). 

Since that time, there have been further investigations into various active ingredients administered by intracavernous injection that resulted in the discovery of effective new therapies for treating erectile dysfunction.

Despite strong supportive evidence on the effectiveness of these agents, only two commercial products have been developed. Caverject Impulse® and Edex® are FDA-approved for the treatment of erectile dysfunction. Both products contain only prostaglandin as a single ingredient.

In addition to formulary limitations, high cost and inconsistent insurance coverage make commercial options prohibitive for patients. The limited commercial options led physicians to seek compounded formulations using active ingredients known to cause an erection when administered by injection. Patients who experienced sensitivity or side effects with prostaglandin needed another option. 

Trimix: An Effective and Reliable Treatment for ED

Trimix is a compounded medication consisting of three ingredients in a sterile injection dosage form. Ingredients include an alpha-Adrenergic antagonist (phentolamine), prostaglandin (Alprostadil), and vasodilator (papaverine) combined into a single injection.

The combination of these ingredients has been found reliable and effective for treating ED.

Several compounding pharmacies who specialize in sterile compounding and men’s health offer a wide selection of strengths and combinations that were developed based on the collective input of expert sexual health practitioners and urologists over many years.

Although there is no standardized dosing protocol for Trimix, experienced practitioners know how to start low and adjust dosing carefully to avoid priapism until the right dose is identified.

When the right dose is administered, Trimix results in an immediate erection (5 – 20 minutes) with increased hardness and retention (stamina) that patients can rely on with confidence.  Most men who take Trimix report positive effects and strong erections.

Bimix and Quadmix: Alternatives to Trimix

Similar injection therapies are also compounded using some of the same ingredients found in Trimix but with important differences.

Bimix is compounded to contain papaverine and phentolamine, two of the active ingredients found in Trimix. Bimix does not contain a prostaglandin. 

Bimix can be a good option for men who haven’t undergone any injection therapy, who have mild to moderate ED but do not respond to oral medications, or who experience side effects from prostaglandin. 

Quadmix contains the same ingredients as Trimix in addition to a fourth ingredient: Atropine. This ingredient promotes smooth muscle relaxation and reportedly increases the positive effects of the other ingredients. Quadmix is usually prescribed to long-term Trimix patients who no longer respond to normal doses of Trimix. 

All three options can be customized in different ingredient concentrations, giving patients access to personalized treatments that result in positive outcomes with no side effects. 

Trimix and similar injection therapies offer a very potent option to treat ED. They are also effective in most of the men who use it. 

It is important to remember that patients with ED should explore other options including oral PDE5 therapy before using Trimix. Intracavernous injections lose efficacy and increase the development of scar tissue with long term, regular use.

Men who had successful results from oral PDE5 therapy and used Trimix reported a decreased efficacy with PDE5 inhibitors after experiencing Trimix. Although these reports are anecdotal, they highlight the importance of physician-guided care in addition to less restrictive access so that patients do not accidentally cause self-harm. 

Trimix and other intracavernous injection therapies should only be prescribed by an experienced practitioner who provides proper guidance and access to priapism treatment.

How to Get a Prescription

Urologists and clinics who specialize in erectile dysfunction treatments usually have a relationship with a local or national compounding pharmacy who produces Trimix.

The doctor’s website may provide information confirming experience with Trimix. You can also try contacting local clinics that advertise ED treatments. 

If your doctor is willing to write a prescription for Trimix but doesn’t know where to send it, an online search for compounding pharmacies who offer Trimix should produce a list of sources.

Be sure to contact the pharmacy to find out what formulations they offer since each pharmacy will most likely have unique formulas. Compounding pharmacies typically offer assistance for practitioners, providing dose guidelines based on the formulas they carry.

Provide the pharmacy phone number to your physician in case they would like to speak with a pharmacist.

Defy Medical offers a national Trimix program to help men access this effective treatment. Our convenient telemedicine platform provides access to expert practitioners, laboratory testing, and affordable pharmaceutical options without needing to visit a clinic. Trimix and other ICI therapies can be shipped from the pharmacy directly to the patient anywhere in the US.  Physician guidance and a dedicated support team will be provided to help patients along the way, as well.

 

Do you need access to Trimix?

We strive to offer a convenient way for men across the country to access Trimix.

Read about Defy Medical's National Trimix Access Program.

 

 

How to Prevent and Treat the Main Side Effect of Trimix

When someone experiences an erection that lasts longer than 4 hours, it becomes a medical emergency known as priapism. Priapism is the primary side effect concerning Trimix patients. It can be avoided with proper adherence to a few rules, and by following your doctor’s guidance. 

Trimix is considered a potent erection inducing agent that is safe to use as a monotherapy. Trimix should not be co-administered with oral ED treatments due to risk of priapism.

Never take PDE5 inhibitors within 24 hours or at the same time Trimix is administered due to increased risk of priapism. PDE5 inhibitors include sildenafil, tadalafil, vardenafil, and avanafil.  Tadalafil (Cialis) should not be taken within two days of a Trimix injection. 

Patients undergoing Testosterone Replacement Therapy with or without hCG can take Trimix or ICI therapies. Patients who begin testosterone after using Trimix regularly may need a slightly lower Trimix dose.

It is also important to learn about the different options used to reverse priapism and always keep a ‘rescue kit’ containing one or more of these options when using Trimix.  Phenylephrine HCL in a low-dose injection can be prescribed for later use as needed to reverse priapism.

An example rescue kit may contain: 
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Sudafed (150mg)

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Benadryl tablets (50mg)

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Phenylephrine HCL injection kit with directions (requires a prescription)

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Amyl Nitrate (optional)

Learn how to prevent and reverse priapism. 

If the rescue kit options fail and the erection has persisted for 4 hours or is painful, go to the emergency room immediately.

A New ED Injection Therapy

A new therapy was FDA-approved for female hypoactive sexual desire disorder (HSDD) and is used off-label by a limited number of men who have access.

Bremelanotide (PT-141) is a peptide hormone administered by subcutaneous injection (thigh, abdomen, or hip) as needed 45 minutes or more prior to sex.

While Trimix is effective at producing a strong erection, bremelanotide may also result in an improved erection and has the additional benefit of accelerating desire. Some patients also report heightened pleasure after administering bremelanotide. 

These additional benefits come with a higher potential for side effects. Bremelanotide can be unpredictable in men, sometimes resulting in a delayed response after administration with a very long duration of action.

Some patients also report nausea and headaches which are not reported with Trimix. Trimix has very predictable and consistent results when compared with bremelanotide. Nevertheless, men who do respond well to bremelanotide find it a very useful tool for treating ED with the added benefits of improving desire and pleasure. 

Read more about bremelanotide (PT 141) injection therapy

Click here to learn more about other common ED treatments.